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The Orthopedic Institute of Pennsylvania Welcomes New CEO

The largest provider of orthopedic care in the South Central PA region has successfully recruited a new CEO to take over the reins starting in April.

William C. Thompson, II is leaving his position as the Director at the world-renown Hedley Orthopedic Institute in Phoenix, Arizona to join OIP. Prior to his work in Phoenix, he was the Director of Operations at the Cardinal Orthopedic Institute in Columbus, Ohio. He also has significant experience as a high level administrator in the acute care hospital setting and in urgent care.

Will earned a BA from the Ohio State University in Political Science and an MBA at OSU’s Fisher College of Business.

He is replacing Dr. Jack Frankeny who is retiring from clinical practice and administration.

The Orthopedic Institute of PA sees patients in 14 locations in Cumberland, Dauphin, Perry, Northumberland, Fulton, and Huntington Counties. They employ nearly 300 employees.

Lyme Disease & Joint Pain

-Symptoms of Lyme Disease
-Treatment of Lyme Disease
-Prevention of Lyme Disease

If you are wondering if a disease can cause all your joints to hurt, Lyme disease is most likely the answer. An infection caused by bacterium carried by deer ticks, Lyme disease can be effectively treated with antibiotics when caught early. However, when undiagnosed and left untreated, the infection can potentially spread to your nervous system, heart and joints, resulting in a complex and debilitating disorder that is more difficult to treat.

Can Lyme disease cause joint pain? The simple answer is yes it can. Here we’ll provide more information on Lyme disease and its relationship to joint pain.

How Do You Get Lyme Disease?

In the U.S., Lyme disease is carried primarily by deer or blacklegged ticks, and it is caused by the Borrelia mayonii and Borrelia burgdorferi bacteria. It’s easy to be bitten by ticks in high-risk areas such as Central PA. The creatures are often no bigger than a poppy seed, so they are very difficult to see before they latch on.

However, not all ticks are Lyme disease carriers. To contract the disease, an infected tick needs to bite you. Bacteria from the tick will eventually make its way from the bite through to your bloodstream, usually taking between 36 to 48 hours. For this reason, whenever you’ve been in the outdoors, particularly in a known tick-heavy area, you should always check your body for parasites before you come back inside.

In the two primary stages of life, U.S. deer ticks feed on rodents, which are a prime source of the bacteria that causes Lyme disease. Ticks move onto feeding primarily on white-tailed deer when they reach adulthood.

If you find a swollen tick attached to you, it could have fed for long enough to transmit bacteria and should be removed with tick tweezers as soon as possible to prevent infection.

Risk Factors for Acquiring Lyme Disease

Where you vacation or live, as well as what outdoor activities you participate in, affects your likelihood of being exposed to Lyme disease. Common factors that put you at risk of contracting Lyme disease include:

• Spending time in grassy or wooded areas. Deer ticks are very prevalent in the Central PA area due to its heavily wooded countryside. Deer ticks thrive in these types of places. Children here are particularly at risk as well as adults who work outdoors.

• Having exposed skin. Ticks find it easy to attach themselves to exposed skin, so if you’re in an area that’s known for ticks, always wear long sleeves and long pants and never allow your pets to run through long grasses.

• Removing ticks incorrectly or not quickly enough. As you already know, bacteria from a tick bite has the potential to enter your bloodstream if the tick has been attached to you for between 36 to 48 hours or longer. If you spot and correctly remove the tick within 48 hours, your risk of acquiring Lyme disease is low, so always check your skin after being outdoors.

The Centers for Disease Control and Prevention notes that older adults and children are most susceptible to the disease, along with others, like park rangers and firefighters, who spend time outside.  It’s estimated that 300,000 people nationwide are diagnosed with Lyme disease each year.

Facts About Lyme Disease in PA

Ticks thrive in the countryside of Pennsylvania in particular, and according to a study published in the Proceeding of the National Academy of Sciences of the United States of America (PNAS), Lyme has a greater likelihood of occurring where suburban developments encroach on existing forest. This is thought to be because the white-footed mouse that is the most important animal in the Lyme disease transmission cycle can live without too many predators under these circumstances.

Notable statistics of Lyme disease in PA include:

• Pennsylvania ranks at number one in terms of Lyme disease cases across the US.
• Pennsylvania reported 7,400 new cases of Lyme disease in 2014 alone. This was a 25 percent increase on the previous year’s numbers, and experts believe that the actual number could be as many as 10-12 times higher.
• Pennsylvania contains 67 counties, and all have reported cases of Lyme disease.
• Pennsylvania contains a reported 10 tick-borne diseases.

What Are the Common Symptoms of Lyme disease?

In the early stages of infection, symptoms of Lyme disease are very similar to a mild flu, including

• Headache
• Fever
• Chills
• Fatigue
• Swollen lymph nodes

For some people, a telltale sign of the disease is the red bull’s eye-shaped skin rash that presents in some, but not all sufferers, within three to 30 days after being bitten by a tick.

Often, these first signs are missed when you’re infected with Lyme disease and are dismissed as the flu or some other virus. This is very worrying because if antibiotic treatment isn’t begun when the first signs of the disease present, your condition can become more serious.

Joint pain is another issue that can occur with Lyme disease. In the worst cases, over several weeks, nervous system and heart issues can develop. If left untreated, you may suffer from arthritis and neurological issues.  In fact, according to the Arthritis Foundation, when Lyme disease is untreated, more than half of all sufferers will develop sporadic arthritis bouts.

