De-stress this holiday season with a gentle yoga practice

Group of women in a yoga class, using blocks to assist in pose.

Practicing yoga can be a great way to get exercise and stay calm during the stressful holiday season. A consistent yoga practice has so many incredible benefits, including reducing heart rate, lowering blood pressure, reducing anxiety and depressive tendencies, and easing back pain — not to mention the stretching and muscle strengthening benefits to the body.

Understanding Joint Anatomy

Yoga uses every muscle and joint of the body. One key thing to remember is that each joint functions differently. For example, the knee is a hinge joint, meaning it allows the leg to extend and bend back and forth with minimal side-to-side motion. Its motion during yoga should remain within the natural back and forth movement of this “hinge”. The hip, on the other hand, has a unique anatomy which enables it to be both extremely strong and amazingly flexible, so it can bear body weight AND allow for a wide range of movement.  The hip joint allows the leg to move back and forth (flexion and extension), out to the side (abduction) and inward toward the other leg (adduction). It also enables rotation, allowing us to point our toes inward (internal rotation) or outward (external rotation) and moving the straight leg in the direction of the toes.

OrthoConnecticut recommends a few tips to as you enjoy your yoga practice this season:

  1. Keep the natural direction of the joint’s motion in mind as you practice – this goes a long way to preventing injury and strain. Be mindful of each joint, its muscles and your skeleton as a whole and how it is designed to move and not move. Work with your skeleton and joints, and not against them, for safe alignment and motion.
  2. Use care to listen to your body to help avoid overstretching your neck, shoulders, spine or legs. Common yoga injuries include muscle strains, torn ligaments and even more serious injuries, so start slowly. The American Academy of Orthopedic Surgeons (AAOS) recommends several steps to prevent yoga-related injuries. Read more here.
  3. Engage in mindful breathing – being present and enjoying the now is restful and recuperative. Here are some breathing exercises to get you started from DoYogaWithMe.com.
  4. Learn and practice yoga at your own speed, with a good teacher. Share information with them about any injuries or illness so they can adapt your practice to your needs. Don’t be afraid to ask questions.
  5. Warm up before yoga. Wear comfortable loose clothing and hydrate! Here’s one helpful floor routine to review from Wettravel and Melina Meza.
  6. Age is not a factor. If standing or floor yoga is not for you, enjoy a class of Chair Yoga as in this routine.

OrthoConnecticut Can Help

Our physicians and physician assistants are available to help you if you’ve injured yourself this holiday season. Contact us today for an appointment and #getmovingCT.

Tips to Avoid Back Pain During Leaf Clean-Up

Fall in New England is synonymous with beautiful changing leaves, but it also a time for yard work, slippery leaves, and avoiding ticks.

Here are some tips from OrthoConnecticut to protect you during leaf season.

  1. Know where the leaves need to go and use the right tools. Are you bagging, mulching, composting, or preparing leaves for citywide leaf curbside collection? Decide upfront what is best for you based on your physical ability.
  1. Mow regularly. Chopping up deciduous leaves, or mulching, as part of regular mowing is both good for your lawn and back. During the heavy leaf falling period, you might want to mow twice a week.
    • Self-propelled or push mower posture is important. If using a push mower, the best posture for mowing is pushing with your legs and arms to reduce strain on back. A self-propelled mower lets you walk behind the mower as it mainly does the work.
    • Take a break every 15-20 minutes to rest. 
  1. Use the right equipment. Here are some ideas for the right tools.
    • Rakes: be sure your rake is the correct fit, that it is proportional to your height and size to avoid straining posture or muscles, and a padded handle.
    • Leaf blowers: save time and energy by considering lightweight gas or electric leaf blowers to blow leaves either into a pile for bagging or onto a tarp for easier moving. Some leaf blowers rest on your back and ease the need to move the blower from arm to arm.
    • Work gloves: protect your hands from blisters and ticks.
    • Good shoes: protect yourself from wet leaves, slipping, skidding and possibly falling with arch-supportive shoes and anti-slip soles.
    • Tarp: helpful for moving leaves from one spot to another for composting.
  1. Posture for raking and lifting leaves: The National University of Health Sciences recommends:
    • Warm up with stretches first
    • Rake in sections, don’t do a large yard all at once, spread out work over several days. Take breaks every 15-20 minutes.
    • Keep your back straight and avoid repetitive motions by switching arms and pulling in different directions to work out different parts of your body equally.
    • Practice proper lifting. BEND AT YOUR KNEES (not at your waist), feet shoulder-width apart. Tighten your abs when lifting, straighten your knees and keep your back straight.
    • For turning, you should avoid twisting at the waist by moving your feet instead.
  1. Avoid ticks. Put pants inside your socks to create a barrier for ticks. Complete a body check following working with leaves and grass.
  1. Drink water … stay hydrated.
  1. Cleaning gutters … ladders, slippery leaves and roofs can add up to big falls. Consider hiring a professional for this task – they’ll have the right equipment and protective gear.

