Ashley Musumeci

Waking Up With RA: 6 Tips to Relieve Morning Stiffness

by

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune condition in which the body’s immune system mistakenly attacks the lining of the joints, resulting in inflammation that can lead to pain and joint deformity.

If you live with RA, you know that one of the most common and inconvenient symptoms of the disease is morning stiffness, which can hinder everyday activity.

Below are some expert tips to help warm up those cold, stiff and painful joints, so can you face whatever comes your way:

1. Set Two Alarms: One for Medication, One to Start Your Day

Before bedtime, make sure to take out your arthritis medication and set two alarms: one to take your medication and one for when you have to start your day.

When Alarm #1 goes off, take your medication. When Alarm #2 goes off, start your day. The hour between allows your joints to warm up. (For example, if you have to leave at 10, wake up at 8 for your medication and then lie back down until 9 to get moving.)

2. Utilize Heating Essentials

Keep some heating essentials nearby to put on when you wake up, such as:

  • A heating pad
  • Mittens
  • Socks
  • Warming salves and creams (e.g., Aspercreme®, Icy Hot®)

3. Exercise

After your joints have warmed up and the medication has kicked in, perform some range-of-motion exercises to loosen tight muscles, ligaments and tendons.

While remaining under the covers, flex and release the joints in your hands, wrists elbows and shoulders on one side at a time. Then, turn your head slowly from side to side to loosen your neck. Finally, flex and release your ankles, toes, knees and hips. When you officially feel less stiff and pained, get out of bed.

In fact—though it may sound counter-intuitive given how painful joint stiffness can be—walking at least 15 minutes and doing random range-of-motion exercises throughout the day are beneficial ways to keep joints in shape by strengthening the supportive tissues.  

4. Take a Shower

A hot shower following exercise is a great way to loosen up. The heat from the shower gets the blood flowing to the surface of your skin, which helps to flush out your joints. If bathing, soak for 10 to 20 minutes while rubbing your joints gently with a washcloth. 

5. Ease Into Activity 

Don’t panic about what needs to be done. Pace yourself when it comes to your morning activities. Doing so will make the act of performing those activities more tolerable until your joints are officially up and running.

6. Check in With Your Rheumatologist Regularly

Your rheumatologist can help you effectively manage your condition and symptoms by monitoring your medication and lifestyle. Be sure to schedule regular visits for optimal care to keep morning stiffness to a minimum and keep the extra warm-up time in the morning for sleep.

Meet Our Specialist

At Northeast Orthopedics and Sports Medicine (NEOSM), our rheumatologist specializes in all aspects of rheumatic disorders, including comprehensive diagnosis, treatment and continued care. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible for this and other musculoskeletal disorders.

Be Seen, Be Safe and 7 Other Tips for Safe Cycling

by

An activity that has been around since the early 1800s, bicycling is a fantastically fun outdoor activity bursting with health benefits, including:

  • Better digestion
  • Burning fat
  • Improving cardiovascular health
  • Keeping your heart healthy
  • Lowering fatigue

In addition to just some of the wonderful health benefits bicycling has to offer, it also serves as a great way to spend quality time with friends and family, and to enjoy any and all nice weather. That being said, there are things you need to consider before hitting the happy, healthy open road.  Below are some tips to keep safe and avoid injury while enjoying the feel of two wheels…

Be Seen, Be Safe

The better you’re seen, the less likely you’ll be struck by a vehicle. Use reflective wear and lights when riding during dawn, dusk or at night.

Wear a Helmet

Wearing a helmet significantly reduces the risk of severe head injury in the event of an accident.

Stay Alert

Always be aware of your surroundings and keep a lookout for obstacles that may be in your path. Keep your head forward (try not to look down) to improve your reaction time to anything that may be in your way.

Be the Car

Drivers are most accustomed to the patterns of other drivers. Ride as if you were driving a car (e.g., check for traffic, be aware of the drivers around you, etc.). Do not weave in and out of traffic. Obey all traffic laws and lights. And go with the flow – always bike in the same direction as the car traffic. Never ride against it.