Although the symptoms and signs of Lyme disease can vary from person to person, they generally appear in stages with early symptoms and signs appearing first, followed by later ones.

Early Symptoms and Signs of Lyme Disease

You can expect a small, red bump on the site of your bite, or where you removed the tick from, and this will resolve within a day or two. This is to be expected after being bitten by any insect, and it in itself is not an indicator that you have Lyme disease.

However, if you have been infected, you can expect the following within a month or so:

• Flu-like symptoms. Early-stage Lyme disease can present as chills, fever, fatigue body aches, stiff neck, headache and other flu-like symptoms.

• Rash development. Between three and 30 days after an infected tick bites you, you may see a rash that looks like a bull’s eye. This will expand over days, and it can grow to as many as 11 to 12 inches across. It is usually not painful or itchy.

Later Symptoms and Signs of Lyme Disease

If you don’t seek treatment, other symptoms and signs of infection may appear over the following weeks and months, including:

• The bull’s eye rash. It is also called erythema migrans, and it may appear on other areas of your body.

• Neurological problems. At any time after the initial Lyme disease infection, even years later, you could develop meningitis, Bell’s palsy (temporary paralysis of one side of your face), weakness or numbness in your limbs and impaired muscle movement.

You may also suffer from:

• Other rashes
• Nausea and vomiting

Many weeks after infection, some people develop:

• Severe fatigue
• Hepatitis
• Eye inflammation
• Heart problems that last either for days or weeks
• Joint pain and arthritis

The Progression of Lyme Disease

Lyme Disease, Joint Pain and Arthritis

Lyme disease and joint pain unfortunately go hand in hand, as Lyme-related arthritis is commonly found in Lyme disease sufferers. If you have Lyme arthritis, you have swollen, painful and aching joints that cause stiffness and pain. It is found in people who are in the late stages of Lyme disease. According to an article in Science Daily, approximately 60 percent of patients with untreated Lyme disease will develop related arthritis.

Lyme arthritis is caused by the bacteria that causes Lyme disease getting into your joints and causing inflammation of your tissues. Over time, this can cause damage to your cartilage. Most cases of Lyme arthritis are short-lasting and affect only one large joint.

Lyme arthritis can affect your:

• Knees (most common)
• Wrists
• Ankles
• Hips
• Elbows
• Shoulders

In the U.S., it’s estimated that about 60 percent of untreated Lyme disease patients will experience intermittent episodes of swelling and lyme disease joint pain for months to years after they are infected by a tick bite.

Thankfully, most Lyme arthritis cases can be treated with antibiotics and NSAIDs, although some people may require surgery to remove some diseased tissue. Around ten percent of untreated patients may go on to develop chronic arthritis, reports Johns Hopkins Arthritis Center.

How Is Lyme Disease Diagnosed?

As the symptoms and signs of Lyme disease are similar to those found in other conditions and are nonspecific, diagnosis is not easy. In addition to this, the ticks that spread the disease can also transmit other diseases at the same time.

Diagnosis is easier when your doctor can see that you have the characteristic bull’s eye rash. However, if you don’t, your doctor will ask you about your medical history, whether you’ve been outdoors in summertime, where you have been outdoors and will give you a medical examination.

Lab tests enable bacteria antibodies to be detected in order to confirm a diagnosis. They are most reliable when you’ve had the infection for a few weeks, as your body will then have had the time to develop the antibodies.

Tests for Lyme disease include:

• Enzyme-linked immunosorbent assay (ELISA) test. This is the test most commonly used to diagnose Lyme disease, and it detects antibodies to Borrelia burgdorferi bacteria. Sometimes the test brings up a false-positive so it’s not typically used as the sole test for diagnosis.

Although the test may not show as a positive result during the first stage of Lyme disease, often the accompanying rash is distinctive enough to make the diagnosis, especially if you’ve been in an area where Lyme disease-transmitting ticks are common.

• Western blot test. If the initial ELISA test comes back positive, the Western blot test will confirm your diagnosis.

How Is Lyme Disease Treated?

Generally speaking, the earlier and more quickly Lyme disease is treated, the quicker and more complete your recovery will be.

Antibiotics are used to treat Lyme disease, and they include: 

• Oral antibiotics. Oral antibiotics are the standard treatment for Lyme disease when it’s in its early stages. Cefuroxime or amoxicillin is prescribed for younger children, breastfeeding or pregnant women and some adults. Doxycycline is given to children and adults over the age of eight years.

The usual length of a course of antibiotics for Lyme disease is between 14 and 21 days.

• Intravenous antibiotics. If you are suffering from complications affecting your central nervous system, you may be prescribed treatment via intravenous antibiotics for between 14 and 28 days. This course of action gets rid of any infection, although it may still take you a long time to recover entirely from your symptoms.

Intravenous antibiotic treatment often causes a range of side effects, including:

• Mild to severe diarrhea
• Lower white blood cell count
• Infection or colonization with other antibiotic-resistant organisms

Even though there is a risk of experiencing these side effects, it’s imperative to undergo the course of treatment your doctor prescribes to avoid the serious complications Lyme disease can have.

It’s important to remember that even after you’ve finished your treatment, you may still experience other symptoms, like fatigue and muscle aches. This is known as post-treatment Lyme disease syndrome, and the cause of the condition is as yet unknown.