OrthoConnecticut Can Help
Our physicians and physician assistants are available to help you if you’ve strained your muscles or back during Fall Leaf Season. Contact us today for an appointment and #getmovingCT.

Nine tips to help with Osteoarthritis

Arthritic seniors hands cutting flowers

If you’re middle-aged or older, it’s likely you have some Osteoarthritis in your hands, fingers, hips, knees, feet or spine. The most common form of arthritis, Osteoarthritis occurs when cartilage between joints and bone gradually wears away causing joint swelling, pain, stiffness, deformity, and reduced range of motion. Most often X-rays are used to diagnose and assess the amount of joint loss, or other issues that can occur like thinning bone, reduced joint space, joint fluid, or bone spurs. If you have osteoarthritis, here are some options your Orthopedist might recommend.

If you’re in pain, seek treatment and get help!

Nonsurgical treatment for joint mobility, strength and pain relief can include:

  • Lifestyle changes
    • Lose weight to reduce joint stress
    • Rest and ice when swollen
    • Include low-impact exercise such as stretching, walking, water exercise, swimming, muscle strengthening and cycling to help strengthen your muscles, joints and keep you active.
  • Medications to ease pain and swelling
    • Use oral NSAIDs (non-steroidal anti-inflammatory drugs)
    • Use corticosteroid or hyaluronan injections in the joint to provide pain relief and cushioning.
  • Walking aids as needed
    • Use supportive/assistive devices – braces, splint, elastic bandage, cane, crutches, or walker.
  • Physical therapy
    • Improve balance, flexibility, range of motion, reduce pain and strengthen the muscles supporting the joints.

OrthoConnecticut recommends you consult your orthopedist surgeon for advice on surgical options, which might include:

  • Arthroscopy
    • In some cases, can temporarily improve pain
  • Osteotomy
    • To realign and reduce joint pressure
  • Joint fusion
    • To fuse bones together and eliminate joint flexibility
  • Partial or complete joint replacement / arthroplasty
    • Resurfaces the arthritic bones with manmade components to eliminate the arthritis and substantially reduce or even eliminate pain.

OrthoConnecticut Can Help

Our physicians and physician assistants are available to diagnose and advise you on the best ways to treat your Osteoarthritis,. Contact us today for an appointment and #getmovingCT.

Girls and Sports is a Win-Win

Schoolgirl baseball team in a team huddle with their coach

Girls participating in sports is a win-win that stretches far beyond known physical aerobic benefits. Being part of a team encourages cooperation, self-reliance, confidence/self-esteem, friendships, adventure, fun, health benefits and the joy of movement and teamwork that carries into adult life.

Are there obstacles? Yes! There are fewer obstacles because of Title IX, but disincentives such as cost, access, and “throws like a girl” comments still exist. Even so, the benefits certainly outweigh them.

What are some of the benefits? According to momsTEAM, a trusted source for parents, sports benefits girls in many ways including getting through the trials of adolescence:

  • Better physical health including better self-reported health, healthier menstruation, stronger bones, and fewer chronic illnesses later in life. Even reduced cigarette/drug use and less sexual activity are linked to playing sports for girls.
  • Higher body esteem plus lower risk of obesity and sedentary lifestyle – Harvard Medical School studied girls between 5th and 12th grade and found a positive relationship between girls playing multiple sports and developing healthy eating habits with good body images.
  • Stronger grades, lower dropout rate – studies have shown higher organization in setting priorities and budgeting time, and better performance in math and science. “High school athletic participation significantly lowers the dropout rate for white females in suburban and rural schools and Latina athletes in rural schools.”
  • Deeper social networks and higher peer acceptance – team sports help develop close friendships and greater entry into the complex social hierarchies of high school. Physical activity is also linked to reduced stress, depression and teen suicides.
  • Enhanced career benefits – team sports nurtures leadership and teamwork skills, self-confidence, and broadens the ability to speak sports vernacular. Donna Lopiano, CEO of the Women’s Sports Foundation, observes, “Sports is nothing more than organizing a group for high performance. And that’s what businesses do.”

