Health Tips - 2013 Archive

Torrance Orthopaedic & Sports Medicine Group
Orthopedic Doctors
Physical, Hand & Aquatic Therapy

Two locations:

23456 Hawthorne Blvd.,
Suite 300
Torrance, CA 90505-4716

El Segundo

Phone: 310-316-6190
Fax: 310-540-7362

By Date: Current | 2016 | 2015 | 2014 | 2013 | 2012

By Topic: General Orthopedics | Neck, Back & Spine | Shoulder, Elbow & Upper Extremity | Hand, Wrist & Forearm | Hip & Pelvis | Knee & Upper Leg | Foot, Ankle & Lower Leg

December 16, 2013
Surgery Is Rare with Clavicle Fractures
Clavicle (collar bone) fractures are usually easy to diagnose as most patients remember hearing a 'crack' to describe the sound they heard when the fracture occurred. There is typically bruising, tenderness, and sometimes a deformity that can be seen or felt. Other symptoms include local swelling and pain over the clavicle.

These fractures are common among young athletes, with sports like ice hockey, cycling, riding, and rugby. Depending on the severity of the fracture, treatment can include the use of a sling for 6-8 weeks. In severe cases, surgery may be necessary (plate and screws). Physical therapy is often necessary to restore function.

December 6, 2013
LET AN ORTHOPEDIC DOCTOR HELP with knee pain after hyperextension...
Hoffa's pad is another name for the fat pad that sits below the knee cap. When it is irritated or inflamed, one can experience extreme tenderness around and below the knee cap. It's a common condition with people who have hyperextended the knee, which is when the knee is forced backwards beyond its natural limits.

Treatments for Hoffitis include the use if ice, rest, anti-inflammatories, taping, aquatic therapy and physical therapy.

November 20, 2013
Ankle OCD in Young Athletes Ages 10-16
OCD (osteochondritis dissecans) of the ankle can occur when blood supply to the bone and cartilage is very poor or cut off. The condition typically presents after trauma to the ankle. In the event of a severe ankle sprain, bone or cartilage pieces can become loose, causing pain and swelling, eventually leading to reduced blood supply. This can lead to bone tissue death.

OCD is a rare condition that often results from sports requiring repetitive jumping and pivoting. It affects young athletes during growth spurts (10-16 years of age).

Symptoms include ankle instability, pain, swelling, and ankle stiffness or immobility. Treatments for OCD include rest, ice, bracing, anti-inflammatory medications, physical therapy, and in some cases, surgery. Surgery is recommended when all other conservative methods fail, if pain persists for more than 3 months, or if ankle motion is extremely restricted.

November 6, 2013
Slipped Vertebra—A Trip to the Operating Room?

Degenerative Spondylolisthesis (DS) is a condition described as a vertebra slipping forward out over the vertebra below it. DS is caused by the weakening of the joints due to degenerative changes such as unstable ligaments. The most common sites are in the lower back at the L4-L5 and L5-S1 levels.

DS typically affects individuals over 50, women more than men. Back pain is the most common symptom, and causes vary. Pain tends to increase with lifting, prolonged standing, and walking up stairs and inclines.

Surgery is rare. More common treatments include activity modification, bracing, physical therapy, and medication. Surgery is recommended if non-invasive treatments fail or if nerve damage is an issue.

October 22, 2013
Is Your Spine Making Your Leg Hurt?

Sciatica is characterized by low back and buttock pain that radiates along the back of the thigh and sometimes to the toes. Numbness and tingling along with limited trunk range of motion can also present. People will sometimes complain more of leg pain versus low back pain. The pain can be described as dull, aching, or sharp. As we get older, changes occur in our spinal discs. In a herniated disc, the material inside the disc bulges against the spinal ligament.

This condition is commonly seen with people between the ages of 40-60.

Treatments include short-term bed rest, physical therapy, medications and in rare instances, surgery. Statistics show that the condition resolves within 2-4 months with non-invasive treatment. Only a small number, about 2%, of patients will undergo surgery.

October 18, 2013
Rotator Cuff Tears: painful, weak shoulders

The rotator cuff is a group of tendons that allow the muscles to lift and rotate the bone of the upper arm. The location of the tendons under the shoulder blade make them very vulnerable to damage.

CAUSES & SYMPTOMS: Damage to the rotator cuff can be caused by an injury such as a fall. It can also be damaged by overuse, poor circulation around the cuff, and/or a gradual weakening of the shoulder tendons.

As people age, it is normal for the rotator cuff tendon to wear and degrade, resulting in a painful, weak shoulder.

With a damaged rotator cuff, it may be difficult and/or extremely painful to lift or rotate the arm with the same range of motion as before the injury. Pain is also very common at night, often radiating down the arm.