Treating Lyme Disease-Related Joint Pain

When a patient with Lyme disease presents with joint pain symptoms, they may be suffering from Lyme arthritis. If antibiotics are not used to treat Lyme disease, there’s a good chance that a patient could develop Lyme arthritis. For most people, once the underlying bacterial infection is treated, the associated arthritis also resolves with no additional treatment required.

However, in some cases, even when the Lyme disease is treated with oral or intravenous antibiotics, the arthritis persists. This is known as antibiotic-refractory Lyme arthritis, which means patients may need medications that treat the pain and inflammation associated with arthritis. The main way that doctors determine if a patient has arthritis despite being treated for Lyme disease is the persistent inflammation that causes joint pain.

It’s believed that patients with antibiotic-refractory Lyme arthritis are more susceptible to excessive inflammation due to two factors:

• A bacterial strain that is particularly inflammatory
• Patient genetic factors that cause a predisposition to marked pro-inflammatory pathways and immune system dysregulation

Whatever the cause, Lyme arthritis that continues to cause joint pain after antibiotics have been administered will require additional treatment to help sufferers manage their symptoms. Some of the most common treatments that may be attempted include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): These are over-the-counter and prescription medications that both relieve arthritis pain and reduce inflammation. They’re usually taken orally, but they can also be applied to swollen joints as a topical treatment. The most well-known NSAIDs are aspirin, ibuprofen and Aleve.
• Anti-inflammatory medications: If your inflammation becomes extreme, your doctor may prescribe a potent and fast-acting anti-inflammatory medication to get this symptom under control. An example of this is corticosteroid medications.
• Prescription opioids: In rare cases, a patient may experience painful symptoms that are not aided by NSAIDs or other treatment options. In these instances, your doctor may prescribe opioids like codeine, hydrocodone or oxycodone. These are not recommended for long-term use, however.

If you would prefer to treat your arthritis symptoms naturally without medication, there are a few options you can try:

• Losing weight will put less pressure on joints, thus relieving pain.
• Low-impact exercises, like aerobics or swimming, allow for increased flexibility in your joints.
• Hot treatments for joint stiffness and cold treatments for pain, swelling and inflammation make a world of difference.

Your doctor may even recommend physical therapy to increase joint flexibility and muscle strength so that you can more effectively manage painful symptoms.

How Can You Prevent Lyme Disease?

The best way you can avoid Lyme disease in central PA, and indeed, anywhere there is a risk to human health, is to avoid walking in brushy, wooded areas with long grass. Other precautions you should take include:

• Tick-proof your yard. Clear leaves and brush on a regular basis and ensure you mow your lawn regularly.

• Cover up. When you’re in grassy or wooded areas, wear long pants tucked into your socks, shoes, a long-sleeved shirt, a hat and gloves. Wear light-colored clothing to make it easier to see ticks.

• Stay on trails. Try not to veer off from trails and avoid taking any routes through long grass or bushes. In addition, always keep your dog on a leash, as dogs are prone to tick bites, too.

• Wear insect repellent. An insect repellent with at least 20 percent or higher concentration of DEET will help protect your skin from tick bites. If you’re a parent of young children, you should always apply repellent to your kids rather than letting them do it themselves and take care to avoid their eyes, mouth and hands. Chemical repellents can be toxic, so always use them with care and be sure to read the label.

It’s also good practice to apply permethrin-containing products to your clothing for extra protection.

If you’re visiting anywhere that might have an active tick population, it’s important to be proactive about checking your family and pets for ticks. Deer ticks can be as small as a pinhead, so it’s imperative to be vigilant. Areas to particularly focus on checking are behind and in your ears, behind your knees, under your arms, on the back of your legs and anywhere else a small arachnid could escape detection. Also, the following precautions may help you find a tick before it’s too late:

• Check yourself, your children and your pets for ticks. After being out in any wooded area in Central PA, it’s a good idea to thoroughly check yourself, inside your belly button, under your arms, around your waist, in your body hair and hair on your head.
• Shower with a washcloth. It’s a good idea to shower as soon as you get home, as ticks can sit on your skin for hours before they bite, so showering with a washcloth can remove them before they have time to do any damage.
• Remove any ticks as soon as possible with tweezers. Either using regular tweezers or specialized tick tweezers that can be purchased from any outdoors store, you should quickly remove any ticks you discover on you, your children or pets. Gently grasp the insect near its head and pull steadily, and carefully, being sure not to crush or squeeze the tick. Once you have done this, dispose of the tick carefully and apply antiseptic to your skin.
• Never assume you’re immune. Even if you have had Lyme disease in the past, you can always get it again, so it’s crucial to remain aware of any risks in your area.

When it’s caught and treated as early as possible, Lyme disease can be fully treated, saving you from potential complications like arthritis and joint pain. You and your family can be tick aware while still enjoying the great outdoors and protecting your health.

If you have Lyme disease and you’re currently suffering from joint pain, contact us here at Orthopedic Institute of Pennsylvania (OIP) for an appointment.

OIP on the cutting edge of total joint replacements

The Orthopedic Institute of PA performed Total hip and knee replacements on patients of the Pennsylvania Employee Benefits Trust Fund (PEBTF) as part of a year-long trial in an attempt to improve outcomes and reduce costs.  The results were published nationally by the Health Care Incentives Improvement Institute HCI3.  The results can be summed up by HIC3’s comment: “what OIP pulled off is impressive.”

