Return to the Pre-Injury ‘You’ With Our Orthopedic Clinical Specialists

Surgery is always a big deal and is generally only recommended when non-operative treatments and therapies are no longer seen as viable ways to return to pre-injury mobility. Yet, if you are about to undergo or have undergone an operation on the hip, shoulder, knee, wrist, hand, neck, foot, ankle, spine or any other part of the musculoskeletal system, the surgery is but a very important step in the process that will restore you to your pre-injury self. The far longer bit that takes you from the moment in which the anesthesia wears off to you finally jogging, mountain biking or playing soccer like the pre-injury you again is the absolutely essential post-operative rehabilitation program through which your Mount Sinai Orthopedic Clinical Specialist (OCS) will guide you. 

After surgery, your ability to regain normal motion, strength and to return to your pre-injury self, is dependent on the restorative orthopedic rehabilitation plan your OCS will devise for you. Orthopedic rehabilitation will bring you through a range of exercises to strengthen the muscles around the affected joint(s). Strong muscles are not only necessary so your body functions as it once did, but they will lower the risk of the once-injured joint re-injuring or dislocating itself by protecting it and absorbing any force that might occur during physical activity. Orthopedic rehabilitation will also improve circulation and flexibility to the affected areas to aid and hasten the healing process, prevent the appearance of blood clots and to gradually increase your range of motion to its pre-injury level.

Your Mount Sinai OCS is your post-operative guide to returning to the pre-injury ‘you’. An OCS is specifically trained to restore your strength and range of motion without compensation and to help prevent re-injury during the recovery process. When you are working with an OCS, you are under the expert care of the most qualified and experienced physical therapists available. All OCSs are recognized by the American Board of Physical Therapy Specialists as clinicians with the highest levels of expertise and specialization in orthopedic physical therapy. What is more, to attain the celebrated distinction of OCS, a therapist must have a minimum of 2,000 hours of direct patient care in the area of orthopedics. 

Among the first people you will see when you wake up from your surgery will be your OCS who will first give you a thorough evaluation and then set you a structured post-operative physical therapy plan to minimize pain and swelling and to restore normal movement, flexibility and function as soon as possible. Your first session with your OCS will likely be in your hospital bed or in a chair. As you heal and progress, the exercises will become more dynamic and might include a medley of ankle pumps, squats, flexions, abductions, rotations, extensions, contractions, bends, raising exercises and stretching. As you move toward a full recovery, your OCS might recommend swimming or pool exercises, cycling or even low impact activities like golf and dancing. Sports like basketball, soccer, football and others that require high impact movements – as well as weight training – should be avoided until your OCS gives you the go-ahead. 

Are you interested in what your recovery from orthopedicsurgery might look like? Do you have any questions about our Orthopedic Clinical Specialists and their transformative rehabilitation programs? Please get in touch with us at (212) 241-6321.

Take Control of Your Pain with the McKenzie Method

When pain becomes so severe that it impedes or obstructs your life – and the quality thereof – it is time to take decisive action. For some of us, our backs hurt so much that it is virtually impossible to get out of bed. Others might experience a burning, stabbing pain in the legs from sciatica, which – aside from being deeply unpleasant – can severely reduce mobility. Still some people are affected by a throbbing, aching pain in elbow and knee joints, which often results in losing practical limb function for stretches of time. Indeed, if we are unable to simply get out of bed, walk from one place to another or achieve simple movements with our arms and legs, we are in a situation in which pain is utterly controlling, dominating and possibly even ruining our lives. Wouldn’t it be nice if there were a way to take back control of our pain – and therefore our lives – with an innovative and credible therapy that has a remarkable track record of success? 

Thankfully this isn’t a pipe dream – it’s called the McKenzie Method of Mechanical Diagnosis and Therapy. It takes its name from its inventor, New Zealand Physiotherapist Robin McKenzie and it has been successfully used as an interactive way to treat, neck, spinal and extremity pain for more than 30 years throughout the world. Our McKenzie Method therapists at the Mount Sinai Department of Rehabilitation Medicine are trained to assess and diagnose our patients musculoskeletal systems to locate and subsequently treat any pain issues in or around joints and/or muscles.

Prospective patients who believe that the McKenzie Method might be a viable option to help them mitigate and hopefully eliminate their pain symptoms will begin with an initial assessment with one of our therapists. No expensive and potentially intimidating tests like an MRI are generally required. All we’ll want to do is conduct a safe and reliable screening of your musculoskeletal system by testing the mechanics of your body and seeing its responses to various positions and movements.

