Thursday, 17 of January of 2019

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Sprains & Strains

Whether you’re a teen playing high school sports, an adult who is an avid runner or a senior who plays weekly doubles tennis, chances are that at some point, you’ll experience the discomfort of an occasional sprain and strain – the most common injury sustained in sports today, reports the American Academy of Orthopedic Surgeons.

Many people think of sprains and strains as the same injury. They’re similar, but distinct. Here’s the difference.

A sprain occurs when you overstretch or tear a ligament. For example, step awkwardly off the curb and land on the side of your feet and chances are you’ll sprain your ankle. Jump down from break wall at the beach onto a sidewalk and you can twist and sprain your knee. Or try to break your fall by stretching out your arm and chances are you’ll sprain your wrist or shoulder.

When you sprain something, it means that you’ve injured one or more ligaments, the fibrous band of connective tissue that connects the bones and stabilizes the joint. Overstretching or tearing a ligament puts pressure on the joint and can force it out of alignment.

A strain is an injury to a muscle or tendon. Just like ligaments connect the bones, the tendons connect the muscles to the bones. Overstretching or the opposite, contracting a muscle or tendon, can cause injury. Chronic overuse and repetitive movement, perhaps caused by intensive training, can set up a repetitive injury cycle.

Who’s at risk for sprains and strains?

Just about everyone, but especially athletes. RICE or rest, ice, compression and elevation are typically the first line of defense prescribed by the physician. Anti-inflammatory over-the-counter medication can also help reduce swelling and decrease discomfort.

But a severe sprain or strain may require medical treatment. If the pain and swelling continue after initial treatment with RICE, call your doctor. You may need X-rays, more intensive treatment or even physical therapy to help strengthen and rebuild the injured tissues.

Prevention Tips

It’s not always possible to prevent a sprain or strain if you’ve an avid athlete. But NIAMS (The National Institute of Arthritis and Musculoskeletal and Skin Disease) offers these prevention tips: 1. Wear appropriate shoes for the sport and make sure they fit well. 2. Warm up and stretch before intensive exercise. 3. Run on flat surfaces. 4. Stop exercising when you’re tired or in pain.

Want to know more about orthopedic-related injuries? Go to

Back Safety For The Holidays: Travel, Tree Trimming and More

Tis the holiday season and time to reflect on the many blessings in our lives and to enjoy the company of friends and family. But it’s also the time of year when we’re busier than ever and often feeling stressed, which can show up as tense shoulders, neck and back pain. Add to that all the lifting, pulling, pushing and twisting we do to clean and decorate the house, set up the tree and put up the outdoor lights. It’s easy to hurt yourself or aggravate old injuries.

For many people, the holidays also mean traveling by airplane to visit to family and friends. And improperly lifting or carrying heavy suitcases and carry-on bags can literally be a real pain in the neck. Even if you’re not traveling, heavy shopping bags full of presents can put a strain on your back, shoulders and neck, too.

Here are some holiday safety tips from the American Orthopedic Association:

Choose the right luggage. Two smaller bags are easier on your back than one heavy one – and make sure you are using a lightweight suitcase with a handle, one you can pull behind you, not carry.

Lift properly. Bend your knees and lift using your leg muscles, being careful not to twist your spine. Never stretch and reach for anything heavy – that’s a sure way to hurt your back. Carry heavy suitcases or shopping bags close to your body for better balance and carry the bags in both hands, rather than on just one side. The same applies to backpacks. Carry a backpack over both shoulders rather than slinging it onto one shoulder only.

Be careful of overhead compartments. Lifting your luggage into an airplane’s overhead compartment can be a challenge, especially if you don’t have a lot of upper body strength. Don’t lift your bag straight up into the compartment. Instead, lift luggage onto the top of the seat. Then place both hands on either side of the suitcase and lift up. If your luggage has wheels, put the side with wheels in first; then push the bag to the back of the compartment.

Ask for help and avoid rushing. If your suitcase is heavy or awkward, ask a flight attendant for assistance. It’s not worth attempting it yourself and making your holiday miserable because of neck or back strain.

