Curing Golfers Elbow

Last week we focused on what Tennis elbow was and how we can get it “on the mend”. This week, we are going to take a look at the inverse – golfers elbow and explain how you can treat it. Both these elbow problems occur frequently to baseball players due to overuse, strain, and the repetitive motions found in pitching and batting.

What is Golfer Elbow?

Golfer’s Elbow, known as Epicondylitis, causes the inner side of the elbow joint to feel tender and painful – you are more prone to this condition when involved in throwing motions (or playing golf), yet those with manual occupations can also be affected.

The affected tendon is the common flexor tendon which attaches the flexor muscles of the forearm to the inner side of the elbow. These muscles have a myriad of responsibilities from throwing to allowing your fingers to curl up. Golfers elbow occurs due to microscopic tears that cause the tendon to degenerate. The condition becomes chronic or long-lasting if the tendon that attaches to the bone calcifies – and in rare cases, larger tears can develop causing more issues. The vast majority of cases, however, are not serious and can be self-managed.

Symptoms include pain and tenderness on the inner side of the elbow. Pain is usually felt just over the bone and is triggered by gripping, squeezing, or pulling. The symptoms are extremely telling which means no extra investigation is usually required.

How Can You Manage the Symptoms?

If the elbow is sore after physical activity, apply ice for 15 minutes every few hours. We highly recommend you follow our tips on PRICE that can be found by clicking this link.

Most cases of Golfer’s Elbow can be managed just by modifying activities. That may mean, depending on the severity of pain, you must stop playing and or training until your physician or physio gives you the go-ahead to get back on the field. A small number of more severe cases may require a steroid injection. In very rare cases surgery may be necessary.

Anatomically guided Corticosteroid injections can also be a solution. This involves steroids being injected around the tendon and its insertion into the bone. Although this is minimally invasive, there are risks and possible side-effects you should consider with your physician. 

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

What is Tennis Elbow? What Can You Do About It?

Noting that baseball season is well underway, let’s take a look at one of the more common issues affecting baseball players – tennis elbow. Most baseball players don’t play tennis, or at least that we know of, however, they seem to get this strange pain in their elbow? Why is that? This week, we will identify what tennis elbow is and how we can cure it.

What is Tennis Elbow?

Tennis elbow is a condition that causes pain around the outside of the elbow. It is clinically known as lateral epicondylitis and is often the result of strenuous overuse of the muscles and tendons of the forearm, near the elbow joint.

The elbow joint is surrounded by muscles that give dexterity to the elbow, wrist, and fingers. The tendons in your elbow join muscle and bone together and are what allow you to control the muscles of your forearm. Damage to this area causes the symptoms of tennis elbow.

Common symptoms of tennis elbow are pain around the outside of the upper forearm – below the bend of the elbow. This pain is usually exaggerated when lifting or bending the arm, gripping small objects such as pens, or when twisting your forearm – when turning a door handle or opening a jar. It is often difficult to fully extend your arm when suffering from tennis elbow.

Pain can range from mild discomfort to severe pain even when the elbow is still and worsens when you use the damaged arm. The episode usually lasts between six months and two years depending on treatment. The majority of people will make a recovery within a year.

What Can You Do About It?

Tennis elbow will tend to get better by itself and you can recover without treatment. In most cases, you won't need to do anything but rest. There are some things you can to help speed along recovery.

It’s important that you rest your injured arm and stop doing the activity that’s causing the problem. That can mean you will have to stop playing baseball, take a break from painting and decorating, and stop doing whatever activity that is damaging the area. Compressing the area with ice several times a day can help reduce internal swelling – alongside taking paracetamol or other pain reliefs.

You should follow our PRICE procedure which you can read about here.

Physiotherapy may be recommended by your physician for more serious cases. Massaging and manipulating the affected area can reduce stiffness and improve the range of motion in your arm.

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

The PRICE We Pay for Playing Sports

Injuries can occur during sports even if we take all the preventative steps to shield ourselves from them. There are some steps we can take to minimize damage to an injury by following 5 steps after the impact and throughout rehabilitation – this procedure is an acronym: PRICE or RICE. Please note, this process works for relatively small tears and sprains - if you have sustained a serious injury you will need to go to the accident and emergency.

Protection

The P in Price stands for protection. After suffering a strain or localized damage during a sporting bout make sure you protect the area afterwards. Ensure no more harm comes to it and begin your recovery process immediately.

Protection usually becomes more relevant when the pain has ceased to be noticeable, but the area is still sensitive to damage. It is easy to forget about and therefore easily damaged again. Make sure to protect sensitive areas.

You can purchase area specific padding to protect damaged areas – for example – if you cycle to work and are recovering from serious knee damage – you should make sure you have a knee pad.