If our McKenzie Method clinicians believe this treatment is for you, you will be classified into one of three syndromes:

·     Posture Syndrome – When normal soft tissue becomes painful due to prolonged postural stress.

·     Dysfunction Syndrome – When pain is caused by mechanical deformation of structurally impaired soft tissue, usually from scarring or adaptively shortened tissue.

·     Derangement Syndrome – The most common classification and refers to pain caused by a disturbance in the normal resting position of joint surfaces. 

Based on your classification, Mount Sinai’s McKenzie Method therapists will tailor a treatment plans specifically for you that will involve a range of safe and effective exercises to do with your therapist at one of our Mount Sinai locations and some others for you to do on your own at home that will quickly set you on your way to a life of which you are in control, with less pain and greater bodily mobility and function. 

If you suffer from sciatica, arthritis or shooting pain in your shoulders, upper arms, hips or buttocks, intermittent pins and needles or numbness in your feet or hands, aching elbows or knees or you have difficulty bending down as a result of a stiff and painful lower back, the McKenzie Method might just be the treatment you have been looking for.

If you any of the pains or symptoms mentioned in this blog are similar to the ones you are experiencing, get in touch with us at (212) 241-6321 to see if the McKenzie Method is right for you.

What Is Craniosacral Therapy? And How Can It Change Your Life?

Acute physical pain like headaches or back aches ruin well deserved days off at the weekend. If allowed to continue, not only will you be suffering from chronic pain but also mental fatigue. Issues like chronic pain can be pervasive and cause serious mental health problems like depression and increase likelihood of illness as they drain your ability to rest. They can increase stress levels and make what would be otherwise easy to manage health conditions much more difficult to deal with. At Mount Sinai’s Department of Rehabilitative Medicine, we have a fantastic method of dealing acute pain.

Craniosacral Therapists work to improve the movement of cerebrospinal fluid and reduce tension through gentle manipulation of the head and spine which can help you not only overcome daily hassles but also thwart chronic and emotional pain. Treatment consists of entering our relaxation sanctuaries with our fantastic on-site craniosacral therapists and beginning your treatment on a couch.

Our therapists will begin by exploring your with gentle hands, identifying and working through pressure points and built up tension in the body. Your body and nerve system will respond to the therapists touch as they pick up on tensions or distortions which may be indicative of ill health. Your therapist will help your body relax allowing the body to find an equilibrium.

What makes craniosacral therapy unique is the empathy our therapists have with your body. Their unique training allows them to identify and patiently relieve your body of tension and chronic pain.

The Primary Respiratory Mechanism (PRM)

This is a mechanism that is proficient in working and has been summarized in five ideas and encompasses the routine.

1. Inherent motility of the central nervous system
2. Fluctuation of the cerebrospinal fluid
3. Mobility of the intracranial and intraspinal dural membranes
4. Mobility of the cranial bones
5. Involuntary motion of the sacrum between the ilia

If you are experiencing chronic pain and heightened levels of stress in your daily life, and especially if you are struggling to cope, please call (212) 241-6321) to see if we can help.

 

A Beginner’s Guide to Yoga

In our last issue we looked at stress and how it can slowly degenerate your bodily systems by shutting them down in preparation for a fight or flight response. If you haven’t read it yet, then click here to learn more. Yoga is a method we use at Mount Sinai’s Department of Rehabilitative Health, to help patients alleviate stress and tackle long term health problems. It also focuses on preparing patients to develop mobility, flexibility, and range of motion. We have set up some basic yoga tips so that even if you don’t pop in to see us – you can participate.

 

Firstly, you need to ensure you are in the right environment. Practicing yoga in your office isn’t going to be beneficial if you are constantly interrupted by impromptu meetings and telephone calls. Our first tip is to practice in a quiet environment where you are unlikely to be disturbed by others.

 

As we are trying to disengage from the world, it is important ensure that there is nothing that could possibly interrupt you. Our specialists frequently report people struggling to maintain a good temperature. If you are too cold or too hot and the environment is a distraction, then it would be wise to adjust it. This will make the session more effective than otherwise.

 

One of the easiest positions for beginners is the corpse position (otherwise known as the dead pose). This will give you a great entry into yoga that you can try this afternoon – or whenever you can gift yourself the time.