Dr. John Kagan and his staff wish all of their patients and their families a safe and happy holiday. For more information about orthopedic-related medical conditions, go to

NSAIDs for Joint Pain

NSAIDs or non-steroidal inflammatory drugs are the number one choice for everything from headaches, colds, muscle aches and stiffness to minor orthopedic injuries like a sprained ankle or pulled muscle.

According to the American Academy of Orthopedic Surgeons, NSAIDs are also the most commonly prescribed medication for joint pain related to osteoarthritis in the hip, knee, elbow and shoulder.

Chances are that at some point in your life, you’ve benefited from taking an NSAID, which includes the familiar list found in most people’s medicine cabinets: aspirin, ibuprofen, Motrin, Advil and Aleve, all of which are available over the counter without a doctor’s prescription. Relafen, Celebrex and Naproxen are also NSAIDs, but require a doctor’s prescription.

How NSAIDs Work For Joint Pain

NSAIDs relieve pain and discomfort, lower fevers and reduce inflammation, which is why they are so effective for joint pain caused by osteoarthritis, a degenerative inflammatory disease that breaks down the cartilage cushioning the bones.

More specifically, NSAIDs block an enzyme called clocooxygenase or COX from being released by the body. There are two forms of COX: COX-1 helps maintain kidney function and protects the lining of the stomach from stomach acid, while COX-2 is produced when joints are injured or inflamed.

A Few Precautions

As with all medications, NSAIDs have potential side effects. For NSAID’s that means possible gastrointestinal stomach upsets, including ulcers and GI bleeding. To reduce this risk, it is generally recommended that you take NSAID medications with food and to not exceed the recommended dosage.

NSAIDs can also prevent blood clotting, which makes them helpful for people at risk for heart attack and heart disease. But the drugs’ anti-blood clotting properties can also make them a problem for people with heart disease who already take blood-thinning drugs. Because of these possible medical concerns, your doctor may prescribe an NSAID like Celebrex, which only blocks the action of COX-2 – it does not affect the lining of the stomach or interfere with blood clotting.

If you are unsure about whether it is safe to NSAID medications – or which ones, ask your doctor. While ultimately, patients with severe joint pain may need surgery to gain adequate pain control and restore mobility, most of the time non-surgical treatment that includes NSAID medication can be very effective, at least in the initial stages of osteoarthritis.

For more information about joint pain, go to

Causes of Hip Pain

The first step in treating hip pain is to determine the cause. Your age, level of activity, gender and medical history are important clues in helping the doctor diagnose the source of persistent aches and pains. For example, someone in their 20s or 30s is more prone to certain types of medical conditions than someone in their 70s or 80s.

The four most common causes of hip pain include:

Osteoarthritis. Former president George H.W. Bush, singer Billy Joel and Olympic skater Rudy Galindo are among the millions of people who have received a hip replacement due to osteoarthritis, a painful condition that causes inflammation and breakdown of the cartilage in the hip joint.

Hip Fractures. Ninety percent of all hip fractures in the U.S. are the result of falls, says the American Academy of Orthopedic Surgery. In addition, women are two to three times more likely to have a hip fracture than men. That’s because women are more likely to develop osteoporosis, a degenerative condition that weakens the bones and makes them more brittle. It takes a lot to break a hip bone – except when it’s been damaged by osteoporosis.

Bursitis. Repetitive stress on the hip joint from sports such as running and bicycling, work that requires standing for long periods of time, and even gardening or stair climbing can irritate and inflame the bursa. The bursa is a small fluid-filled sac that cushions the muscles and the bones in the hip. If you have bursitis, the pain may be worse after you’ve been sitting for long periods of time or it may wake you up at night if you happen to lie on the affected hip.

Muscle Strains and Tendonitis. Overdoing it in sports, training errors, excessive stretching, or sudden increases in the level of activity can stress the hip tendons beyond capacity or tear the muscle fibers, causing pain and swelling and loss of strength. The AAOS offers these easy suggestions to prevent muscle strains or tendonitis: warm up before stretching, stretch slowly, wear the right shoe for the sport and participate in a conditioning program that builds muscle fitness and flexibility.

