Health Tip: Shovel Snow Safely

Health Tip: Shovel Snow Safely

(HealthDay News) — Snow shoveling is a factor in thousands of injuries and as many as 100 deaths in the United States each year.

The National Safety Council suggests how to shovel safely:

  • Do not shovel after eating or while smoking.
  • Take it slow and stretch out before you begin.
  • Shovel only fresh, powdery snow; it’s lighter
  • Push the snow, rather than lifting it.
  • If you do lift snow, use a small shovel or only partially fill the shovel.
  • Lift with your legs, not your back.
  • Do not work to the point of exhaustion.
Shoulder Instability:  More common than you would think

Shoulder Instability: More common than you would think

Professional athletes aren’t the only people who suffer from unstable shoulders. We’ll walk you through the most common causes of — and treatments for — this condition.

Because professional athletes have undergone intense training to mold their bodies into peak physical shape, it’s easy to assume that they’re immune to the common injuries that affect the rest of us. Recent news, however, has shown that no one is completely protected from injury. For example, Tom Brady and Aaron Rodgers — two of the best quarterbacks in the NFL — have both shown that they are suffering from significant shoulder injuries, with Rodgers missing the remainder of the season due to a broken collarbone.

In fact, shoulder damage is one of the most common injuries for NFL players and laymen alike. Since the shoulder is the most mobile joint in the body, it’s especially prone to problems. For most of us, however, shoulder injuries are caused by gradual wear and tear rather than sudden trauma. While these injuries don’t ultimately result in chronic instability, they can hasten the degeneration of the cartilage in the shoulder, which then can leave the shoulder unstable. Fortunately, these problems can be effectively treated with the help of a qualified orthopedic specialist such as Dr. Main and Dr. Gershtenson, and a rigorous rehabilitation program.

What Is Shoulder Instability?

Shoulder instability is a chronic condition that leads to frequent dislocations of the shoulder. It occurs when the end of the humerus (the ball of the shoulder joint) separates from the glenoid (the socket of the shoulder joint). These dislocations can be either partial or full.

Shoulder instability has a variety of causes. In many cases, it’s simply a product of previous shoulder dislocations, since a traumatic dislocation often causes tears in the stabilizing cartilage and ligaments. A shoulder is more likely to be dislocated again if it’s already been dislocated. Unusually loose ligaments in the shoulder can also heighten the risk, especially if they’ve been loosened by repetitive motion and strain, as often occurs in football players, swimmers, and tennis players.

Symptoms and Diagnosis

There are several symptoms of a chronically unstable shoulder. One of the most common is frequent subluxation, or repeated partial dislocations. Often caused by overhead motions, these subluxations create a brief feeling of pain and a slipping sensation in the shoulder. In more severe cases, full dislocation may occur, resulting in intense pain and visible abnormalities like bumps in the shoulder. Shoulder instability can also result in a “dead arm”, or a feeling as though a nerve has been pinched.

While you can perform some tests on your own, self-examinations can further aggravate the shoulder — so it’s best to let a professional diagnose your condition. In addition to consulting your medical history, a doctor may move your shoulder into specific positions to test the stability of the joint. If these movements cause pain or further displace the shoulder, it’s likely unstable, and X-rays and an MRI might be needed to determine the extent of the injury.


Non-traumatic shoulder instability can often be treated nonsurgically, through rest, anti-inflammatory medication, and physical therapy. If the instability is the result of trauma and it creates a Bankart lesion (a tear in the cartilage), then arthroscopic surgery is usually necessary to stabilize the joint and prevent recurrent dislocations, which can otherwise lead to degeneration and premature arthritis.

Physical therapy largely consists of various stretching and strengthening exercises that rebuild the joints, ligaments, and muscles and restore their range of motion, stabilizing the shoulder in the process. These exercises are often targeted to strengthen the rotator cuff and the scapular muscle, and can be aided by resistance bands. In addition, your physical therapist will teach you how to properly use your shoulder, reducing the chance of painful subluxation and dislocation while you heal.

If you’re concerned about your shoulder, our team of best-in-class orthopedic physicians at CompOrtho are here to help. With our extensive experience, we have the knowledge and ability needed to help you at every stage of treatment, from diagnosis through rehabilitation. If you’re searching for a reliable and compassionate provider, contact us today to schedule an initial consultation.

What Is a Cortisone Shot?

What Is a Cortisone Shot?

Cortisone shots can potentially provide long-lasting relief from pain and inflammation in the joints.

Many injections can greatly reduce pain and inflammation caused by musculoskeletal injuries or chronic conditions such as arthritis, significantly shortening recovery timelines and providing lasting relief. One shot we particularly recommend to patients entails an injection of cortisone into a damaged joint. We’ll tell you what you need to know about this tried-and-true treatment for pain and inflammation in the joints.