TREATMENT: A physician may prescribe therapy to strengthen the muscles and provide pain relief. In some cases, the physician will recommend a rotator cuff repair. This involves stitching the torn tendon onto its attachment to the arm bone. After the repair, the physician will prescribe therapy to assist with shoulder mobility, pain relief and strengthening.

October 8, 2013
Many Ways to Treat Shoulder Pain from Bursitis

Within the shoulder, the fluid-filled bursa sac sits between the tissues and provides cushioning. Bursitis happens when the bursa and the rotator cuff tendons get compressed between the bones of the shoulder. Left untreated, this chronic impingement can lead to fraying and eventually tearing of the rotator cuff tendons.

• Repetitive impact
• Overuse
• Poor postural awareness

• Pain and weakness of shoulder muscles, especially when using the arm overhead
• Limited shoulder mobility, such as trouble reaching up and behind the back

Bursitis can also appear in the hip, knee, and elbow.

• Rest
• Ice
• Anti-inflammatory medication
• Cortisone injection
• Physical therapy: massage, ultrasound, interferential current, range of motion exercises
• Surgery in some cases

October 1, 2013
Cortisone Injection Therapy for Pain Relief

Cortisone is a steroid that can be effective at reducing inflammation, especially in the joints. Cortisone is naturally produced by the adrenal glands in your body when under stress. The cortisone that is injected into your body is synthetically produced. It is injected directly into the area of inflammation.

Cortisone injections usually begin to work within a few days and can last up to a few months. They have been found to be helpful with trigger finger, carpal tunnel syndrome, tennis elbow, shoulder bursitis, frozen shoulder, plantar fasciitis of the foot, and many more conditions. Most physicians limit treatment to three cortisone injections because continued cortisone usage can cause tendon or cartilage damage. Physicians usually weigh the effectiveness of the first injection to determine how to proceed with care.

September 23, 2013
Do orthopedic surgeons always want to operate?

An orthopedic surgeon is first and foremost a medical doctor who helps patients get better. Most of the time that doesn't mean actually having surgery. The doctors at TOSMG estimate that for every patient who comes to them with orthopedic problems, less than 1 in 10* will actually have surgery. So what happens to the rest?

Physical therapy, rest, ice, anti-inflammatory medications, changing habits, injection therapy, and stretching are among the most common prescriptions for our patients. It's only when a combination of these more conservative treatments fail that surgery may be suggested. But the simple fact is that most people get better without it.

*Estimate only. Does not include patients who are referred for a surgical consultation, meaning that another doctor has already determined, and that the TOSMG doctor agrees, that the patient needs a highly trained, expert orthopedic surgeon in order to get the best outcome.

September 16, 2013
Helping a Hurting Hip

Hip bursitis is diagnosed when the fluid-filled bursa sac around the hip joint becomes inflamed or irritated. The condition is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. People over 50 and especially women are most commonly affected by hip bursitis, and they may have the following:

• Hip pain
• Hip tenderness
• Pain made worse by repetitive movement
• Stiffness around the hip joint and outer hip
• Pain at night while lying on the hip

See an orthopedic doctor if you have any of these symptoms. Hip bursitis shares some common symptoms with other orthopedic problems, and can go misdiagnosed for years as a result. It may also coexist with obesity, arthritis, and back pain. To get an accurate diagnosis, see an experienced orthopedic doctor who will conduct a thorough physical exam and take MRI and/or x-ray images.

There are many treatment options for hip bursitis, including rest, cold packs, anti-inflammatory and pain medications, cortisone injections, stretching, physical therapy, and more. Surgery is rarely recommended.

September 9, 2013
"My Achilles' tendon hurts!"

Achilles' tendon pain and problems often arise from having muscles that are too tight. More specifically, the gastrocnemius muscle (calf muscle) is one of the main causes of Achilles' tendon ailments as well as many other problems seen in the foot and ankle. Researchers believe the tight calf muscle is an atavistic trait (passed down over time) and/or due to lack of stretching and some types of shoe wear. Some symptoms may include:

• pain in the back of heel (Achilles area)
• pain in the arch
• intermittent cramping in the calf

In children this can manifest as a condition called idiopathic toe walking where the child looks like he/she is tip-toeing around when walking. This often resolves on its own by age 2-3. A tight calf muscle can also cause a foot that is flat to become more flat over time.

While most symptoms are fleeting, those that cause limitations to daily activities or last for more than a few weeks should be evaluated by an orthopedic doctor. Most of these conditions can be treated nonsurgically with physical therapy, bracing, and/or activity modification. A minor surgical procedure called a gastrocnemius recession can stretch the calf allowing more flexibility. This should be reserved as an option only if nonsurgical treatment has failed.

September 3, 2013
Thoracic Outlet Syndrome

Thoracic outlet syndrome is a general term used to describe brachial plexus disorders, or problems with the nerves and blood vessels that extend from the spine through the shoulder joint. The condition usually arises when these nerves and blood vessels sustain an injury, or when they become compressed as they pass over the first rib.