Keep Your Bike in Tip-Top Shape

Before any ride, ensure that your bike is comfortable and in good working condition. Check your brakes and your wheels. Make sure your bike and seat are appropriately adjusted for your height (to avoid distracting discomfort).

Stay Comfy

For longer (or bumpier) rides, make sure to wear padded bicycle shorts and padded riding gloves to reduce the risk of painful nerve compression.

Use Hand Signals

Use hand signals to indicate to drivers and other cyclists what direction you’re headed. Be sure to make eye contact with drivers; do not assume they have seen you and will stop.

Keep an Eye Out

Look out for rough, uneven patches of road or slick surfaces to avoid losing control of the bike. If you see a questionable surface, slow down or walk the bike across.

By sticking to these tips, you can be sure that your next bike ride will be a fun and safe experience.

Come to the Specialists for Bike Injury Care

At NEOSM, our team of orthopedic physicians specializes in all aspects of sports medicine, including comprehensive diagnosis, treatment and preventive care of sports-related injuries. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible.

NEOSM Gives Back: First Successful Drive for Local Schoolchildren

by

Northeast Orthopedics and Sports Medicine (NEOSM) banded together to provide $1000 worth of school supplies to East Ramapo children heading back to school this fall. 75 backpacks filled to the brim with supplies including scissors, pens and pencils were given to children of struggling families. A ceremony was held at NEOSM’s Nanuet location to present the donation to the superintendent.

“It’s an opportunity to give back to the community,” stated Carol Garabed, Director, NEOSM Human Resources. “We’re very excited about how this went.”

Preparing for Preseason Training: A Guide to Getting Back on the Field Safely

by

It won’t be long before crisp weather, falling leaves and cheers from the stadium are upon us. Autumn is fast approaching, which means that preseason training for the season’s traditional sports—such as football and soccer—is just around the corner.

The question is: After spending the summer relaxing, how do you properly prepare for preseason to avoid being injured before everything officially kicks off?

The answer: adequate preparation.

That said, here are some tips to help you gear up for the brisk but brutal preseason training awaiting you:

Go for a physical

Having a physical before preseason starts ensures that you’re healthy and ready to play. If something hurts, have it checked out by a physician. Failure to do so could result in serious injury later on during the season.

Get your body moving

Master the art of fundamental moving patterns, such as squatting, jumping and kicking. This creates a solid foundation for your body to build upon. Agility, flexibility and strength do not develop overnight. The sooner you start, the sooner you’ll see results. For example, try alternating intervals of hard sprints with light jogging. This will teach your body proper balance and endurance for running longer distances (which will come in handy when you have to motor down the field).

If you’re not sure where to begin, talk to your physician or coach to learn suitable training techniques.

Take care of your body

Eat well, sleep well and keep consistently hydrated before, during and after preseason training. Pack on the fruits, veggies and lean meats. Make sure you get eight to 10 hours of solid shut-eye. Keep water on you—and in you—at all times to avoid dehydration.

Remember: A well-balanced body is a well-performing body.

Assess, assess, assess

Get assessed by a trained professional—such as a strength/conditioning coach or physical therapist—to ensure your body is balanced with functional movement. If imbalance or dysfunction occurs, a professional can give you the proper techniques you need to correct the problem before it leads to injury.

On a similar note, make sure that all sports equipment fits well (including footwear); ill-fitted equipment can result in accidental injury during the season.

By following these tips, you’re sure to kick start a safe and fantastic season, on and off the field.

 

Come to the Sports Specialists 

At Northeast Orthopedics and Sports Medicine (NEOSM), our team of orthopedic physicians specializes in all aspects of sports medicine, including comprehensive diagnosis, treatment and preventive care of sports-related injuries. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible.

Swimming and Cupping: Is Michael Phelps Onto Something?

by

Michael Phelps entered the pool deck at the Rio Olympics, stripped down for competition, and characteristically slapped his arms and shoulders immediately before his race. But the eyes of the world were on something even more conspicuous than the time clock and his medal count. Those millions of viewers noticed bruises the size of baseballs decorating his strong shoulders. The marks might have led one to think his bouquet of medals smacked him.

