Athletic trainers, commonly mistaken for “trainers” or “personal trainers”, are certified and licensed healthcare providers with an extensive educational background in the evaluation and treatment of musculoskeletal injuries. Athletic trainers (AT’s) have been reported in sport medicine and orthopedic physicians’ offices since the mid -1970’s. However, more recently there has been a greater focus on the benefits of the AT in a physician office. Comprehensive Orthopaedics has been utilizing the athletic trainer model since 2006. Since that time the model has continued to grow to increase physician efficiency, patient care, and clinic flow. A majority of our physicians (9 total) have a lead AT that helps maintain and manage their practice.
ROLES AND RESPONSIBILITIES IN A PHYSICIAN OFFICE:
Our athletic trainer provide comprehensive support to each of our physicians to aid in meeting all clinical needs for their different practices. The AT has many roles in the physician office which include:
Initial patient assessment
Presentation of findings to physician
Scheduling addition tests and procedures
Patient education in pre- and postoperative instructions
Wound care and dressing care
Brace fitting, casting, and splinting
Home exercise instruction
Gait and crutch training
Completing insurance paperwork
Answering patient phone calls and questions
Our Athletic Trainers help our physicians to:
Increase patient and clinic flow
Aid in physician productivity, allowing more patients to be seen per day
Improve communication with referral sources such as physical therapy or other healthcare providers
Act as an extension of the physician to enhance medical services
Narrow staff to a single ancillary provider that encompass many skills to improve patient care and satisfaction
Tendonitis can affect anybody, from office workers to athletes. Here’s how to keep your symptoms under control.
Tendonitis is a common problem, affecting athletes, office workers, and musicians alike. Indeed, it can affect almost any part of the body, though it’s most common in the tendons of the shoulders, elbows, wrists, and knees. Some of the most frequent types include patellar tendinitis (or “jumper’s knee”), lateral epicondylitis in the elbow (or “tennis elbow”), and Achilles tendinitis.
As common as it is, however, tendonitis can be a debilitating condition, creating chronic pain and greatly restricting the patient’s range of motion. Fortunately, some basic knowledge of its common causes and symptoms can help you seek relief from this condition.
CAUSES AND SYMPTOMS OF TENDONITIS
Tendons are strands of elastic fibrous tissue that connect muscles to bones, providing stability to the joints and enabling a free range of motion. Any tendon in the body can become inflamed or irritated, causing pain, tenderness, and swelling in the affected tissue.
The most common cause of tendonitis is prolonged stress or gradual wear caused by repetitive movements, though it can also be caused by sudden trauma. As a result, most people develop tendonitis while performing their jobs, enjoying hobbies that rely on a specific joint, or playing sports A typist, for example, is most likely to have tendonitis in the wrist, while weightlifters may suffer from biceps tendinitis. Aging also increases the likelihood of developing tendonitis, since tendons become less flexible with age.
TREATMENT FOR TENDONITIS
The severity of tendonitis can vary greatly depending on the specific cause of the inflammation and the particular tendon affected. Most cases of tendonitis, however, can be successfully treated without surgery. Some of the most common courses of treatment include:
Resting the affected area
Avoiding activities that cause flare-ups or increased pain
Taking over the counter anti-inflammatories like Advil or Aleve
If your tendonitis does not respond to these conservative treatments, the inflamed tendon may need to be repaired with a minimally invasive surgery. During the procedure, your surgeon will mend any tears in the tendon and remove any permanently damaged tissue.
Since tendonitis is an injury that often results from overuse, the best treatment in many cases is simply to refrain from using the joint in question. Some effective preventative measures include stretching before exercise, wearing protective braces, using proper technique when lifting, and always maintaining correct posture.
Whether you suffer from tennis elbow or jumper’s knee, our team at New York Bone and Joint can help. With decades of combined experience in treating injured tendons, our specialists are able to provide comprehensive assistance at every stage of the process, from identifying the source of the problem to crafting a personalized treatment plan. If you worry that you may have tendonitis, contact us today to schedule a consultation.
Risky opioids are no better at controlling chronic back or arthritis pain than non-opioid drugs, including Tylenol or Motrin, new research finds.
With opioid overdose deaths rising in the United States, the findings suggest addictive medications like oxycodone (OxyContin) or morphine don’t have to be the first choice against crippling arthritis pain or chronic backache.
“We found that opioids had no advantages over non-opioid medications for pain, function or quality of life in patients with low back pain and osteoarthritis pain,” said study lead author Dr. Erin Krebs.