Tips to keep girls in the game as they grow into adulthood

  • Make sure she is hydrating and participating in safe muscular warm-ups, stretching, and cool downs to reduce risk of injury.
  • Pace participation and training to her body strength and stamina.
  • Help her maintain balance between athletics in her overall repertoire of activities, R&R time, and schoolwork.
  • Keep an eye on stress and seek to main balance on girls wanting to achieve a certain level of advancement – let it be fun and a natural progression to wanting to be physically active as adults.
  • Show your girls, through your activity, that aging does not mean less activity or enjoyment of sports! And if there is pain, how to rest, ice and get help.

OrthoConnecticut & OrthoCare Express Can Help

Our physicians and physician assistants are available to advise on sports safety. We know accidents happen, that’s why walk-in orthopedic specialist care is available 7-days a week at our urgent care service,  OrthoCare Express. Download our vCard so the contact information is already in your address book, should an emergency happen.

10 Tips for Managing Knee Pain When You Travel

Close up of woman leg with pain - long driving on the way.Knee pain while traveling is common, but if you’re prepared you don’t have to be sidelined. Sitting in tight, no-room-to-stretch airline seats, bouncing trains or buses, and sitting in one position in a car for too long can exacerbate pre-existing knee conditions or create knee stiffness and muscular cramping.

Whether it’s arthritis, runner’s knee, kneecap, meniscus, ligament, or other knee conditions causing you discomfort, employing these helpful strategies can reduce or eliminate knee pain while traveling.

General Strategies

  • Dress comfortably in loose or stretchy clothing, wear supportive shoes and compression socks to increase circulation and help prevent blood clots.
  • Plan breaks in your schedule so you can minimize long stretches of travel. Shorter hops mean more walking and stretching – – and the breaks can enhance your explorations at different destinations along the way.
  • Don’t sit too long, move and stretch more. Get up and walk around to avoid stiffness or cramping and to relieve pain. Slide your feet/legs forward and back while seated to stretch your muscles and knee joints – be sure to repeat often.
  • Seat location can help. Reserving an aisle seat (preferably a bulkhead) on planes, trains and buses makes it easier to stretch legs (periodically) into the aisle.
  • Know your cars cruise control. If safe, periodically use cruise control while driving to stretch your legs out. Make frequent rest stops to stretch and move.

Tips to Prepare for Travel

  • Ask your Orthopedist about preventative treatment. Would a knee brace, assistance device, compression socks, corticosteroid or hyaluronic acid injection (to reduce pain or lubricate your joint), or anti-inflammatory medication be of help for your knee condition.
  • Keep all advised medications in a handy location and in the prescription or over-the-counter bottles for easy identification and safety instructions. Ask if premedicating 30 to 45 minutes before travel is helpful.
  • Be prepared for icing or heating your knees. Why not pack a reusable hot or cold bag for relieving sore knees. Ask your doctor which is appropriate for your condition.
  • Ask your Orthopedist for knee strengthening exercises. Some examples include:
    • Pull your heels. Strengthen your hamstrings by lifting your toes with your helps on the floor until you feel tension in your hamstrings. Hold for 10 seconds.
    • Lift your legs. Do straight leg lifts if room allows to strengthen your quadriceps (or front thigh)
    • Slow and careful backward walking to strengthen hamstrings and stabilize knees over time.

Tips Post Travel

  • Keep moving, if possible, to avoid stiffness. If in pain consider applying heat or ice as appropriate, rest and elevate your knee. Does your hotel have a hot tub? Go and enjoy for stiff muscles. Most importantly, enjoy your travels.