Treatment for hip pain may range from rest, ice and over-the-counter medication to surgery. For a list of painful hip conditions that require surgical intervention by an orthopedic surgeon, go to

Steps To Prepare Your Home Following Hip Replacement Surgery

A few weeks before you’re admitted to the hospital for hip replacement, you’ll want to begin making preparations for what to expect post-surgery during the recovery period. While some people may opt to spend a few weeks in a short-term inpatient rehab center, others prefer to go directly home.

If you do go home, remember that your spouse, a family member, friend or home health aide will need to assist you with daily activities for the first week or two since your mobility will be limited. You’ll need help with bathing, using the toilet, cooking, grocery shopping, and driving to doctor appointments.

To make your return home safer and more comfortable, here are some suggestions from the American Academy of Orthopedic Surgeons. Consider it your pre-surgery to do list.

1. Sleep on the first floor. You won’t want to climb stairs, so if your bedroom is not on the first floor, designate any area for sleeping. Consider renting a hospital bed rather than sleeping on a couch. You’ll also want the bathroom on the first floor. If necessary, get a portable commode chair.

2. Avoid anything that you could strain your new hip joint. Many of today’s beds are oversize and high off the ground. Be sure that you can sit on the edge of the bed and have your feet easily touch the floor.

3. You won’t want to stand for too long, so place a firm-backed chair in the kitchen, bedroom, bathroom or other room you use frequently. That way you can sit to rest and to do daily tasks.

4. You’ll most likely be using a walker at first. Attach a bag or basket to the walker and place frequently used items in it such as a notepad, pen, tissue, cell phone and the remote control. It will make your life much easier.

5. Make meals in advance and freeze them so you won’t have to worry about cooking. If family or friends ask how they can help, have them prepare a meal for you. Get all items, especially toiletries that you may need now. You want to avoid have to shop for last minute items after you get home.

6. To avoid slipping and falling in the bathtub or shower, consider getting a special rubber-tipped shower chair. At the very least, place non-slip suction mats on the floor of the bathtub or shower floor. Installing grab bars in the bathroom is also a good idea.

7. Temporarily remove all loose throw rugs and make sure that the lighting is good throughout the house. You don’t want to risk tripping and falling.

8. Small pets can get underfoot easily. Consider asking a family member to take them for a short time, have them boarded at the kennel or if appropriate, have them stay outside in the yard during the first couple days or week.

Hip replacement is a very common orthopedic procedure. As the number of baby boomers age, the number of people undergoing the surgery is expected to increase considerably. For information about how the surgery is performed, go to

Hip Dislocation

What does remodeling the house, falling off a ladder, a car accident or hurting yourself in a very physical sport like football, snow skiing, wrestling or basketball have in common? You have a greater risk of dislocating your hip joint.

It takes a lot of force to dislocate the hip, which is structured as a ball and socket joint to give you maximum range of motion and flexibility for walking, turning, jumping and sitting. The bottom of the thighbone has a ball-like shape, which fits into a cup-shaped socket in the pelvic bone. Dislocation occurs when a severe blow to the hip forces the thighbone out of the socket. A car accident is the most common cause of hip dislocation.

The American Academy of Orthopedic Surgeons calls a hip dislocation an orthopedic emergency that requires immediate assessment and treatment. The injury is very painful and temporarily immobilizes the joint. The joint may swell and look visibly deformed or out of place.

X-rays will allow the doctor to determine the extent of damage to the hip joint and to see whether there are other related injuries to the ligaments, bone or cartilage. Depending on the diagnosis, treatment can include reduction and immobilization, or for more severe injuries, surgery. Rehabilitation is required for best recovery.

What is a reduction? During this procedure the physician gently manipulates the thighbone back into place in the socket. It’s usually done under anesthetic in the operating room. After the reduction, then joint may be immobilized for a while until it is safe to begin rehabilitation. It can take several months for a dislocated hip joint to heal completely.