Symptoms often include:
• numbness and tingling in the fingers and arm
• muscle weakness
• poor posture
• diffuse arm pain at night
• pain that radiates from the neck towards the face

If you have any of these symptoms, see an orthopedic doctor to get an accurate diagnosis before beginning any type of treatment. Physical therapy is a conservative form of treatment during which postural training, stretching, strengthening, and work ergonomics can be addressed. Doctors may prescribe anti-inflammatory medication. If conservative management fails, surgery may be needed.

August 19, 2013
Ankylosing Spondylitis

AS is a systemic condition leading to the inflammation of the spine and sometimes larger peripheral joints like hips, shoulders, and knees. The chronic inflammation can lead to the destruction of ligaments and causes ossification (bone growth) in the joint. The cause is unknown but research points to possible genetic and environmental factors.

Symptoms of AS include recurrent episodes of low back pain, morning stiffness, and limited back extension over a 3-month period. When/if the condition progresses the pain becomes more consistent and severe, and it can eventually affect the upper back and neck.

Management for AS can be in the form of anti-inflammatory medications and physical therapy for postural training, strengthening, and stretching. High impact activities and exercises that cause excessive flexion/bending are highly advised against. Surgery is rarely performed.

August 12, 2013
Morton's Neuroma

Morton's neuroma is a painful condition that can affect the bottom of your foot, more specifically the "ball" of your foot. This burning, sharp pain is usually caused when there is a thickening of the tissues around the nerves that lead to the toes.

• Typically there is NO deformity that is visible through the skin
• Tingling and/or numbness in the toes
• Feeling of standing on a pebble or folded sock
• Burning pain beginning in the ball of the foot that may radiate into the toes

• Irritation, pressure, or injury to one of the nerves that leads to the toes
• Wearing high heels or tight-fitting shoes
• Certain sports that involve high-impact activities, such as running
• Those with foot deformities, such as bunions, hammertoes, and abnormal arches are at higher risk for developing Morton's neuroma.

• Any foot pain that last longer than a few days should be examined by a medical professional
• Physical exam of the foot
• Imaging tests, such as x-rays, MRI, and ultrasounds, to rule out any other sources of foot pain

• Changing footwear
• Proper shoe orthotics
• Surgery to remove the affected nerve

Please feel free to contact us with any questions about Morton's neuroma or other orthopedic needs. Torrance Orthopaedic & Sports Medicine Group is committed to pursuing the health of each and every patient.

August 5, 2013
Strengthen your core!

Most people think of abdominals when they hear the word core. The core consists of muscles of the abdomen, pelvis, low back, and hips.

Core exercises are important in order to maintain balance and stability. Gym equipment is not required to keep your core strong. Any exercise that involves the use of abs and back muscles in a coordinated manner counts as a core exercise.

Example: A simple bridge is a great way of strengthening all of the core muscles. Simply lie on your back with the knees bent, keep your back in neutral spine. Then tighten your abs and squeeze your buttocks as you lift the hips off the floor. Make sure to breathe out when you lift your hips and breathe in when you lower them.

July 29, 2013
Trigger Finger

Have you ever had a finger that seems to get stuck? This could be a disorder called trigger finger.

Characteristics of trigger finger include a locking or snapping sensation. The finger flexor tendon is like a rope that connects the muscles of the forearm to the bones of the fingers. It works like a pulley system is a series of rings that form a tunnel through the tendons. With trigger finger, inflammation or scarring causes the finger flexor tendon to have difficulty pulling through the pulley system. This results in a locking sensation when flexing or extending the finger. Tenderness and discomfort can occur at the base of the finger. Often the triggering occurs more in the morning, at night, and when gripping.

Eliminating the locking and pain while allowing finger mobility is the goal of treatment. To reduce inflammation at the flexor tendon and tendon sheath, a hand therapist can fabricate a splint. Taking anti-inflammatories or a cortisone injection can also be helpful in reducing inflammation.

If conservative treatment does not relieve the symptoms, surgery may be an option. In surgery, the surgeon will open the pulley at the base of the finger to allow the tendon to move more freely. Occupational or physical therapy after surgery can also be helpful to improve function and strength.

Please feel free to contact us with any questions about trigger finger or other orthopedic needs. Torrance Orthopaedic & Sports Medicine Group is committed to pursuing the health of each and every patient.

July 22, 2013
Achilles Tendon Rupture

An Achilles tendon rupture is a very common soft tissue injury where the tendon that attaches the calf muscles to the heel tears, either partially or completely.

An Achilles tendon rupture can occur with sudden acceleration or abrupt deceleration like jumping or running up hill. The injury occurs most often in people in their 20s and 30s, and it affects men more often than women. Common causes are decreased calf strength and flexibility, excessive weight and corticosteroid injections to the tendon.