Patient satisfaction remained high, while costs were reduced by $4,189 per patient. Due to more effective pain management and advanced rehabilitation programs, hospital stays were shorter and more patients were discharged safely to the comfort of their own homes rather than to inpatient rehabilitation facilities.

HCI3 describes the excellent results as due to “the rather dramatic care process improvements achieved.”

Congratulations to our surgeons at The Orthopedic Institute of PA!

For additional information about the ‘The PEBTF Total Joint Bundled Payment Pilot:  A Best Practices Summary’, check out HCI3’s Case Study online at: http://prometheusanalytics.net/sites/default/files/attachments/PEBTF-Case-Study_0.pdf

How to Prevent Common Fall Sports Injuries

The roar of the crowd as the running back heads into the end zone for a touchdown. The satisfying smack of the ball as a middle blocker delivers a thundering spike. The sweet swish of a goal hitting the back of a soccer net. The unison cries of cheerleaders as they execute a cupie. The anguished yell of a player going down with an anterior cruciate ligament tear.

Those first four sounds are welcome signs that fall sports season has arrived. That last one is not, but alas, it happens all too often to athletes around the Central PA area. Fall sports injuries are commonplace, yet many of them are preventable when you plan ahead.

This is important, because more kids than ever are playing sports. According to the National Federation of State High School Associations, an all-time-best 7.8 million kids participated in sports last year, including more than 319,000 in Pennsylvania. Many of their parents also remain active, with one in four still participating in sports.

With this in mind, we’ve put together a guide to fall sports safety and injury prevention, designed to address concerns we hear from our patients and their parents about how to enjoy a fun and healthy fall season. We love sports, and we want our patients to feel confident and secure as they participate in them. Follow these tips to keep playing hard this fall.

The Most Common Fall Sports

You can play most any sport in the fall — even baseball, once relegated to spring, has fall ball while basketball has indoor leagues in October and November. But some of the most popular traditional fall sports at the high school, college or adult level include:

• Football
• Field hockey
• Cross country
• Soccer
• Cheerleading
• Volleyball
• Tennis
• Golf

These sports all require a mix of cardiovascular training and strength to succeed, as well as precision. It’s not easy to hit a tiny ball onto the green or veer around mud puddles that pop up suddenly as you run a course. Unfortunately, each sport also carries some risk, whether it’s from whacking into an opposing team’s player, being thrown up in the air, or executing a forehand swing again and again.

The Most Common Fall Sports Injuries

Each year, some 1.35 million children suffer injuries while playing sports. Of those, strains, sprains and fractures are the most common. We treat those here at OIP, along with many other conditions. Here’s a look at some of the sports injuries most likely to be sustained during the fall and a few things to look out for and keep in mind when dealing with these conditions.

Fractures

Nearly every sport calls for rapid movement, and you often come into contact with other players. Anyone who’s ever watched a penalty corner in soccer knows how easy it is to get knocked around when you’re going for the ball. Add in sticks in field hockey, and it’s little wonder broken arms and legs can happen.

Fractures hurt a great deal. Though we tend to think of a broken arm or leg, you can suffer broken bones in anything from your fingers to your metatarsals in your feet. Not every fracture is the same, either. We see a range of different broken bones:

• Open fracture: A bone pokes through skin
• Comminuted fracture: A bone has been broken more than once
• Bowing fracture: A bone bends but doesn’t snap, a condition limited to children
• Complete fracture: A bone breaks in two
• Greenstick fracture: One side of the bone is cracked, but the other remains intact

Fractures require immediate treatment. Not all breaks will need a cast, but many will necessitate a long break from the field.

Strains

Muscle strains come from sudden movements, moving in a way the body isn’t used to or overuse. We often think of strains as the aches that dog weekend warriors, but an athlete in great shape can still sustain a strain. Football, soccer and field hockey players tend to suffer more back and leg strains, while tennis, golf and volleyball players are more prone to arm, elbow and neck strains.

Symptoms of a muscle strain may include:

• Swelling
• Spasming
• Cramping
• Trouble moving

The best treatment for strains includes a mix of rest, icing and elevation. Your muscle needs time to repair itself, which will happen more quickly if you reduce the pressure on it by letting it relax as much as possible. For a leg or ankle strain, crutches may even be necessary for a few days. In severe cases, surgery could be necessary for a strain, but most will heal in a short period of time.

Sprains

Sprains are tears or stretches of your ligaments, which tether bones together at a joint. Most sprains occur when you twist part of your body in an awkward way. For instance: you land on the side of your ankle instead of your foot after kicking a ball. Fall sports can lead to all types of sprains, from ankles to elbows and knees. Hand injuries can even occur in a sport such as soccer, where you don’t use your hands, if you fall and land awkwardly on your hand.

Many people who tear their ACLs, one of the most devastating types of fall sports sprains, often report hearing a pop or feeling the tear. An ACL injury may require surgery and months of rehabilitation, and athletes may be limited in what they can do on the field when they return. In most cases, however, you can heal from a sprain through:

• Rest
• Icing and compressing
• Immobilizing with a splint
• Elevating
• Taking anti-inflammatories to reduce swelling

Concussions

No matter the season, concussions are a constant when it comes to sports. Contact sports such as football often lead to hard blows to the head. In soccer, repeatedly heading the ball can result in a concussion. Cheerleaders can fall from heights of five feet or more when executing flips, lifts or pyramids. Not every blow to the head results in a concussion, but they can occur from what may appear to be a mild knock.