Rest

The R in Price stands for Rest. After sustaining damage to a ligament or joint you will need to stop aggravating the area - it is important to avoid activities that cause pain. Ideally, lie down in a comfortable position to minimize bleeding, swelling and further damage. Rest may also include the use of crutches, a protective brace, or tape/sling.

You should look to rest the damaged area as soon as possible after damage has occurred.

Ice

The I in Price stands for Ice. You should ice the injured area for 10-20 minutes every 2 hours. Use an ice pack or a makeshift “crushed-ice-in-tea-towel” to help reduce inflammation of the damaged area. Do not ice an area for extremely long lengths of time as inappropriate icing can sometimes make an injury worse rather than better.

The sooner after the impact you begin icing the better (and faster) your recovery will be.

Compression

The C in PRICE stands for Compression. After the incident you can use compression bandages to minimize swelling. If on applying compression you experience a change of colour, pins and needles, or any colour change in your extremities then the bandage is too tight, and you or the physio will need to loosen it. Ensure you remove the band before you go to sleep.

Elevation

The C in PRICE stands for Elevation. Immediately after the area has been iced and compressed you should raise the injured area above your heart – reducing blood flow to the damaged area – which minimizes bleeding and swelling. Ideally, you should elevate the limb whilst undergoing the rest of the procedure – but this can be tricky and prove to be more trouble than it’s worth.

You can continue to elevate the area in your day-to-day life to aid the limb in recovering.

PRICE is a reactionary therapy which seeks to minimize damage after impact or damage on small tears and sprains. As aforementioned, it is not a method to deal with serious damage such as a broken arm.

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

How to Recover from a Serious Injury

Everyone on a Sunday afternoon from the cheering dads on the sideline to the star quarterback is aware of the constantly looming threat of muscle tears and sprains. They happen, and there is no fail-safe way of ensuring you never receive one. Even the iced bathed and well-oil superstars with the best coaching and physiotherapy in the world cannot avoid the wrath of torn muscles – and it’s nothing to be ashamed of – even Achilles was eventually thwarted by a tear in his ankle. Maybe he should have subscribed to our blog.

Last week, we outlined PRICE – Protect, Rest, Ice, Compression, Elevate - which is the immediate response you or a physio should have a sprain or tear. The sooner after the injury you attend to the area the better effect it will have. Your physio will be able to advise you on the level of the tear (graded from 1-3) and help draft a bespoke plan as to how you should implement the routine.

In most cases, the subsequent procedure should see you through most of the recovery. For more serious damage, consulting a physiotherapist on a regular basis for sports massages may be necessary. During your first visit, your physiotherapist will likely ask you about the activity that led to this damage and conduct a thorough physical examination to determine how severe the tear is. This is especially important if there was no on-site physio after the initial damage. Your comprehensive plan could include:

·        Ice or heat to reduce swelling

·        Electrotherapeutic modalities which use sound waves to heat up and repair deeper tissue

·        Soft tissue mobilization to relieve muscle spasms or tight muscles

Your physio will include self-stretching routines to mobilize muscles and reduce long-term damage. Stretching the damaged area will allow it to regain flexibility as weakness tends to occur when you do not move or contract a limb for a long period of time. It can also affect your ability to move a joint at full range. Stretching can help loosen tight muscles and increase the range of motion after sustaining a sprain or tear. These can either be done with your physiotherapist or at the gym/home. Stretch programmes work best alongside sports massages – however, if you do not have access to these – then foam rollers (which you can find by typing “buy foam roller” into Google) are fantastic at self-massaging.

The final step to recovery is strength training. This doesn’t mean an Arnold Schwarzenegger Boot Camp but a progressive exercise routine that will gradually build up the damaged area. After a muscle is damaged but before it is fully recovered the area will still be significantly weaker than it was before. The job now is to build up to your “normal” amount – and exercises should be given according to your level of fitness and specific muscles affected. Strengthening your muscles will help you get back to your previous activities and can help prevent future injuries.

If you have suffered from a tear or strain, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. Contact our switchboard at (212) 241-6321

Introducing Dr Joseph E. Herrera

This month we have taken an in-depth look at how sports injuries can affect your life and highlighted preventative steps to avoid sports injuries. This week we would like to introduce you to a sports-specialist at Mount Sinai’s Department of Rehabilitative Medicine – Dr Joseph E Herrera. During sports seasons it is important that players look after themselves off the field as well as on. If you are looking at rehab to get back into shape or fighting off a hamstring tear - wherever you are on your journey to recovery (or the MBA), Dr Joseph Herrera can give you some coaching tips.