What Is a Cortisone Shot?

A cortisone shot is an injection composed of a corticosteroid medication and a local anesthetic. Used to relieve pain and inflammation, it’s most commonly injected into a joint, often in the shoulder, hip, or knee. These shots are often one option in a comprehensive treatment plan for chronic inflammatory conditions such as arthritis, tendinitis, or rotator cuff impingements or tears.

How Long Does a Cortisone Shot Last?

A cortisone shot’s effectiveness depends on the severity of the patient’s condition. In most cases, pain and inflammation will marginally increase for about 48 hours following the injection, and will decrease precipitously thereafter. In some cases, a single injection can provide relief for as long as several months.

Generally, cortisone shots should only be given two times per joint per year. Repeated cortisone injections can damage the cartilage in the joint.

What Are the Side Effects of a Cortisone Shot?

Cortisone shots are typically safe in moderation, but since they infrequently lead to serious complications, they should be taken under a doctor’s supervision. Be sure to let your doctor know if you suffer from diabetes or other any other conditions affecting your blood sugar levels, as well as any medications that you are currently taking.

Most cortisone shots have some minor side effects, including a temporary uptick in pain and inflammation in and around the joint, and a thinning and lightening of the skin around the site of the injection. In some cases, however, they can result in a sudden spike in blood sugar if you’re diabetic and have poorly controlled blood sugar levels. .

What If the Cortisone Shot Doesn’t Work?

Cortisone shots provide a source of temporary relief from inflammation and pain. They will not solve the underlying problem, and pain may gradually return as the shot’s effectiveness subsides. As a result, cortisone shots should be administered as part of a more comprehensive treatment plan that may include physical therapy or surgery.

Fortunately, our team of orthopedic specialists at Comprehensive Orthopaedics has several years of experience in treating joint problems. Regardless of your specific condition, we’ll work with you to develop a personalized treatment plan that provides lasting relief from your symptoms.

Everyone should strengthen their ankles!

Everyone should strengthen their ankles!

Injuries of the ankle are common among athletes and amateurs in many different sports and exercises. Working out at the gym, enjoying summer jogs, or playing any type of sport are typical ways to injure your ankle. Unfortunately, spraining, rolling, or fracturing your ankle is easy to do and will often occur again without the proper rehabilitation and strengthening of your ankle joint. Strengthening your ankles is also a great way to do thing outside of sports – such as wear high heeled shoes without wobbling!

There are many exercises and stretches you can do to strengthen your ankles, which can help to prevent future injury or help to recover from a previous ankle injury.

Balance Training

Working on your balance strengthens your ankles, as they are the joints that hold your weight steady on your feet. Try holding your weight on one foot, grabbing your opposite ankle behind your back. Work toward increasing the amount of time you balance on each foot. Eventually, work up to catching and throwing a ball while standing on one foot, or doing one-legged squats.

Band Exercises

You can purchase the resistance bands you would find at your physical therapy gym for very little cost. Wrap them around the top of one foot and curl your toes to stretch your foot and ankle. Make sure to match the number of repetitions on the other foot. These bands can be used to stretch the foot and ankle is a variety of ways and directions – consult your physical therapist for proper form and technique.

Jumps and Skips

Another way to strengthen your ankles is to do exercises that require jumping or skipping. These work the muscles in your foot and your ankle. They get your ankles used to landing and absorbing that impact, as well as aiding your balance.

You can do jumping squats, scissors kicks, or do skips or bounds if you are exercising in a large area.

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Need another reason to keep your weight under control?

Excess weight can cause dislocation of your knee and may even lead to a complication that results in amputation of your leg.

A new study attributes a surge in dislocated knees to the U.S. obesity epidemic.

“Obesity greatly increases the complications and costs of care,” said study lead author Dr. Joey Johnson, an orthopedic trauma fellow at Brown University’s Warren Alpert Medical School.

“As the rate of obesity increases, the rate of knee dislocations increases. The total number of patients who are obese is increasing, so we are seeing more of these problems,” Johnson explained.

Knee dislocations result from multiple torn ligaments. Vehicle crashes or contact sports, such as football, are common causes.

For the study, the researchers analyzed more than 19,000 knee dislocations nationwide between 2000 and 2012. Over that time, people who were obese or severely obese represented a growing share of knee dislocation patients — 19 percent in 2012, up from 8 percent in 2000.

Obesity is also linked to more severe knee dislocations, longer hospital stays and higher treatment costs, according to the study published recently in the Journal of Orthopaedic Trauma.

And the chances that a knee dislocation would also injure the main artery behind the joint and down the leg were twice as high for obese patients than for those whose weight was normal, the findings showed. This severe complication of knee dislocation — known as a vascular injury — can lead to leg amputation if not treated, the study authors said.