“This is important information for physicians to share with patients who are considering opioids,” added Krebs. She’s an investigator with the Minneapolis VA Center for Chronic Disease Outcomes Research.
Not only does the study suggest switching to opioids probably won’t help, but Krebs said the prescription painkillers will probably cause unpleasant side effects.
“Instead, they should consider trying other non-opioid medications or non-medication treatments,” Krebs suggested.
Long-term back pain hampers 26 million Americans aged 20 to 64, the American Academy of Pain Medicine has found. And roughly 30 million adults have pain from osteoarthritis, the wear-and-tear form of the disease, according to the U.S. Centers for Disease Control and Prevention.
In general, patients with chronic back or arthritis pain should first seek relief through exercise and rehabilitation therapies, said Krebs, who is also an associate professor of medicine at the University of Minnesota.
That’s because opioid medications, while promising significant pain control, come with substantial risks.
“The main harms are accidental death, addiction and physical dependence,” Krebs explained. “Everyone who takes opioids — even those who do not misuse them — is at risk for these serious harms.”
To compare the effectiveness of different means of pain relief, the new investigation enrolled 240 adults, average age 58, from June 2013 through 2015. All were receiving care for moderate to severe chronic back pain, or hip or knee arthritis pain.
None of the study participants had taken opioids on a long-term basis, the researchers noted.
After enrollment, half were randomly assigned to receive a year of opioid treatment. Depending on “careful trial and error,” Krebs said, this variously included morphine, hydrocodone/acetaminophen (Vicodin), oxycodone, and fentanyl patches. Daily dosages were restricted to 100 morphine-equivalent milligrams.
The non-opioid group received other pain relievers, including acetaminophen (Tylenol), and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve).
Over time, some patients in the non-opioid group were also offered prescription drugs, including amitriptyline or gabapentin, or topical analgesics such as lidocaine. In cases where nothing else worked, they were additionally prescribed nerve pain medications, such as duloxetine (Cymbalta) or pregabalin (Lyrica), or the narcotic tramadol (Ultram).
One year out, investigators determined that the two groups differed very little in terms of their ability to walk, work or sleep without pain.
The non-opioid group fared “significantly better” in terms of pain intensity compared with the opioid group, and experienced “fewer bothersome side effects,” Krebs said.
Dr. David Katz is director of the Yale University Prevention Research Center. He said that for treating long-term musculoskeletal pain, “use of opioids is both ineffective and ill-advised.”
“Anyone who has undergone surgery — and I have a number of times — certainly knows the value of opioid analgesia. When pain is acute and truly overwhelming, potent narcotics work, and essentially nothing else does,” he said.
“But the value of opioids fades quickly over time, and the liabilities increase,” Katz explained. “So an informed approach would tend to be very short-term use of opioids, when pain is most intense, with early and explicit plans to transition to alternatives.”
Katz agreed with Krebs that non-medicinal “holistic approaches to pain management, often involving team care, tend to be best” for controlling chronic pain.
“There are many ways to treat pain that don’t involve drugs at all,” Katz added.
The report was published in the March 6 issue of the Journal of the American Medical Association.
“The traumatic injuries are something that you can’t avoid in the nature of sports,” said Michael Hughes, Clinic Coordinator and lead Physical Therapist at Agape Physical Therapy of Gates. “A lot of kids will come from the winter and start their spring season, and they don’t have a good strengthening regimen when starting their specific sport. It can lead to some injuries if they don’t have the proper muscle training.”
Orthopedic surgeons at Strong Memorial Hospital are seeing similar trends. According to a hospital spokesperson, orthopedic sports medicine surgeon Mike Maloney, M.D., confirms that he’s seeing the same rate of increase in his practice. We’re told Maloney specializes in treating elite student athletes and says the following factors are causing the alarming increase in this injury:
• The increasing level of intensity in scholastic sports
• More kids specializing in one sport and doing year-round training in that sport
• Lack of emphasis on proper nutrition
• Lack of focus on preventive care – teaching kids how to get conditioned to be strong, and how to move to help prevent injury.
Jeff Bobzin can’t preach it enough to the youth soccer players he coaches in Gates.
“We encourage kids to drink a lot of water, eat right and exercise,” Bobzin said.
Boys between ages 10-14 make up more than half of the reported injuries in the study. Therapists at Agape say its important for parents and kids to map out a training plan to prevent serious body injuries.