For more information about hip injuries, go to

Symptoms of Osteoarthritis of the Hip

Pain, tenderness and stiffness in your hip – what’s going on? Unlike a major trauma from a car accident or fall, the discomfort from osteoarthritis of the hip can be subtle at first. You may notice a twinge of pain or an achy feeling in your hip after tennis, a long walk or a day of yard work.

Over time, the symptoms can become more pronounced. Rather than just hurting after exercise or chores, your hip may give you trouble when you get out of bed in the morning and after you’ve been standing or sitting for long periods of time. Eventually, the discomfort may even wake you up at night, prompting you to change positions to get more comfortable. As osteoarthritis progresses, some people experience a dull ache nearly all the time, causing them to walk with a limp and making it hard to climb stairs or get up from a chair.

According to the American Academy of Orthopedic Surgeons, the most common symptoms of osteoarthritis include:

  • Pain in the hip that may radiate to the lower back or down the leg
  • Tenderness and swelling in the hip area
  • Stiffness and loss of flexibility in the hip joint, making it hard to move and remain active
  • Crackling, creaking or a grating sensation in the joint
  • Bone spurs may form around the edges of the joint

If you have been living with symptoms of osteoarthritis for a while, it’s time to see the doctor. About 10 million Americans have osteoarthritis, making it a very common complaint. You don’t have to live with the pain or allow it to put a limit on your enjoyment of life.

For more information about osteoarthritis of the hip, go to

Staying Flexible As We Age

As the American Academy of Orthopedic Surgeons (AAOS) notes, while there may be not be a fountain of youth, staying active through regular exercise that promotes stretching and flexibility can offer many anti-aging benefits. Aerobic activity that raises the heart rate is important for fitness and conditioning, but stretching is just as vital for good health.

Gentle exercise stretches the muscles, reduces tightness and tension, and increases blood flow. It promotes flexibility in the joints, which improves our range of motion and can lessen many common aches and pains. The repetitive motion of exercise also promotes the body’s natural process of lubricating joint surfaces, says the AAOS.

Here are additional reasons why stretching and staying flexible is important no matter what your age.

Regular exercise and stretching helps maintain balance, which reduces the risk of falling.

Exercise stimulates muscle growth, counteracting the tendency to lose muscle mass with age. Muscles that are toned and strong reduce stress on the joints.

Stretching improves the flexibility and elasticity of tendons and ligaments, lowering the risk of sports-related injuries.

Exercise increases bone mass, density and overall strength, which may prevent osteoporosis and decrease the potential for fractures later in life.

When stretching, the Mayo Clinic suggests following proper technique for the best results. Perform a low intensity exercise like brisk walking for five to ten minutes to warm up muscles before stretching, making sure that when you are stretching, you don’t bounce or push it until you feel pain, which can cause small muscle tears. Stretch the calves, thighs, hips, lower back, neck and shoulders – the major muscle groups. And remember to stretch both sides of the body equally.

Not all exercise is equal. The AAOS cautions again being a “weekend warrior.” Fast-paced, competitive activity on the weekends only can do more harm than good and can put you on the path for developing injuries ranging from stress fractures to torn or inflamed tendons and ligaments. It’s much better to take a short time every day for gentle stretching and moderate exercise.

Orthopedic surgeons are doctors who specialize in treating musculoskeletal injuries that affect the bones, muscles, ligaments and tendons, joints and cartilage. Dr. John Kagan has more than 20 years experience treating patients of all ages with orthopedic-related conditions. Learn more about his expertise at

Nonsurgical Treatment for Joint Pain

Surgery is not always the immediate solution to stiffness, pain and limited range of motion due to joint pain in your knee or hip. Before suggesting the most appropriate treatment plan for your condition, the doctor will take into consideration many factors, including the extent of damage to the joint and whether it was caused by a degenerative condition like osteoarthritis or injury due to an accident, sports or other factors. In many cases, the first step is a series of nonsurgical therapies. These may include one or more of the following.