Be aware of the symptoms of concussions and keep an eye out for them after a head blow. They include:

• Nausea or vomiting
• Head and eye pain when exposed to a bright light
• Confusion or disorientation
• Fatigue
• Ringing in the ears

If you experience those symptoms, you should contact your doctor immediately. They’ll recommend the proper treatment, which will likely include a mixture of rest and refraining from activities that require a lot of thinking. If you’ve had more than one concussion, you may need to discuss further safety measures to avoid long-term brain distress.

Shin Splints

Do your lower legs feel sore or tender? Does it hurt when you run? You may have developed shin splints, an overuse injury often seen in fall sports where athletes run at a high intensity, such as cross country, soccer or field hockey. The repetitive motion of running — jarring the tissues holding your muscles to your bone — causes shin splints.

They tend to occur early in a season, when your body isn’t used to running, and ease as your body adjusts. Upping your mileage or workout intensity too quickly can spur shin splints, as can running on hard surfaces, such as concrete. You may be predisposed to developing shin splints if you have high arches, too.

Most cases of shin splints will respond to the usual treatments for strain, including rest and icing. It’s important to take time away from your sport to allow your body to heal sufficiently before you start running again. But in a small number of cases, athletes need further treatment, such as:

• When the orthopedist suspects a stress fracture
• Tendonitis develops
• You don’t have shin splints at all, but rather a rare condition called chronic exertional compartment syndrome, in which pressure builds up in the muscles.

Patellofemoral Syndrome

Pain in the front of the knee can be excruciating. If your knee hurts when you squat, sit, walk up the stairs or jump, you may have developed patellofemoral syndrome, which is common in athletes, and especially in teens. Symptoms include the knee buckling or making grinding and popping sounds.

Patellofemoral syndrome occurs when the cartilage beneath the kneecap becomes worn or soft. This can lead to a shifting of position of the kneecap, and poor alignment can cause the pain.

Initially, your doctor will advise you to avoid any activities that cause pain in the knee. It’s also treated by:

• Wearing a brace to keep the kneecap in place
• Ice and rest
• Avoiding long periods in bent-knee positions
• Strengthening the knee with stationary bike riding
• Taking an anti-inflammatory medicine

How to Prevent Fall Sports Injuries

Now you know what injuries fall sports players are most susceptible to. The good news is, you may be able to avoid some of these injuries.

The first and most important rule of injury prevention for any sport, whether it’s football or field hockey, is to get a physical. Most high schools and middle schools require athletes to have a physical at the beginning of any sports season. The pediatrician will examine the athlete for any signs they should not be competing, or tip off parents for things to keep an eye on.

The physical is essentially a proactive way to address any limitations or problems your child may experience in their chosen sport. For instance, if a volleyball player suffered an ACL tear a year earlier, the doctor may have special instructions about running and jumping. You may also want to consult your child’s orthopedist if they’ve had issues in the past.

Of course, not all athletes are kids. In fact, injuries can be far more common for “weekend warriors” who limit their activity to short, intense bursts on the weekend. They put themselves at greater risk of getting hurt because their body has not been conditioned to such intensity. It’s easier for a muscle to tear or an ankle to give out when the body is put in such distress.

If you haven’t had a physical in a couple years — or worse, longer than that — get to the doctor before your flag football, soccer or volleyball season begins. Think of it like your yearly car inspection. You need to know everything’s working right before you can get back on the road.

Other Fall Sports Safety Tips

If you or your child have already had your physical, great job! But there are a number of other fall sports injury prevention tips you can follow. Make sure you keep these in mind so your family can enjoy a fun and injury-free season.

Warm Up Properly

Tip: Getting the body limber and ready to move will prevent many sports injuries. To reference the car analogy once more, your car can’t go from 0 to 100 miles per hour in an instant. It needs time to build to that top speed. It’s the same for your body.

Execution: Perform stretches and light calisthenics before any game or practice instead of jumping into sprints or full-body blocking, and your body will be ready to move without hesitation.

Cross-Train to Prevent Injury

Tip: The stronger your body is, the better it can handle strains and respond to pressure. Many athletes these days have a tendency to specialize — that is, to play just one sport. That can be great for developing skills, but it means your body does the same thing over and over, and it can make you more susceptible to injury. Challenging the body with new exercises, including weight-bearing exercises that strengthen bones as well as muscles, will help you improve as an athlete, too.

Execution: At least once a week, do something other than your chosen sport. If you’re a runner, try lifting weights. If you’re a football player, try swimming. If you’re a volleyball player, try biking. Use different muscles in order to balance out your regular training.

Make Sure Courts and Fields Are in Good Condition

Tip: You wouldn’t let your child go to a school where the doors were falling off their hinges or the windows were bashed out. Don’t let them play on a shoddy field or court, either — the consequences can be just as dangerous. If a soccer player streaking down the field suddenly catches their foot in a divot, they could sprain their ankle or worse.

Execution: Ask coaches if playing surfaces have been inspected. Don’t be afraid to speak up. If this concern has never been raised before, offer to act as a liaison between your league and others to improve the condition of area fields. For youth and adult sports, many leagues rely on volunteers to get fields ship-shape. You may need to help out to ensure your or your child’s safety.

Rest After Sustaining an Injury

Tip: Athletes tend to be competitive. They want to get back on the field as soon as possible, and many will try to skimp on the time off they’ve been told to take. They may claim “I feel fine!” or “I don’t really need three weeks of rest!” But that’s usually not true. The doctor has prescribed this time off because it’s necessary to heal properly, even if they can’t feel it happening.