Conservative treatments include rest and physical therapy. Large tears may require surgical repair.

Should you have any questions regarding Achilles tendon injuries or other orthopedic concerns, please contact us here at Torrance Orthopaedic & Sports Medicine Group. We're open Monday through Friday 8:30 a.m. - 5:30 p.m. for appointments and we welcome walk-ins on Saturdays 9 a.m. - 1 p.m.

July 15, 2013
Dupuytren's Contracture

Duputren's is a fixed flexion contracture of the hand, which means that the fingers are bent towards the palm and cannot be fully extended or straightened.

As the condition develops, first nodules, then cords form along the tendons of the hand. These cords thicken and shorten, causing finger motion to become restricted. The small and ring fingers are the most commonly affected. The condition progresses slowly over time and affects men more than women.

Treatments for minor cases can involve splinting, physical therapy, or the use of enzymes to break down the cords and nodules. An outpatient procedure called aponeurotomy, where a surgeon releases the cords with a needle, can also be done. More involved cases may require invasive surgery followed by therapy.

Please feel free to contact us with any questions about Dupuytren's Contracture or other orthopedic needs. Torrance Orthopaedic & Sports Medicine Group is committed to pursuing the health of each and every patient.

July 10, 2013
Platelet Rich Plasma (PRP)

The process of healing happens in several stages. Inflammation, one of the healing phases, has been the subject of a lot of exciting research in orthopedic surgery and sports medicine. Platelet rich plasma, or PRP, is a fast growing option that can aide in the inflammatory stage.

PRP is obtained from an individual's own blood. As the name suggests, it has a high concentration of platelets, which are a specific type of cell that plays an integral role in blood clotting. Many factors that are that are required for cell healing and are critical for cell recruitment, multiplication, and specialization are contained in these platelets and plasma portion of blood.

To obtain PRP, a blood sample is collected from the patient. The sample is placed in a centrifuge, which separates the blood into its different components. The platelet rich plasma can then be extracted from the sample. It is treated and delivered via ultrasound guided injection to the injured area, typically bone or soft tissue such as a ligament or tendon. Following the injection, exercise is discouraged for a very short period of time.

Ongoing medial studies have shown promising signs regarding the effectiveness of platelet rich plasma treatments. Because the PRP is obtained from a patient's own blood, it is considered a relatively low-risk treatment with the potential to improve or speed up the healing process.

Please feel free to contact us with any questions about PRP or other orthopedic needs. Torrance Orthopaedic & Sports Medicine Group is committed to pursuing the health of each and every patient.

June 28, 2013
Adhesive capsulitis (frozen shoulder)

Adhesive capsulitis is a disorder in which the shoulder capsule and the connective tissue surrounding the joint becomes stiff and inflamed. Many patients are often frustrated because of the level of pain and the lengthiness of the recovery. This condition can last up to 24 months. Approximately 70% of frozen shoulder patients are women, although males with frozen shoulder seem to take longer to recover.

• Diabetes
• Stroke
• Accidents
• Lung disease
• Connective tissue disorders
• Heart disease

• Shoulder pain, usually constant and may increase at night; painful activities include hair care and reaching for the seatbelt
• Restricted mobility in shoulder

1. Freezing - Painful Phase
Goal: Reduce pain and maintain mobility in the shoulder
• Ultrasound or iontophoresis to reduce inflammation
• Passive range of motion (therapist moves the patient) to assist with mobility; effective way to prevent adhesions (tissues stuck together) and maintain current range of motion

2. Frozen - Stiff Phase/Pain Decreases
Goal: Increase mobility in the shoulder
• Heat
• Joint mobilization
• Active and passive motion

3. Thawing - Less Painful Phase
Goal: Continue to improve mobility in the shoulder
• Strengthening exercises
• Manipulation by a doctor under anesthesia if mobility still restricted; can help break up adhesions and scar tissue

Please contact Torrance Orthopaedic & Sports Medicine Group with any of your orthopedic needs, where caring for families in the South Bay is our privilege.

June 24, 2013
Peroneal Tendonitis (ankle tendon inflammation)

Peroneal tendonitis is the inflammation or irritation of the tendons that run behind the outside bony prominence of the ankle (lateral malleolus).

• Excessive repetitive forces during standing and/or dynamic activities (example: marathon running)
• High arches
• Recently tried a new exercise
• Significant and sudden increase in exercise activity
• Poor footwear

• Pain around the back of the ankle

A board certified orthopedic surgeon can properly diagnose this condition and create an effective treatment program. This is commonly the safest and fastest route back to health.

• Anti-inflammatory medications
• Physical therapy
• Ice
• Muscle strengthening
• Bracing
• Activity modification
• Specific shoe inserts or orthotics
• Surgical repair of peroneal tendon tears can clean up the tendon and bony spurs

Please contact Torrance Orthopaedic & Sports Medicine Group for any of your orthopedic concerns, where caring for families in the South Bay is our privilege.