OrthoConnecticut Can Help

Our physicians and physician assistants are available for travel consults in advance of your journey. Contact us today for an appointment and enjoy a safe and wonderful trip!

Reference: thepointsguy

Today’s Youth Sports Injuries and How to Keep Up

By Dr. Joshua B. Frank, OrthoConnecticut, Coastal Orthopedics

Lacross-girlsOver the years we have learned a tremendous amount about sports, physiology, bio-mechanics, and technique. This advancement in knowledge has allowed athletes to become faster, stronger, quicker, and more efficient.

Sports medicine has advanced concurrently, and there has been a particular focus on youth athletes. Sports injures can be thought of in two categories: acute and sub-acute, or chronic injuries.

Acute injuries can cause immediate pain, are often quite obvious. In some cases, the initial injury is not very dramatic and may not cause a person to stop playing sports. These injuries should be addressed in a timely manner, as negligence and lingering pain can cause permanent disability. Children can sustain similar injuries as adults, and we have witnessed that the diagnosis of pediatric anterior cruciate ligament (ACL) and meniscal injuries is on the rise. This may be related to increased awareness and better diagnosis of these injuries. If left untreated, these injuries may lead to further damage to the knee and even the onset of early arthritis. Acute knee injuries should be evaluated by a physician on medical professional and may require x-rays or MRI.

Sub-acute or chronic injuries can also sideline a young athlete. While sports are great and teach children excellent life skills as well as improve physical condition, there is a point where overuse of specific joints and muscles can be problematic. The threshhold may be different among different athletes and may change as a child grows.

In an effort to improve athletic ability, children and adolescents are often specializing in one sport and participating in that sport year-round. Whether it be on a team, in camp, or even in the backyard, year-round sports can lead to fatigue and injury. Overuse injuries can occur all over the body. Thee are even names to associate injuries with certain sports. For example, a chronic, over-use injury to the growth plate of the proximal humerus (shoulder) is known as “Little Leaguer’s Shoulder.”

Obviously, these types of injuries are not limited to baseball. We do not yet know how much time is too much time in gymnastics practice, or ice-skating or even playing basketball outside. We do believe that performing multiple sports over the course of a year allows for different muscles to be used and rested. Also, periods of rest and time without any major sports participation is also beneficial.

Another important recommendation is to prepare for the upcoming season well in advance. A period of limited activity followed by a sudden onset of intense training can easily lead to aggravation of growth plates, tendons, and apophyses. In general, a graduated schedule of increased activity with appropriate stretching may help prevent these conditions. Even though training camp often begins in August, young athletes should be preparing on their own, well in advance of these intense training periods.

We are delighted to see so many youth engaged in fitness and athletic activities, especially as obesity rates grow in the country. With the increased prevalence of childhood obesity, it has become even more evident that many children are not nearly active enough. With appropriate training, rest, and conditioning we hope to prevent many injuries and keep our young athletes safer.

Skiing Injury Prevention

Preparing for injuries can help prevent or minimize common snow skiing-related injuries and help you to avoid hospital, doctor’s offices and emergency room visits and costs.

  • Common Ski injuries include:
    • Knee injuries such as injuries of the anterior cruciate ligament
    • Arm or shoulder injuries, breaks, dislocations and sprains
    • Shoulder and lower leg fractures
    • Skier’s thumb
    • Head injuries should always be checked out as they can be serious, even life-threatening
  • A few tips can help prevent ski injuries:
    • Get assistance selecting appropriate equipment
    • Match the ski run to your ability level
    • Taking a ski lesson to learn how to fall correctly and to brush up on your skills helps reduce risk of injuring

For more tips on proper preparation, appropriate equipment, a safe environment and preparing for injuries from the American Academy of Orthopaedic Surgeons learn more here.


Accidents happen, we’re here to help. Visit our board certified orthopedic surgeons specialists at OrthoConnecticut and OrthoCare Express where our goal is to help our patients regain mobility, lead active lives and attain optimal well-being.

What You Should Know – Running Right to Avoid Common Injuries

By Ross Henshaw, M.D., Sports Medicine Specialist, OrthoConnecticut

RUNNING-1024x576Running is a wonderfully efficient way to improve your health, except when it produces chronic injuries. The best way to safely enjoy a running program is to gradually build the intensity of your workouts.