Execution: Follow doctor’s orders to the letter. Don’t return to the field until the doctor has okayed it. Though it may seem devastating to miss a “big game,” athletes who come back too soon could be endangering their careers, not just their seasons.

Speak Up About Pain

Tip: Especially when you’ve suffered a blow to the head, being proactive can help protect your health. Concussions carry even more serious consequences when they are not treated. There’s often a desire among athletes to appear “tough,” so they play through the pain. But in truth, pain is your body’s way of telling you something’s wrong.

Execution: See your doctor or orthopedist if you suffer pain that lasts more than a few hours, you suffered a blow to the head or you simply know something in your body isn’t right. Remember: the sooner an injury gets treated, the sooner you can be back on the field.

Invest in High-Quality Equipment

Tip: Playing sports can be expensive. It’s tempting to skimp on some of the “extras,” such as mouth guards or cleats, that aren’t provided by the school or that you have to replace every few years. But in the long run, it’s better for your wallet — and your health — to spend the money on proper equipment to keep you or your child safe.

Execution: Talk to other parents or your teammates about where to find the best-quality equipment. A coach or trainer may also recommend effective brands or stores. You can often find dentists or dentists-in-training who will outfit teams with mouth guards for free, as a public service.

Change Positions

Tip: When you play the same position in every game and practice, you repeat the same movements day after day. This repetitive motion leads to bursitis, or inflamed bursa sacs, and tendonitis, or inflamed tendons. Though getting reps at the position you play is important, you should also be moving around the field to prevent these repetitive motion injuries.

Execution: This can even benefit your team, if you need to build an argument to an overzealous coach. It helps the quarterback of a football team to understand what their receivers see on the field. This will help him get the ball to them more effectively if he understands, for example, where to throw the ball to keep it away from a defensive back who’s closing in.

Enjoy Downtime

Tip: Playing sports is fun. You may want to do it year-round, month after month. But your body needs a break. Instead of going from football to basketball to baseball, make sure you take some time off between seasons. In addition to allowing your body to rest, it helps avoid mental burnout, which can lead to injury when you become too tired to use proper form or pay attention during key moments of a game.

Execution: Even just a week’s break between your fall and winter sport can give the body some much-needed downtime. Go see movies, plan a vacation or veg on the couch. Being inactive for a few days can be just as valuable as being active the rest of the year.

Fuel Your Body Properly

Tip: A strong body will resist injury better than a weak one. Eat a balanced diet with lots of calcium to build strong bones that keep you running fast. Hydration can also be tricky during the fall, often leading to dehydration and poor form that encourages injuries. Fall’s early months can be just as hot as the summer, so don’t skimp on water during practice and games just because the calendar says it’s late September. And don’t forget to stay hydrated during the chilly month of November, even though you may be sweating less than you did two months ago.

Execution: Drink before, during and after your game or practice. Try new veggies and fruits every week to keep your diet interesting. Find tasty sources of calcium to provide insurance for your bone health.

Have You or Your Child Sustained a Fall Sports Injury?

Sometimes, despite your best precautionary efforts, injuries happen. We’re here to help you get through them. If you or your child gets injured during a fall sports game or practice, contact OIP. We can help diagnose the problem quickly and work to have you or your child back in the game — after the proper amount of rest, of course.

Clearing the Smoke Around Joint Replacement

Did you know the risks of complications after a total joint replacement are increased for smokers?

• The infection rate is six times higher in smokers than in non-smokers.
• The rate of blood clots and wound complications is significantly higher in smokers.

However, If you stop smoking four weeks before joint replacement surgery, you can reduce your risk of complications by 41%!  On average, each week you are able to avoid tobacco; your risk of complications goes down by 19%. If you eliminate nicotine, the blood flow to your skin returns to normal in two weeks, allowing more normal surgical wound healing.

If you are also able to avoid smoking for two weeks after surgery, your wound healing complications are significantly reduced.  In addition, some prostheses are not cemented into place.  For long-lasting success, they require your own bone to grow into the prostheses.  That would require at least six months of smoking cessation after surgery to optimize your chance of a successful joint replacement.

If you decide that stopping smoking is the right thing for you to do, up to 22 percent of people who stop in order to undergo a joint replacement never go back to smoking.

So if you are considering a joint replacement surgery, please seriously consider stopping smoking four weeks before surgery and do not smoke at least two weeks after surgery.  You can consult with your orthopedic surgeon and your primary care provider for ideas and options for smoking cessation.

What You Need to Know About Anterior Hip Replacement Surgery

– Differences Between Posterior and Anterior Hip Replacement Surgery
– Preparing for Anterior Hip Replacement Surgery
– Recovery After Anterior Hip Replacement Surgery

Conditions That Can Lead to Hip Replacement Surgery

While Roger’s pain started immediately after a near spill on a slippery, sandy beach, his doctor explained that he had an underlying issue that would have made hip replacement surgery inevitable at some point of his life. Common conditions that often lead people to have either posterior or anterior hip replacement surgery include the following:

• Osteoarthritis
• Rheumatoid Arthritis
• Osteonecrosis, also known as Avascular Necrosis
• Injury
• Fracture
• Bone Tumors

For most people, hip pain starts as a minor discomfort and worsens over time as their hip joint continues to deteriorate. Depending on the amount of pain you’re experiencing and how your damaged hip joint is impairing your ability to do routine things, your doctor may initially choose to treat your hip without surgery to delay the procedure for as long as possible. Alternative treatments include the following:

• Exercise: An exercise regimen can strengthen the muscles around your hip, which can alleviate your pain and make it easier for you to perform the tasks that are part of your daily routine.