Patients with a vascular injury averaged 15 days in the hospital, compared with about one week for other patients. Their average hospitalization costs were just over $131,000 and $60,000, respectively.

The study authors said doctors should be especially watchful for vascular injury in obese patients whose knees are dislocated.

“That subset of obese patients who come in with complaint of knee pain need to be carefully evaluated so as not to miss a potentially catastrophic vascular injury,” said study co-author Dr. Christopher Born, a professor of orthopedics at Brown.

Reducing obesity rates could help reverse the growing number of knee dislocations, the researchers suggested.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on knee problems.

SOURCE: Brown University, news release, Nov. 3, 2017

Don’t Delay Hip Fracture Surgery. Here’s Why

Don’t Delay Hip Fracture Surgery. Here’s Why

Seniors with a fractured hip need surgery as soon as possible or they could suffer life-threatening complications, a new Canadian study concludes.

Having surgery within 24 hours decreases the risk of hip fracture-related death. It also lowers odds of problems such as pneumonia, heart attack and blocked arteries, the researchers found.

“We found that there appears to be a safe window, within the first 24 hours,” said lead researcher Daniel Pincus, a doctoral student with the University of Toronto.

“After 24 hours, risk began to clearly increase,” Pincus said.

U.S. and Canadian guidelines recommend hip fracture surgery within 48 hours of injury, but it’s likely that many people don’t receive care that quickly, he noted.

In the United Kingdom, guidelines call for surgery within 36 hours, but hospitals often fail to get patients promptly into the operating room, Pincus added. Rates range from 15 percent to 95 percent among U.K. hospitals, according to the report.

Oftentimes, there’s no operating room or surgeon available, or other patients are awaiting surgery, Pincus explained.

“There’s a triage system and these patients historically were not prioritized,” he said. “Sometimes there’s medical reason for the delay, but that’s very rare. We’re starting to realize there’s almost no reason why a patient should be delayed.”

Delay also likely occurs because doctors approach these elderly patients with a good deal of caution, said Dr. Harry Sax. He is executive vice chair of surgery for Cedars-Sinai Medical Center in Los Angeles.

“The perception is that if you’re old and you’ve broken your hip, that you’re going to have a lot of other [health problems],” said Sax, co-author of an editorial accompanying the new study. “Therefore, I need to spend several days running tests on you to try to make sure I can get you through the hip fracture surgery. ”

To see how this delay affects the health of patients, Pincus and his colleagues evaluated data on over 42,000 people treated for hip fracture at 72 hospitals in Ontario between April 2009 and March 2014. The patients’ average age was 80.

The investigators compared patients based on whether they had surgery before or after 24 hours.

Overall, about 12 percent of hip fracture patients died within the month following their surgery.

However, patients who got surgery within 24 hours were 21 percent less likely to die during the following month, compared with those who had a delay in surgery, the findings showed.

Those patients also had lower complication rates. They were 82 percent less likely to develop a blood clot in the leg veins (deep vein thrombosis); 61 percent less likely to have a heart attack; and 49 percent less likely to suffer a blood clot in the lung (pulmonary embolism). They were also 5 percent less likely to develop pneumonia during the month following surgery.

“The problem is the longer you sit in bed, the more likely you are to get pneumonia and blood clots. The unfixed bone is continuing to flick off little bits of fat, which can go to the lungs,” Sax said. “The delay doesn’t necessarily make things better. It could make things worse.”

People with an elderly relative facing hip fracture surgery should ask the health care team to get their loved one into surgery as soon as possible, with as little additional testing as possible, Pincus and Sax said.

“A prompt evaluation to make sure there’s nothing quickly correctable should be done, but otherwise the patient should move to the operating room as quickly as possible,” Sax said.

Families should ask doctors about every test, scan or screen that delays the surgery, Sax said.

“The question needs to be, what is the information that you’re going to gain and how would that change your management of this patient,” Sax said. “There are very few things you find with all this expensive testing that you can do anything about.”

The patient would be best off in a hospital that has a specific program to manage elderly people with hip fractures, Sax added. These programs have a team of surgeons, geriatricians, anesthesiologists and other professionals well-versed in the procedure.

“If you can find a hospital that does that, the chances are your outcomes are going to be better,” Sax said.

The study was published Nov. 28 in the Journal of the American Medical Association.

More information

For more on hip fractures, visit the American Academy of Orthopaedic Surgeons.

SOURCES: Daniel Pincus, doctoral student, University of Toronto, Ontario, Canada; Harry Sax, M.D., executive vice chair, surgery, Cedars-Sinai Medical Center, Los Angeles; Nov. 28, 2017, Journal of the American Medical Association