WHAT THE PROS SAY

Typically, a running coach or trainer will recommend increasing distances no more than 10 percent a week. If you have an underlying health condition or are new to exercise, make your first step a consultation with your physician. If you have a history of orthopedic injury or joint pain, seek the advice of an orthopedic surgeon.

THE TOP FIVE COMPLAINTS

Hip Bursitis – This is an overuse injury caused by friction between the iliotibial tendon band and the hip bone. This large tendon travels over the bony prominence on the outside of the hip, goes all the way down to the leg and attaches just below the outer side of the knee. When we run, this band rubs back and forth over the outer hip bone; over time the friction creates inflammation. Our bodies have natural “cushions” called “bursa” that are designed to reduce this friction, but if they have not had time to adapt they can swell and hurt, causing pain in the front of the knee. This condition is common among runners.

Kneecap Pain and Patella Tendonitis – This results in pain in front of the knee and is common among runners. The quadriceps muscle in the front of the thigh powers our ability to straighten the knee. It works by using the kneecap or “patella” for leverage across the knee. This generates pressure and can cause the kneecap to become sore. The quadriceps muscle tapers to become a tendon that attaches to the kneecap and then to the shin bone (tibia) via the patella tendon. When strained, the quadriceps and patella tendons can also develop micro tears and become inflamed. Treatment includes rest, anti-inflammatories, strengthening exercises, cross training and progressing back to running while avoiding hills.

Shin Splints – This can occur on one or both shins, but most commonly on the dominant leg. This condition is caused by inflammation where the Soleus muscle in the calf attaches to the tibia. As the muscle helps runners with “pushing off,” it pulls on the attachment site, which may become inflamed and swollen. This pain usually hurts only when running. Treatment for this overuse is rest and cross training.

Achilles Tendonitis – The strong Achilles tendon is prone to inflammation when starting a running program. Our calf muscle tapers off to become the Achilles tendon that inserts into the heel and powers the push-off of the running stride. Running uphill demands more stretch from the calf, forcing it to work harder. This can lead to micro tears of the small Achilles fibers.

Micro tears do not become full tendon ruptures, but cause inflammation and swelling as the body tries to repair and regenerate the area. The usual treatment is rest, stretching, strengthening, cross-training and as the pain dissipates, a gradual return to running with limited hills.

Plantar Fasciitis – The most common early symptom of this comes with morning’s first step. The plantar fascia is a tight band of tissue that supports the foot arch. It attaches to the heel and traverses across the sole, attaching broadly across the end of the foot.

When we run, the plantar fascia can become overstressed at the smaller attachment on the heel, especially in individuals with tight calf muscles. Initially, inflammation starts after the run and hurts upon standing after a period of inactivity. When the foot and ankle bend to stand flat, the fascia stretches and hurts. The best treatment is to recognize it early and rest.

PAIN IS A WARNING!

Most of us can enjoy running without ever suffering from these common maladies. My best advice is to cross train and to recognize symptoms early and not ignore the pain. If you pay attention to symptoms, you can help avoid painful injuries and stay active.

About OrthoConnecticut
OrthoConnecticut is the region’s premier, multi-specialty orthopedic and pain management practice. Thirty-one fellowship- trained, board-certified physicians offer patient care at nine offices in Danbury, Darien, New Canaan, New Milford, Norwalk, Ridgefield, Sharon, Southbury and Westport. The practice’s urgent care service, OrthoCare Express, is open 7 days a week for emergencies and is available in Danbury, Darien, Norwalk and Westport. To make an appointment with Dr Henshaw, or to learn more about OrthoCare Express, please visit http://www.myorthoct.com/, or call 1.833.ORTHOCT (1.833.678.4628).