June 3, 2013
Basilar Joint (Thumb Meets Wrist) Arthritis

Basilar joint arthritis (also called 1st CMC joint arthritis) is a degenerative joint disease affecting the area where the thumb meets the wrist. This joint is responsible for thumb swiveling and pivoting motions.

Cartilage, which normally blankets the joint and the base of the thumb bone, is worn away and the bones can no longer glide smoothly. This causes damage to the area.

1. Joint pain, especially when gripping or pinching
2. Joint inflammation
3. Decreased mobility of the thumb
4. Joint grating, cracking, or popping sounds
5. Joint stiffness
6. Weakness while pinching

1. More prevalent in women than men
2. People 45 years or older
3. Family history of basilar joint arthritis
4. Post menopausal

1. Apply heat or cold can assist with pain.
2. Gentle exercises can help maintain mobility.
3. Reduce the amount of stress to the thumb. Common tools such as jar openers and wide-barreled pens may help

1. Therapy: A hand therapist can make a custom splint to support the joint at the base of the thumb.
2. A doctor-administered Cortisone injection will not cure arthritis but can help reduce inflammation and provide temporary relief.
3. Surgery may be necessary if more conservative treatment does not help.

Please contact Torrance Orthopaedic & Sports Medicine Group with any of your orthopedic needs, where caring for families in the South Bay is our privilege.

May 20, 2013
Bone Spurs

Bone spurs (osteophytes) are the body's reaction to stimuli. When parts of the body are constantly stressed with repetitive motion, impact, or pressure, the body thinks it is injured and begins to form new bone at the location of the stress. The new bone formation is called a bone spur. People often begin to feel pain when the bone spur adds pressure to the nerves or begins to impact other bones or tendons. Bone spurs can occur on all parts of the body. For example, plantar fasciitis is a common diagnosis in the foot, where bone spurs occur on the heels. Another common place where bone spurs occur is in the shoulder.

If you do not feel any symptoms from your bone spur, it may not be necessary to treat it. If symptoms do arise, diagnosis by an orthopedic doctor followed by physical therapy can be an effective way to treat bone spurs. A physical therapist can use ultrasound and deep massage to decrease pain. Rest, icing, taking anti-inflammatory medication, and stretching are also helpful treatments for bone spurs. Surgical removal is another option.

Please call Torrance Orthopaedic & Sports Medicine Group for any of your orthopedic needs, where caring for families in the South Bay is our privilege.

May 13, 2013
MRI and X-ray...what's the difference?

MRI stands for magnetic resonance imaging and has been used for more than 30 years. MRI's use a magnetic field and radio wave pulses to form images of the structures inside the body. They do not use harmful radiation, and they are completely painless. An MRI machine is a tube that embodies a circular magnet. Within the tube is a bed that the patient lies on while being scanned, which takes about 30 minutes. MRI scanners can find things that other types of scanners cannot. They can take images from almost any angle and show a 360-degree view. This provides a very concrete approach to investigating diseases within the body. Some MRI's are closed, which can be uncomfortable for patients with claustrophobia. Torrance Orthopaedic & Sports Medicine Group has an OPEN MRI machine on-site.

X-ray stands for x-radiation and was developed in 1895. Lasting just a few minutes, x-rays are a painless and quick method of showing images of the structures within the body. The procedure can last about a few minutes. X-rays effectively show bones, some dense tissue, and metal objects such as pacemakers and metal plates. They use x-ray beams, which are absorbed into the body in various amounts, depending on how dense the area is. White area on x-rays are the more dense material, such as bone or metal. Gray represents fat and muscle. The biggest risk to having an x-ray is the exposure to dangerous ionizing radiation. This can increase the chance of birth defects and diseases, and can change some DNA.

Please contact Torrance Orthopaedic & Sports Medicine Group for your next x-ray or MRI. Caring for families in the South Bay is our privilege.

April 29, 2013
Rheumatoid Arthritis:
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder. The origin of RA is unknown. The most common area that it affects is the hands, but it can appear in the wrists, elbows, shoulders, neck, and knees as well.

Symptoms of RA differ from person to person, but the most common symptom is joint inflammation. Joint inflammation can cause stiffness (especially in the morning), water retention, pain, increased skin temperature, and a redness tone to the skin. These symptoms may cause patients to feel tired, less hungry, and have muscle aches. With more severe cases of RA, tissues of internal organs and the synovial lining of tendons can be affected.

Conservative treatment for RA can include:

  • Gentle exercises to assist with flexibility
  • Education in joint protection and energy conservation
  • Splinting for protection or for positioning
  • Strengthening activities and pain management

The most effective treatment for RA is early and aggressive intervention. Please contact Torrance Orthopaedic & Sports Medicine Group for your orthopedic needs, where caring for families in the South Bay is our privilege.