• Walking Aids: Walking aids such as a cane or walker can relieve some of the stress on your hip, which can help you postpone hip replacement surgery.

• Acetaminophen: If you have hip pain without inflammation, your doctor may use this medicine to control your pain.

• NSAIDs: If you have hip pain with inflammation, your physician may treat your pain with a nonsteroidal anti-inflammatory drug such as aspirin or ibuprofen.

• Topical Treatment: Some people treat their hip pain by applying a topical analgesic product on the skin around their hip.

• Corticosteroid Medications: When NSAIDs fail to reduce a patient’s hip pain, the individual’s doctor may try to delay hip replacement surgery by prescribing corticosteroid medications such as prednisone or cortisone to alleviate the person’s discomfort. Depending on your doctor, they may inject a corticosteroid directly into your hip joint.

Deciding to have hip replacement surgery is a very personal decision. You have to consider various factors, including your finances, health insurance, the length of your recovery, the ability of your friends and family members to help you as you recover and the amount of vacation and sick time you have at work, just to name a few. In general, the time may be right for you to consider hip replacement surgery if you’ve exhausted your alternative treatment options and your pain and loss of joint function have negatively impacted your quality of life.

Differences Between Posterior and Anterior Hip Replacement Surgery

While many people seem to think that total hip replacement using an anterior approach is a new procedure, the truth is that doctors developed the anterior method of hip replacement surgery more than 50 years ago. The Centers for Disease Control and Prevention reports that surgeons perform approximately 332,000 total hip replacements in the United States each year, while the New York Times reported that around 400,000 total and partial hip replacements are performed in America annually.

According to the American Association of Hip and Knee Surgeons, the number of hip replacements performed annually may grow to 500,000 by 2030. Despite the frequency of these surgeries, it’s estimated that only 15-20 percent of hip replacement surgeries employ the anterior approach to hip replacement. However, that doesn’t mean one method is superior to another.

Even though surgeons have performed both posterior and anterior hip replacements for decades, anterior hip replacement surgery has only started to become more common as the medical world strives to provide patients with a more overall positive experience. There are many reasons why more posterior hip replacement procedures are performed, but the two most likely factors are the specialized training and equipment that are typically necessary to conduct anterior hip replacement surgery successfully.

Each approach has unique benefits and risks, which your orthopedic surgeon will discuss with you fully ahead of time. However, in addition to the training and equipment required by those performing the anterior technique, there are some distinct differences.

Both procedures involve removing the damaged head of the femur and any damaged cartilage from the socket. Then, a metal or ceramic ball is attached to the bone, and a new metal socket is put in place. Between the new ball and socket, a plastic spacer allows for a smooth gliding movement. But there are several aspects of these two methods that distinguish each approach to hip replacement surgery from the other:

• Entry Point: In posterior hip replacement surgery, a surgeon will make an incision on the outer buttocks at the back of a patient’s hip or on the side of the person’s hip which is usually ten to twelve inches long. With anterior hip replacement surgery, an incision is made on the front of a person’s hip and is four to five inches long.
• Muscle Detachment: With the posterior approach to hip replacement, a surgeon has to cut through major muscles to access a patient’s hip. Since there are fewer muscles in the front of a person’s hip, a surgeon can work through muscle fibers while performing anterior hip replacement surgery instead of having to cut through them.
• Hospital Stay: With a posterior hip replacement, patients can expect to stay in the hospital for three to ten days. The anterior approach, however, allows them to return home within two to four days.
• Recovery Time: Because the posterior technique involves cutting muscles around the hip joint and giving them enough time to repair, the recovery time is longer — generally two to four months. Since the muscles around the hip joint are not cut with the anterior approach, recovery only takes two to eight weeks.
• Post-Surgical Precautions: When patients undergo a posterior hip replacement, they must follow a set list of very careful precautions for up to 12 weeks to prevent further injury. Because the anterior approach has less risk of complications, there are no specific precautions that need to be followed.

As we mentioned, the posterior method is the approach most commonly utilized by orthopedic surgeons because many believe it gives them better visibility of the joint. They also feel it provides for more precise placement of hip implants. In many ways, the posterior approach is minimally invasive, but the anterior technique is even less invasive.

As the medical world revisits what makes a successful hip replacement, there are those who embrace the anterior approach as a better method of total hip replacement. The actual amount of time spent in surgery is shortened using this technique. It also allows for patients to recover faster, regaining mobility quickly with minimal pain. And many feel that it minimizes the risk of complications for the patient before, during and after the operation.

Even though posterior hip replacement surgery and the anterior approach to hip replacement differ in several key ways, the goal of both procedures is the same. Both surgeries are designed to alleviate anterior hip pain and restore function so that people can resume their normal daily activities without experiencing discomfort, or at least without as much discomfort as they had before surgery.

According to one source, experts consider total hip replacement surgery “among the most valued developments in the history of orthopedics” regardless of which method is used to restore a person’s mobility and reduce the individual’s pain. Hip replacement surgery doesn’t just provide short-term benefits, it also provides lasting ones. According to some studies of knee and hip replacements, 90 percent of artificial hips still function after 20 years and 70 percent of the manufactured joints still work after three decades.