Exercise can help manage joint pain and increase flexibility by strengthening the muscles that support the joint. Aerobic exercise that increases your heart rate, such as tennis, brisk walking, dancing, climbing stairs and swimming can improve circulation and help keep your weight at a good level, which decreases the stress on the joints of the knee and hips. Some patients may benefit from physical therapy sessions.


RICE, which stands for rest, ice, compression and elevation is always helpful for temporary management of joint pain. Heat therapy increases blood circulation and aids in stretching. Cold therapy with cold packs, ointments and sprays can reduce pain.


Over-the-counter analgesics, anti-inflammatory medications, non-steroidal anti-inflammatory drugs (NSAID) and pain relievers give temporary relief and can reduce swelling and tenderness. Prescription NSAID medications, such as Celebrex, may also be helpful. In addition, oral supplements like glucosamine and chondroitin sulfate can reduce swelling and discomfort.
Cortisone Injections

Cortisone injections are powerful anti-inflammatory agents that provide quick and effective temporary pain relief. However, cortisone can be given only a few times a year because of its effect on muscles and bone.

Joint Fluid Supplements

Hyaluronic acid is one type of joint fluid supplement that can act as a lubricant or “joint grease.” The supplements don’t cure the problem but will provide temporary relief from discomfort.

Supportive Devices

For patients with chronic knee pain, the American Academy of Orthopedic Surgeons recommends using a knee brace, cane, or wearing energy-absorbing shoes or inserts can provide some relief from pain by providing support to the joint.

For more information about treating joint pain, go to

Going Home From The Hospital After Knee Surgery

If you or a family member will be having knee surgery, you might be wondering what to expect when you return home from the hospital. How much discomfort will you be in? Will you be able to get by without help or will you need someone to assist you? How soon will you get back to your regular activities?

Here is an overview of what you can expect for the first few days and weeks after your knee surgery.

1. You will definitely need someone to assist you at home – preferably a spouse or another family member who can stay with you around the clock for a while until you feel strong enough to manage on your own. Because you will not be able to drive a car for about six weeks, you will also need to rely on someone to take you back and forth to doctor appointments, to the grocery store or other errands.

2. Exercise is vital to recovery. Short walks are good and will strengthen the muscles in the upper and lower leg, while helping stabilize the knee joint. You will also be prescribed specific exercises to improve the range of motion and flexibility in your knee. A physical therapy may come to the house or you may go for therapy at the doctor’s office or outpatient center. Expect to use crutches or a walker at first to help you get around. And be sure to rest frequently and not overdo it at first.

3. Medication will be prescribed for pain control. It’s much easier to prevent the pain that to “chase it.” Take pain medication about 30 minutes before physical therapy. Ice packs and elevating the leg will help reduce swelling and discomfort. A footstool can be handy for elevating your leg.

4. For a few weeks, If you can avoid, sitting in chairs that are low to the ground, chairs without arms or overstuffed furniture. It will be difficult to pull yourself up and out of this type of furniture.

5. Expect to use crutches or a walker to help you get around at first. The doctor will let you know how soon you can put weight on the leg and knee that underwent the procedure. Always lead with your non-operated leg and knee first.

6. Don’t leave preparations to the last minute – get your home ready a week or so before surgery. Have the laundry done, the house cleaned, food shopping done and meals frozen and ready for when you need them.

7. Remove throw rugs and eliminate clutter, including moving furniture if necessary, to avoid tripping or falling when you get home.

8. Some final tips for when you do get home:

• Don’t attempt to carry anything. Attach a bag or basket to your walker to make it easier to carry small items. Slide items along the counter rather than picking them up and carrying them.
• To make showering easier, use a hand-held shower hose and be sure to place a non-skid rubber mat on the bottom of the shower stall or bathtub.
• Use liquid soap so you won’t have to worry about bending over to pick up a bar of soap if you drop it.
• Avoid climbing stairs. If you do have to use stairs, make sure there is a handrail to help you.
• Expect full recovery to take approximately six to eight weeks.

For more information, visit

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