 

• Lie flat on your back. Stretch your arms out, spelling out the letter T. We recommend, for comfort reasons, that you place a suitable pillow under your head and/or knees.
• Close your eyes and begin to enter a relaxed state of mind. The essential part here is to form a clear intention to yourself that you intend to relax. Begin breathing deeply and exhale at a rate of 1:2 (e.g. 1 second inhale 2 second exhale).
• Lightly contract muscles and relax them. This can begin with whichever muscle group you desire. A great focus is on muscles that are particularly tight or stressed – only you can really know that. For example, you tighten your shoulders periodically and then release them. Tighten your quadriceps, then release them. Your buttocks… Continue going through all your muscles periodically from your feet to your head.
• You will at this stage begin to defuse bodily tension. After you have completed these fairly simple exercises, you can happily remain lying in a state of relaxation for as long as you desire. We recommend practicing between 10 to 30 minutes for practical reasons – if you can do longer then great.
   
  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.
   

 

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.

 

 

 

 

Avoiding Work Related Musculoskeletal Disorders

The workplace, for the most part, tends to be a safe environment. But there’s one deadly aspect that looms over all of us workers who sit behind computers all day – sitting down all day and the posture you keep while doing so. The duration and way you sit can have a negative impact on the rest of your life and cause life altering muscular skeletal disorders (MSDs). This week, as we continue to wage our war on inactivity and MSDs, we are going to give you top tips to use in and out of work to avoid long term damage.

 

Astronauts found that life under zero gravity led to accelerated bone and muscle loss during studies conducted over 40 years ago. A similar effect occurs when sitting at your desk all day

MSDs are serious, and studies have linked them to a heightened risk of type 2 diabetes, some types of cancers, and early death.

 

The first step we can take is to look at your equipment. That is your computer, it’s placement, and your chair. This can be summarised as follows:

 

• Adjust your chair so that your feet are placed firmly and comfortably on the floor. If this is not possible, then you should bring this up with your employer who should accommodate you with a foot rest of some description.
• You should ensure, while adjusting your chair, that your screen is at eye level. This will stop you from straining you neck one way or another. Secure your keyboard at a comfortable level so that you can easily use it without slouching or overstraining.
• Your chair should be bent at a 90-degree angle and you should be able to slip two fingers between the bottom of your thigh and your chair – and your backrest should push your lower back slightly forward.
• Do not use your handset for long periods and replace it with a headset if you need to make frequent long phone calls.
   
  These seemingly minor alterations could change your life. Speak to your employer if there is anything you need, and they should aid you in avoiding bad habits with a new chair or headset.
   
  On top of this, to reduce your risk of ill health from inactivity one should exercise approximately 150 minutes a week.
   

If you are experiencing MSD related pain and would like to discuss it with one of our physicians, then please contact us on (212) 241-6321) to see if we can further help.

 

Motion Related MSDs

This week, with an intention of holistically covering MSDs – we are going to outline how poor body mechanics can contribute to this ailment.  To recap, MSDs are injuries or pains in the musculoskeletal system, including the joints, ligaments, muscles, nerves, tendons, and structures that support limbs. They are not only costly for people but companies too across the United States. It is estimated that 50 billion dollars a year is spent on direct costs of MSDs, and indirect costs could be up to 5 time more. Whether you are a worker or an employer – MSDs should be of concern to you.

 

The good news is that MSDs are highly avoidable – but they do pose a threat to people who are frequently lifting or moving heavy objects – either in the gym or as part of their daily work routine. The principle method of avoiding MSDs is using correct lifting techniques.

 

Gym Goers

 

Ensure you are aware of proper lifting technique – and get a personal trainer if you need to.

 

It is highly advisable that if you are new to the gym or weightlifting that you get yourself a personal trainer – even if its just for a couple of months. Use the trainer until you feel comfortable weight lifting alone. This will teach you good posture and technique that you can keep with you for the rest of your life. Good technique will mean that you don’t damage or overuse areas that are unintended with a particular motion, for example – curving the spine when deadlifting can damage your spine irreparably and lead to unforeseen MSDs down the line. Not only can bad technique give you MSD but it also increases the likelihood of them developing at a later stage.

 

 

Work Related Lifting

 

Make sure you follow protocol on lifting and/or moving heavy objects in the workplace.

 

There are probably guidelines at your place of work concerning how you should lift. The most famous example is keeping your back straight when lifting heavy objects off of the ground. The best advice we can give you aside from seeing you in person is that you should follow these guidelines. They are set out to prevent overuse of wrong muscle groups, joints, or tendons when lifting – which can lead to MSDs through repetitive strain. If you are a company, you should ensure that your workers all have access to lifting guidelines as high effort task repetition could seriously injure your workers if not managed properly.

 

If you are experiencing MSD related pain and would like to discuss it with one of our physicians then please contact us on (212) 241-6321) to see if we can further help.