Download article as pdf:
pdf(English) Running Right to Avoid Common Injuries
pdf(Español) Correr Correctamente para Evitar Lesiones Comunes
pdf(Português) Correr Corretamente para Evitar Lesões Comuns

de Quervain’s Tendonitis

By Michael G. Soojian, MD
Hand & Upper Extremity Surgeon

Living in a digital worldIF YOU ARE experiencing a shooting pain from your wrist into your thumb, you may be suffering from a common form of tendonitis called de Quervain’s tendonitis. This condition gets its name from Dr Fritz de Quervain who first described it in 1895, and is often referred to by other names such as texting thumb, gamer’s thumb, and mother’s wrist. Anatomically, two separate tendons start in the forearm and pass through a small sheath or tunnel as they cross the wrist, before they attach to the thumb. Repetitive movements can cause these tendons to experience friction and lead to a build-up of inflammation within this sheath, which manifests as pain, swelling and a feeling of weakness with routine daily activities. This condition usually occurs as a result of repetitive gripping and lifting, and other activities such as swinging a hammer, using a cell phone, working in the yard or even carrying a baby. Less commonly, this problem can result from trauma, i.e. a direct blow or a sudden yank to the hand or wrist.


This condition usually occurs as a result of repetitive gripping and lifting, and other activities such as swinging a hammer, using a cell phone, working in the yard or even carrying a baby.

DeQuervain’s tendonitis can usually be diagnosed by physical examination which can detect swelling and tenderness over the tendon sheath. Many patients feel as though their “bone is sticking out” but in actuality it is a thickening of the soft tissue sheath they are feeling. X-rays can be taken to rule out other sources of pain, but in most cases end up being normal. In its early stages, DeQuervain’s tendonitis can often be successfully treated with bracing and oral anti-inflammatories such as ibuprofen. Occupational/Hand Therapy can also help some patients. When these simple treatment options fail to provide relief, cortisone injection is usually recommended and can cure this problem about 75% of the time. When all else fails, a minor surgery can decompress the tendons and definitively treat the problem. This surgery entails a brief trip to the operating room and is performed under local anesthesia that is usually combined with an intravenous sedative (“twilight anesthesia”). After the surgery, the hand and wrist are wrapped in a soft bandage for a few days and routine activities are encouraged. The majority of the symptoms usually resolve within two weeks, and most patients are pain free within four to six weeks.

Osteoarthritis (OA)

By Lisa M. Cyr, OTD, OTR/L, CHT
Occupational Therapist/Hand Therapist, OrthoConnecticut

Strong Male Hands Twisting a Stubborn Jar Lid (Close-Up)OSTEOARTHRITIS (OA) is one of the most common joint disorders and is one of the leading causes of disability in the United States. It affects as many as 12% of the American population over 25. One in 4 women and at least 1 in 12 men will suffer from the pain and loss of function caused by osteoarthritis (OA) of the carpometacarpal joint (CMC) of the thumb during their lifetimes. When the smooth cartilage covering the ends of the bones in the thumb wears away, the bones rub against each other, causing friction and damage to the bones and the CMC joint. This can cause severe pain, swelling, and decreased strength and range of motion, making it difficult to do simple daily tasks. This may lead to loss of function, depression and decreased quality of life, causing many people to ultimately seek surgical intervention for relief.

There are many potential causes for arthritis at the base of the thumb. Since the thumb is involved in at least 40% – 50% of every task that we do with our hands, it is subjected to many forces and strains throughout each day. Each time we pinch something between the fingertip and thumb tip, there is up to 25 times more force at the CMC joint than at the tip! Straining to open a new jar, holding a pen tightly when writing, buttoning tight buttons, pulling tight weeds, twisting a key in a stiff lock, trying to pull open a new bag of cereal or chips, holding pliers or other tools or overly large cups are all examples of ways we repeatedly strain our thumbs each day. Texting, with its repeated thumb motion, can irritate an already inflamed CMC joint.

These techniques are most effective when incorporated early in the disease when people first notice twinges of pain at the base of the thumb with pinching or gripping activities.


Research shows that the disabling effects of basal joint disease can be minimized with conservative interventions such as joint protection strategies, short term immobilization to rest the painful joint, and hand exercises.

A referral to a skilled Occupational Therapist/Hand Therapist for two or three sessions can help significantly decrease pain at the base of the thumb, and enable people to continue doing the activities most important for their quality of life. A skilled Occupational Therapist/Hand Therapist accomplishes this by educating the patient in joint protection techniques and adaptive equipment. Patients are either fitted with a custom thumb stabilizer or educated about an over the counter soft support to help rest the painful CMC joint. The patient is given a home exercise program to help delay the progression of the arthritis. These simple techniques have been shown to dramatically improve pain and function for many people with basal joint arthritis.