But the bruises Phelps sported come from cupping, or suction cup therapy, a training modality that Phelps has used in his routine for the past couple of years. Cupping is an ancient therapy that has been around for thousands of years, originally practiced by Chinese, Egyptian and Middle Eastern cultures. Cupping’s origins were to pull toxins out of snakebites and infections. In the case of athletes in contemporary times, however, it is used to promote blood flow, relieving pain and swelling. In turn, this leads to an easing of muscle soreness. Outside of sports, cupping is also used to alleviate acne, shingles, breathing problems, arthritis, congestion, asthma and the common cold, among other conditions.

In an article on swimmingscience.net, the author contends that although the benefits of suction cup therapy for swimmers are not yet scientifically proven, athletes and therapists report the following advantages:

  • Improved blood flow
  • Improved flow of lymphatic system
  • Improved muscle flexibility
  • Pain relief
  • Reduced inflammation
  • Relief from tight muscles
  • Stress relief

How does cupping work?

Trainers (or therapists) heat or pump air into glass (or sometimes silicone) cups in order to create suction on the skin and pull it away from the underlying muscles. The cups remain on the skin for five to 10 minutes. Initially, the process results in a tight feeling and may be uncomfortable when the cups are pulled off the skin. Others find the procedure pleasurable, like a deep massage. The resulting cupping marks (e.g., Phelps’ bruises) heal in a few days to a week.

In addition to Michael Phelps and a number of other swimmers who displayed evidence of cupping in Rio, the U.S. men’s gymnastics team also uses the system. The American gymnast Alexander Naddour spoke about the procedure in his Rio interviews, mentioning that he regularly employs cupping, even using a do-it-yourself method.

Is cupping effective?

Several small studies have generated mixed results. One review compiled in 2012 of 135 cupping studies determined that the technique might have some benefits, particularly in the case of alleviating muscle tension. However, the review pointed out that most of those studies had basic flaws.

A recent New York Times Wellness blog quotes Leonid Kalichman, an Israeli academic who co-authored a review of cupping. He mentioned it is possible that those who undergo cupping experience a placebo effect. However, he endorses the possible physiological effect, as well. He speculates that it may be the case that cupping triggers a process that produces cytokines, small proteins that play a role in the immune response.

In any event, experts say the procedure is relatively safe. The only potential side effects include:

  • Burns
  • Bruises
  • Mild discomfort
  • Skin infection

Michael Phelps may have grabbed the Rio headlines, but the first buzz among contemporary world-class swimmers who employ cupping dates back to when Australian Olympic gold medalist Grant Hackett sported cupping welts on his back at the 2004 Games. American multi-time Olympic medalists Natalie Coughlin and Nathan Adrian have also sported cupping bruises. Cupping is growing in popularity in swimming circles, such as its recent adoption by prominent college swim programs.

So, is cupping worth a try? If Michael Phelps does it, it’s guaranteed there will be followers. After all, who can argue with history? He has a record 28 Olympic medals, including 23 golds…and counting!

 

At Northeast Orthopedics and Sports Medicine (NEOSM), our sports medicine specialists provide outstanding care and medical support for sports-related injuries. We can help athletes of all ages and activity levels develop a customized treatment plan. For more information or to schedule an appointment, contact us today.

The Lowdown On Total Knee Replacement Surgery: What Patients Need to Know

by

Total knee replacement (TKR) surgery is a procedure in which the entire knee joint is replaced with an artificial prosthesis. Known to be the most common joint replacement surgery, a TKR is designed to improve the function of the knee.

TKRs alleviate arthritic pain typically resulting from:

  • Osteoarthritis: The breakdown of the cartilage that covers the end of the bone in a joint
  • Post-traumatic arthritis: A form of osteoarthritis that develops following injury to the joint, such as a ligament tear or a fracture
  • Rheumatoid arthritis: A chronic inflammatory disorder in which the immune system attacks the joints in the body

When Is Total Knee Replacement Necessary?

A TKR is the last option for arthritic patients after all other conservative treatment modalities have failed. These could include:

  • Exercise to improve movement of the knee
  • Injections to manage pain
  • Weight loss to reduce stress on the knee
  • Medications to manage inflammation and pain

What Should Be Expected Prior to Total Knee Replacement Surgery?