April 22, 2013
Ganglion Cysts:
Ganglion cysts are small cystic swellings around the tendons or joints, most often found in hand, foot, or knee. They are also known as "bible cysts" because the treatment in the past was to hit the cyst with a bible or large book to cause it to rupture.

Ganglion cysts are most common in the hand, more notably the wrist or fingers. They are often on the back of the hand. It is also common to have swelling at the metacarpophalangeal joint (where the finger meets the hand) and interphalangeal joint (the next joint out from there).

There are various causes of ganglion cysts, but the most common reason is a protruding area due to a weakened portion of a tendon sheath or joint capsule.

The most common treatment for ganglion cysts is surgery. A surgeon will aspirate (drain) the cyst and inject the area with corticosteroid. Stiffness and scar formation can occur from the surgery.

Please contact Torrance Orthopaedic & Sports Medicine Group for any of your orthopedic needs, where caring for families in the South Bay is our privilege.

April 15, 2013
Mallet Finger:
A common injury among basketball, volleyball, and baseball players--when to seek orthopedic care

A mallet finger is a deformity of a finger caused when a particular tendon that straightens the finger is damaged. When an object strikes the tip of the finger or thumb, the force can damage the thin tendon. A piece of bone may even be pulled away, depending on the force of the blow. This results in the affected finger being unable to straighten.

A mallet finger may appear to be swollen and bruised, sometimes painful, and the fingertip will almost always be drooping. An x-ray will be ordered to inspect for a major misalignment or fracture.

The typical treatment will include a custom splint to allow for proper healing of the tendon. Surgery is not common unless a severe fracture or misalignment is present. This particular injury is very common among basketball, volleyball and baseball players. Should you suspect this particular diagnosis, see us here at TOSMG for your rehabilitation needs.

April 9, 2013
Restless leg syndrome:
Restless leg syndrome (RLS) is a disorder that stems from the nervous system. Symptoms of RLS include tingling, throbbing and the urge to move the legs. RLS can also affect a patient's sleep habits because it can interfere with sleep patterns.

Patients who suffer from RLS can take medication such as ropinirole and pramipexole. Many patients reports short-term relief but can also have negative long-term effects.

Studies show that exercise and stretches can help reduce RLS symptoms by 50%. Exercising and completing stretches in small amounts throughout the day are most effective. Make sure to gear the total amount of exercise by your individual endurance and tolerance. Studies show that lower body resistance in coordination with aerobic activity is most beneficial. For example, try easy lunges during a walk. Pumping your ankle (similar to pressing a gas pedal) can help circulation as well. Because tight leg muscles are a common symptom, try stretching your calf, hamstring and quadriceps. Avoid exercise within 2 hours before bedtime to keep your sleep cycle consistent. Most importantly, do no overdo it. For some patients with RLS, too much exercise can increase symptoms. Listen to your body.

April 3, 2013
Are protein bars healthy to eat?
For the past few years, protein diets have been the weight loss craze. Have you heard people say, "Eat more protein and you will lose weight"? The US RDA for people over the age of 14 is 46-56 grams of protein daily. The correct amount for each person depends on age, activity level, and other health considerations. If you consume too much protein, it can be challenging to your kidneys and liver. It can also cause constipation if you don't increase your fiber and water intake.

Some of us reach for a protein bar as a filler between mealtimes, and others may eat protein bars as a meal replacement.

Although protein bars brag that they have a high level of protein, there are other ingredients that may not be so healthy such as high fructose corn syrup, sugar, sodium, and partially hydrogenated or hydrogenated oils. Be sure to look at the nutrition label and take into account the extra calories that the protein bar contains toward your daily caloric intake.

Protein bars are most effective after a workout because they contain protein and a complex carbohydrate, which helps build muscle. To increase lean muscle, lift weights and then eat a protein bar within 30 minutes of your workout to replenish your muscles.

March 27, 2013
Is juicing healthier than eating fruits and vegetables?
Some experts say that juicing can give your immune system a boost, help with digestion and weight loss, and reduce the risk of cancer.

Juicing can be beneficial because it allows your body to focus only on nutrient absorption and your digestive system to take a backseat because the fiber is extracted. Also, for those of you who don't enjoy eating fruits or vegetables, juicing may be a way to spice up your diet.

In some cases, juicing can lead to foodborne illness. All raw foods can contain pathogens that can lead to unpleasant side effects such as vomiting and diarrhea. If you do plan on juicing, make sure to wash your fruit and vegetables thoroughly. It is also important to drink the fresh juices immediately to prevent bacteria production and some experts believe that the antioxidants and phytonutrients break down once they are exposed to light and air. Lastly, the juicing process removes the healthy fiber from fruit and vegetables.

The bottom line? While juicing is believed to have health benefits, there is little scientific evidence suggesting that it is better for you than eating whole fruits and vegetables.