Dr Joseph E. Herrera is a Board-Certified Physician who joined Mount Sinai after the completion of an Interventional Spine and Sports Medicine Fellowship at the renown Beth Israel Medical Center, New York. He then completed his residency and served as Chief Resident in Physical Medicine and Rehabilitation through a combined program of Columbia Presbyterian Medical Center and Weill Cornel Medical Center. He finished his academic career before joining us by completing a fellowship at Beth Israel Medical Center and has been named an American Pain Scholar by the American Pain Society.

His literary works extend to authoring and editing textbooks such as the “Manual to Musculoskeletal Medicine” and “Essential Sports Medicine and he is the chief editor of the medical journal “Current Reviews in Musculoskeletal Medicine.”

He is currently researching Wii Shoulder Injuries – which are injuries obtained during using the Nintendo Wii Sports devices. His past accomplishment was in adding to the cutting edge of Lumbar Discography Study – and he anticipates beginning work in adding to the literature on Plasma Rich Protein for the Elbow.

Dr Herrera is also the New York State Athletic Commission and Chief Team Physician for USA Boxing Metro which has allowed him to regularly treat and evaluate professional athletes. His in-depth understanding of his field has awarded him the Rocky Marciano Physician of the Year Award for excellence in Sports Medicine.

Dr Herrera comes highly recommended. He was selected as one of the Best Doctors in America and has won an abundant of awards and comes highly recommended by his patients. He maintains an excellent rating on our website – averaging at 4.7/5 rating. His top-rated categories are in the following:

·        He explains in a way you understand

·        He listens carefully

·        They will recommend him to a friend

If you are looking for a sports physician that can help you through rehab or someone to create a bespoke plan of action.

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

Tips from Coach Sinai – Drills to Prevent Musculoskeletal Disorder

When athletes compete on the world stage we know that their results are dependent on the work, discipline, and commitment they have dedicated “off the field”. We never see them practice, but we know they do. Minimizing sports injuries is just like this. It takes commitment when not in your sports gear to ensure your body is functioning in the best way possible when you are. Musculoskeletal disorder develops as a result of our habitual actions but has a severe impact during sporting activities. It is one of the leading causes of sporting injuries – and it is usually the result of seemingly unrelated facets of our lives, like our jobs (assuming our reader isn’t an Usain Bolt of the world). This week, continuing from last week’s preventative approach to physical health, we are going to outline how you can look after your body in the workplace to reduce the risk of a work-related musculoskeletal disorder.

Musculoskeletal Disorder

Musculoskeletal Disorders (MSDs) are injuries or pain in the body’s joints, muscles, ligaments, nerves, tendons and structures that support the spinal cord (from the upper neck down to the back). MSDs are distinguishable by their deep and dull pain, and numbness or stiffness in joints. Common conditions related to MSD include muscle strain in the neck, pinched nerve, carpal tunnel syndrome, and sprains. It can weaken our spine and supportive muscle groups which are then vulnerable when we engage in sport.

The Warm Up

Some injuries are the result of accidents and poor form during physical activities. Most injuries, however, are the result of or are worsened by, poor habits. That means that lifestyle is often the cause of serious sporting damage.

Experts at Mount Sinai’s Rehabilitation Center have identified that MSD is not necessarily the result of a sudden event but that it gradually develops over a period of time and is often aggravated in our work environment.

Some known factors of work-related MSD include:

·       Performing repetitive actions

·       Lack of physical movement

·       Poor body mechanics when lifting, bending or reaching

·       Poor posture at desks (such as computers and workstations)

Your Off-Pitch Coaching

The Mount Sinai team have compiled these top prevention tips to help avoid long-term problems during your work hours. By following these tips, you encourage a healthier lifestyle and minimise the risk of long-term damage during sports.

·       Take breaks during your day. This is important for people who work on their feet and those behind a monitor all day – ensure you rest your body from repetitive strain or ensure your body has time to move around.

·       Incorporate stretching and movement into whatever you do. Your body is like an engine – and stretching it is like keeping it well-oiled.

·       Practice good posture. Avoid slouching and bending in awkward positions. Always lift heavy objects with a straight and stiff back and avoid straining the neck by resting your phone between your ear and your shoulder.

·       Reduce repetitive or prolonged activities regularly. If this is impossible, then look for time to allow those muscles to rest.

·       Adjust your work area so to reduce awkward bending and stretching. If you are bleeding a radiator make sure your tools are near or don’t strain yourself trying to drag a pen with your foot.

It seems unintuitive that seemingly unrelated activities can have such a major effect on our part-time sporting careers, but they do. Reclaim your health by following these tips and ensure you do not create the musculoskeletal conditions that subsequently lead to serious damage.

If you have suffered a sports-related injury or would like to discuss a bespoke plan for dealing with MSD, please contact us at Mount Sinai Department of Rehabilitative Medicine. Contact our switchboard at: (212) 241-6321

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