Prior to a TKR, there are many steps that need to be taken by both surgeon and patient to ensure the greatest possible success during and after surgery. These steps include:

  • Getting all secondary or underlying conditions (through means of medication or lifestyle change) under control
  • Understanding why the arthritis has formed, especially with types of inflammatory arthritis such as rheumatoid
  • Participating in prehabilitation, if applicable. (Prehabilitation is a form of strength training prior to surgery that helps prevent injury after surgery)
  • Maintaining proper dental hygiene. Patients with poor dentition have a higher risk of infection in their mouths, which can potentially spread to other parts of the body
  • Taking a pre-operative course, depending on the hospital. The course–which includes handouts for reference—helps patients fully understand what to expect. It is typically done concurrently with pre-operative testing. It will include tips, such as:
  • No eating or drinking the night before
  • Stop smoking and alcohol consumption
  • Wash with special soap the night before surgery to help avoid infection

What Should Be Expected Following a Total Knee Replacement Surgery?

Though it will be fully explained in the pre-operative course, there are certain things patients can expect during their hospital stay (which is typically one to three nights).

Initial 24 Hours

  • For the first 24 hours, patients will take an antibiotic to reduce the risk of infection
  • Within hours after surgery, patients should expect to physically move around
  • Within 24 hours after placement, a urinary catheter will be removed (if inserted)

Course of Hospital Stay

  • Patients will receive education about incisions and dressings. In doing so, patients and caretakers may learn how to properly clear and maintain the surgical site while it heals
  • The hospital staff (including the surgeon) will do everything in their power to effectively manage pain

Once patients are discharged, they can anticipate certain expectations during their long-term recovery.

First Four to Six Weeks

  • No driving following the surgery
  • Depending upon individual stability, moving away from an assisted device (e.g., crutches, walker)

First Three Months

  • Supervised therapy following surgery
  • Avoid high-impact activities, such as running, jumping or contact sports. Though the knee is artificial, it does not mean that it can sustain long-term heavy use

Important note: Patients must be actively engaged in their recovery. Without that commitment, the rate of healing can decrease drastically due to improper care.

We Are the Joint Specialists

At Northeast Orthopedics and Sports Medicine (NEOSM), our team of orthopedic physicians specializes in all aspects of joint care, including comprehensive diagnosis and treatment of knee conditions. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible.  

For more information or to schedule an appointment with one of our specialists, contact us today.

Northeast Orthopedics and Sports Medicine Now One of the Largest Orthopedic Practices in New York

by

A series of individual orthopedic practices have integrated to form a massive musculoskeletal practice now known as Northeast Orthopedics and Sports Medicine (NEOSM). As a result, NEOSM is one of the largest and most comprehensive orthopedic practices in New York State.

NEOSM is comprised of five smaller orthopedic practices that came together to provide more comprehensive care to the region:

  • Advanced Orthopedics and Sports Medicine
  • Clarkstown Orthopedics
  • Orangetown Orthopedic Associates
  • Premier Orthopaedics of Westchester and Rockland
  • Rockland Orthopedics and Sports Medicine

Serving Rockland, Westchester and Orange County, as well as Bergen County, New Jersey and the surrounding areas, NEOSM has become a major player within the region.

“We are very excited to be uniting these five elite practices under one banner,” states Dr. Cheryl Rubin, an orthopedic surgeon at NEOSM who has been practicing in the region for over 20 years. “By joining forces and working together as a coordinated team, we can provide complete and superior orthopedic care, pain management and rehabilitative services to the patients in our communities.”

With the tagline One team. One goal. Orthopedic excellence., that’s certainly true. NEOSM provides a variety of specialties and utilizes a team approach for the best possible diagnosis, treatment and continued care of all orthopedic disorders. Among the providers are fellowship trained physicians in various specialties, including:

As part of the integration of the practices into one unified entity, NEOSM has just revealed its official branding, complete with the launch of a new comprehensive website:
www.NEOSMTeam.com

ABOUT NEOSM
Northeast Orthopedics and Sports Medicine (NEOSM) is a premier orthopedic practice proudly serving the New York and New Jersey area with 10 convenient locations. Notably one of the largest musculoskeletal practices in the region, the NEOSM team provides complete, comprehensive care to the community. With a multidisciplinary approach, the elite physicians and staff effectively treat a variety of orthopedic conditions and illnesses as part of a treatment plan tailored to meet individual needs.