March 19, 2013
How much water should you drink?
Drinking water should be an important part of your day. Water assists with body temperatue regulation and provides nutrients to your organs and tissues. Mild dehydration can include joint and muscle pain, lower back pain, headaches and constipation.

20% of your water comes from the foods you ingest
80% comes from beverages you drink

How much water should you consume?
Here's a quick way to estimate. Divide your weight in half for the amount of water you should drink. For example, if you weigh 100 pounds, you should drink at least 50 ounces of water or fluids a day. You should also consider your activity level and if you tend to be more physical, add a few more ounces.

Although water is the best form of hydration, you can also consume sports drinks and juices. Take into consideration the nutritional content, such as calories, salt, and sugar level.

March 13, 2013
Are you looking for ways to stay healthy for the summer months approaching?
Most of us are fighting with time and trying to eat healthy. Besides eating three healthy meals, it is beneficial to eat healthy snacks. Snacking helps maintain your blood sugar levels and prevents overeating.

Here are some ideas for healthy snacking:

-Yogurt and Granola: Yogurt contains calcium and vitamin D, which helps strengthen bone, and protein, which promotes lean muscles
-Mixed Nuts: Contain protein and vitamin D, which has been shown to reduce the risk of Alzheimer's disease
-Fruit: Add pineapple and mango to get your daily Vitamin C intake
-Ants on a Log: Pack peanut butter in a celery stick and top it with raisins
-Popcorn: Popcorn is rich in fiber and low in calories
-Nutrition Bar: Choose a bar that has less than 200 calories, is high in protein, has more fiber, and has less sugar and fat
-Hard Boiled Egg: This 70-calorie snack is rich in protein
-Edamame: Try 1/4 cup of this tasty treat, which is high in fiber and protein
Tomato Juice: Just 4 ounces allows you to drink your vegetable intake

Before your work week, prepare a few of these snacks to bring on the go, and get a jumpstart on your summer diet. Enjoy!

March 11, 2013
"Who needs a gym?"
There are plenty of ways to improve your health without having to purchase a gym membership. Staying active is a great way to improve cardiovascular endurance, reduce stress, and lower blood pressure. The benefits are endless. A few great ways to stay active are:

1. Biking by the beach: A great low-impact activity that can help with cardiovascular endurance and get some much needed vitamin D.
2. Hiking: For the more adventurous, outdoorsy individuals who like to challenge their bodies.
3. Mall walking: For those who aren't as adventurous and prefer a more easygoing activity, as well as getting some retail therapy.
4. Take a dance class: Pick a particular dance style that suits your personality, and even if you are not the best dancer, you'll burn plenty of calories laughing at yourself.

Most importantly…do something that you enjoy and have fun with it!

March 4, 2013
"Proper Use of a Cane"
Using a cane or other assistive devices can help in relieving/decreasing pain, adding stability and easing the pull of certain muscles.

Here are a few helpful tips on how to use a cane:

A) Walking: The assistive device should be used on the opposite side of the affected limb. If used for balance, pick a side that's most comfortable.
Move the cane and affected limb at the same time. Stand tall with good posture and look ahead, not down at your feet.

B) Proper fit: The length of the cane should be adjusted so that the top of the cane should line up with the wrist joint when standing straight with the arm completely relaxed at your side.

C) Going up Stairs: Up with the "GOOD". Step with the unaffected limb first.
Then move the cane and affected limb up to the step together.

D) Going down Stairs: Down with the "BAD". Step down with the affected limb and the cane together.
Bring unaffected limb down to the same step. When negotiating stairs, it's always safer to use a railing with the free hand whenever possible.

February 22, 2013
"Baker's Cyst"
A Baker's cyst is a fluid-filled cyst that causes a bulge behind the knee. Common symptoms include tightness behind the knee, swelling, and pain. The pain can get worse when the knee is fully flexed (bent) or extended (straightened). The symptoms may become worse after being active, or after standing for a long time.

The cyst is usually the result of a problem with the knee joint, such as arthritis or a cartilage tear. Both conditions can cause the knee to produce too much fluid, which can lead to a Baker's cyst.

Treatment can include medication, aspiration/drainage of the cyst, physical therapy or even surgery (depending on the cause).

February 15, 2013
"Nerve Pain vs. Muscular Pain"
Nerve pain results from damage to the nerves and is often chronic. The causes vary from chemical irritation, inflammation, trauma (including surgery), compression of nerves by nearby structures (for instance, tumors), and infections. In many cases the cause is unknown. People often report sensations such as: tingling or pins and needles, burning, numbing, stabbing, or electric shock. In some cases the nerve pain may cause extreme sensitivity to touch.

Muscle pain/musculoskeletal pain occurs in muscles or joints. The causes are generally due to injury or inflammation (swelling). There are instances where muscle pain can be caused by diseases, disorders, or medications. This pain does not usually last long and disappears when the injury heals. People with muscle pain report symptoms such as: aching, throbbing, swelling, muscle tenderness or cramping, or stiffness.