What Happened to My Ankle? How to Tell the Difference Between a Break and a Sprain

by

With the warm weather enticing you to join the outdoors and frolic through summer, injuries are bound to happen, even to your unsuspecting ankles. From seasonal sports to harmless gardening, an ankle injury can emerge from any number of situations, including:

  • A motor vehicle accident
  • Tripping over something or falling awkwardly
  • Twisting, rolling or rotating the ankle in an uncomfortable way

When an unsuspecting ankle injury occurs, knowing what kind of ankle injury will play a pivotal role in getting you back on your feet. To determine whether your ankle is broken/fractured or sprained depends upon whether you damaged the bone or the tissue. Let’s decipher how to tell the two apart…

Sprain Versus Fracture

Ankle Sprain: When a sprain occurs, one or more of the ligaments in the ankle become severely overstretched or even torn. (A ligament is a fibrous tissue that helps hold the ankle together.) 

Ankle Fracture: A fracture is a break in a bone. With regards to the ankle, the bones that make up the top ankle joint are typically the most prone to fracture. These include the shinbone (tibia), the anklebone (talus) and the bone of the lower leg (fibula). 

With definitions in tow, determining which ankle injury you’ve suffered can be tricky at best. Here are a couple of questions to consider after injury has occurred:

  • Does the pain seem to radiate from the soft tissues surrounding the ankle but not over the bone? It’s probably a sprain.
  • Is the pain over the anklebone? That may be an indication of a break.
  • Are you unable to put pressure on it or walk? It is possible that the ankle is broken.

If the injury is still unclear or if you are hesitant to rush to the doctor, it may not hurt to carefully observe and lightly treat the injury utilizing the R.I.C.E. method of treatment and assessment:

  • Rest the ankle
  • Ice the ankle to reduce swelling and pain
  • Compress the ankle with an air cast or bandage wrap to stabilize and immobilize the ankle
  • Elevate the ankle until it’s level with the heart to help decrease pain and swelling

If, after two to four days of the R.I.C.E. method, you still have a hard time moving or putting pressure on the ankle, a visit to an orthopedist is in order. This is also true if dark blisters or bruises have developed. Once the orthopedist diagnoses the injury, treatment can begin.

Treatment for a Sprained Ankle

Treatment for a sprained ankle depends on the severity of the injury, which can be graded as mild (Grade I), moderate (Grade II) or severe (Grade III):

  • Mild sprains are typically healed utilizing the R.I.C.E. method combined with range of motion, strengthening and stretching exercises.
  • Moderate sprains are also treated with the R.I.C.E. method, but for a longer period of time. A physician may use a soft cast or a splint to immobilize the ankle and prescribe range of motion, strengthening and stretching exercises. Physical therapy may also be suggested to restore full motion and use of the ankle.
  • Severe sprains are a full tear or rupture of a ligament. When this occurs, the ankle must be fully immobilized and requires a longer period of physical therapy. In some cases, surgery may be required to repair the tear.

Treatment for a Broken Ankle

Fractures may be treated surgically or non-surgically depending on the injury. If the ankle is stable, only one bone is broken and the bones aren’t out of place, the ankle may simply be immobilized with a splint or cast.

However, if the ankle is unstable, surgery is required to reinforce it. During the procedure, a metal plate and screws are used to hold the bones in place. Then, the ankle is positioned in a splint. Once the swelling goes down, a cast is utilized for several weeks as the ankle heals.

It is important to remember that, regardless of whether you suspect a sprain or a break, if often requires an orthopedist to accurately diagnose your condition.

 

Comprehensive Ankle Care 

At NEOSM, our physicians have years of experience in effectively treating all orthopedic conditions and injuries, including those of the foot and ankle. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get moving again.

For more information on ankle injury or to schedule an appointment with one of our specialists, contact NEOSM today.