February 11, 2013
"Hot or Cold?"
People are often confused on when to use a hot pack vs. a cold pack to treat an injury or condition.

Generally, cold packs should be used during acute/sudden injuries (within 24-72hrs). Cold relieves pain and swelling. Cold packs should be applied for 15-20 minutes with a layer between the skin and cold pack to prevent frost bite. Elevation along with cold pack application can further decrease swelling.

Hot packs should be used for chronic conditions or after the swelling has subsided. Heat helps relieve pain, reduce muscle spasms and increase circulation.

The rule of thumb is, use ice for recent injuries and hot packs for chronic conditions.

If you have diabetes, nerve or sensation problems speak to your doctor or physical therapist before applying cold or heat treatments.

February 2, 2013
"Catch your breath"
Whether exercising, having an anxiety episode or a medical condition like COPD, breathing the right way is very important in ensuring that you get the oxygen your body needs. One simple, yet effective technique is called purse lip breathing.

Begin by slowly inhaling through the nose, keeping the mouth closed.
Pucker the lips as if trying to whistle.
Exhale slowly, blowing air through the pursed lips.
Exhalation should be at least twice as long as inhalation. Begin with a two 2 second inhalation and a 4 second exhalation.
Rest and repeat several times.
If you can't remember the exact steps to this technique, remember this...smell the roses, blow out the candles

January 25, 2013
A bunion is characterized as an enlargement at the base of the big toe. Symptoms generally include inflammation, redness, tenderness and pain. They occur nearly 10 times more frequently in women compared to men due to tight fitting, narrow shoes. In some cases genetic factors may predispose one to developing bunions at an early age. Non- surgical treatment options include resting the foot, avoiding walking, wearing wider shoes or sandals, stretching and the use of cold packs/ice. If these methods fail, speak to your doctor about cortisone injections or taking an anti-inflammatory. If all fails, a bunionectomy may be the surgical route.

January 21, 2013
Did you know that tight muscles can cause headaches?
Chronic muscle tension can be due to bad posture, whether sitting, standing or walking in ways that put unnecessary stress on the body. Work habits such as cradling a telephone between the shoulder and ear, hunching over a computer keyboard or a forward head are common causes of muscle tension.

We are often unaware of how we contract these muscles because the actions become part of our habits. Continued muscle tension can lead to ongoing irritation of the nerves that lead to the head, and to chronic headache. Proper body mechanics offer new movement options to replace the poor postures. Physical therapy, aerobic exercise, and biofeedback can have strong headache-relieving effects. These are all good preventative measures that our knowledgeable TOSMG physical therapy team can show you. Talk to your physician about trying physical therapy as a conservative alternative.

January 11, 2013
Drop Foot:
Drop foot or foot drop is often thought of as a neurological disability. Drop foot is not a stand-alone condition, but usually a condition of another underlying health issue. While the condition is caused by neurological problems, Drop Foot can be cured or minimized depending on the cause and possible treatments. Knowing the symptoms and the pre-existing conditions can help determine proper identification and treatment of the condition.

Usually this is caused by a nerve injury below the knee, but sometimes can occur at a higher level. The main symptom of drop foot is the limited ability to lift the front portion of the foot. This causes the foot to drag or "slap" the ground with each step. Raising your thighs when walking, as if stepping over a large object, is another symptom of drop foot.

Treatment for drop foot depends on the cause of the condition. This can range from wearing braces or splints for a period of time to surgery. Braces help hold the foot in place. Physical therapy exercises can also help with normalizing gait/walking. If the condition is caused by nerve damage from physical injury such as strokes, nerve stimulation can help with the use of a battery-operated electrical stimulator. Some cases require surgically repairing the nerve damage.

January 7, 2013
Symptoms of a Spinal Compression Fracture
Being able to identify the symptoms of a spinal compression fracture is important. Notifying your doctor if you suspect a compression fracture is even more important. Compression fractures typically occur in men and women over the age of 50. Women are more susceptible than men. For those over the age of 50, compression fractures are usually due to osteoporosis. Treatment can help to reduce the chance of further fractures. Some methods of treatment include bracing, medications and weight bearing exercises. Speak to your doctor about the best treatment plan for you.

Here are some symptoms that can indicate a spinal fracture:
1) Sudden, severe back pain
2) Worsening of pain with standing, walking, bending or twisting
3) Loss of height
4) Deformity of the spine "hunchback" look
5) Some relief with lying down

The pain typically occurs with a slight back strain with common daily activities like
1) Lifting a bag of groceries or suitcase
2) Bending down to pick an object from the floor
3) Lifting a suitcase or groceries out of the trunk
4) Slipping on a rug or misstep

While not everybody experiences pain in the same way, with compression fractures, pain will subside while the bone is healing.