No matter which approach is chosen, the hip joint has one of the highest success rates for recovery after a surgical replacement. The most important factor is not whether to pick posterior or anterior, but the experience and reputation of your surgeon. An experienced doctor will ensure your risk of complications is very low. The team at OIP is well-known in the field of orthopedics both in Pennsylvania and beyond, and we’re here to ensure you have all the info you need to make an informed decision.

Benefits of the Anterior Approach to Hip Replacement

Anterior and the traditional posterior total hip replacements both have excellent outcomes. The real advancement in total hip replacements that has improved patient recovery is the rapid rehabilitation following both types of approaches. Patients are out of bed within 2 hours of surgery and are frequently home within 24 hours of surgery. Exercises learned pre-operatively are started immediately post-operatively, and recovery can be quite rapid. Patients are treated like athletes and not like patients!

However, the anterior approach does seem to have some additional benefits that many patients enjoy when they choose this method of hip replacement. This includes:

• Less Major Muscle Damage: Because the anterior approach avoids cutting through muscle, this allows for less damage to occur as a result of the surgery. It also means surgeons don’t have to make repairs to these muscles once the operation is complete.
• Less Pain: Patients typically don’t experience as much pain because the surgeon doesn’t have to cut through muscle.
• Quicker Recovery: After the surgery is complete, patients are encouraged to move and bear weight as soon as it’s comfortable. This is often not possible with posterior hip replacements.
• Decreased Risk of Hip Dislocation: The muscles and soft tissue around the hip naturally prevent it from dislocating. When these are cut, as with the posterior method, there is a greater risk of hip dislocation. The anterior technique avoids this by not cutting into the muscle.
• Improved Range of Motion Sooner: With the posterior method, patients have to avoid bending at the hip, internal hip rotations and even sitting with their legs crossed for six to eight weeks as this could cause a hip dislocation. However, the anterior method does not place these prohibitions on patients.

Although there are many benefits to having anterior hip replacement surgery, you should be aware of some precautions before you decide to have anterior hip replacement surgery instead of a posterior hip replacement. These include:

• Not for Everyone: Unfortunately, not everyone is a candidate to have an anterior hip replacement even if they need to have a hip replaced. Anterior hip replacement is generally not an option for people who are obese or extremely muscular, for instance, because they have additional soft tissue that can make it hard for a surgeon to access the patient’s hip joint.
• Possible Nerve Damage: One of the anterior hip replacement complications that can arise is possible nerve damage. It’s important to note that nerve damage is also possible if you have a posterior hip replacement. If nerve damage occurs, you may experience numbness in your thigh. While it happens in less than one percent of patients, nerve damage can also cause meralgia paresthetics, which is an irritation of the skin that the damaged nerve supplies.
• Problems With Healing: One of the anterior hip replacement precautions you should know about is that your incision can become irritated if it’s not cared for properly. One study revealed that surgical incision infections occurred in 1.4 percent of patients who’d had anterior hip replacement surgery and 0.2 percent of people who’d undergone posterior hip replacement surgery. This type of mild complication normally resolves itself even if it’s left untreated by a doctor.

Preparing for Anterior Hip Replacement Surgery

“I found a lot of what I did before my surgery was very helpful during my recovery from anterior hip replacement,” said Roger B. “Probably the most important thing I did was get in shape. I’ve always tried to incorporate physical activity into my daily routine, but I made it a point to visit the gym more often than I normally did in the weeks and months leading up to my surgery. I also increased the length of my walks through the neighborhood as much as I could given the pain I was in.”

“I was 72 years old when I had my anterior hip replacement surgery and my kids were grown-ups. My orthopedic surgeon had advised me to arrange for someone to help me since I wouldn’t be able to drive or do certain things around the house for several weeks after my procedure. So, I called one of my daughters who agreed to help me out. Knowing my daughter was going to stay with me took a lot of pressure off when it came to taking care of everything else I needed to get done to prepare for my surgery. It also helped that she arrived in town several days before my operation and was able to help with my last minute preparations.”

While Roger’s daughter was able to help him throughout his recovery, not everyone has friends and family members whose schedules are flexible enough for them to help consistently during a patient’s anterior hip replacement recovery. If you can’t arrange for someone to stay with you, ask your doctor if it’s possible for you to stay in a rehabilitation center while you recover from your surgery.

In addition to making arrangements for your post-operative care and getting in better shape, there are other things you can do to prepare for your anterior hip replacement surgery, including the following:

• Prepare Meals: You can prepare meals that you can freeze before you go into the hospital to minimize the amount of cooking you or your caregiver will need to do in the days immediately following your operation. Potpies, lasagna, baked ziti and certain soups are all freezable options. You can store your food in single serving containers that can be warmed in your microwave with ease, or you can use freezer storage bags to store your meals.

• Rearrange Your Home: Since you’ll probably have to use crutches or a walker after your surgery, it’s critical that you remove any obstacles that may cause you to fall or that will impede your ability to move around your living space prior to your anterior hip replacement. If you have area rugs that may be tripping hazards, remove them. If a decorative table or another piece of furniture constricts a hallway, temporarily relocate the piece to a room that you won’t have to use during your recovery. Borrowing a walker from your doctor’s office and using it to navigate your home before your surgery will help you to identify the things you need to move.

If you have a multi-story home and your bedroom is not on the ground floor, you’ll need to create a sleeping space on the first floor because you will not be able to climb stairs immediately after your surgery. If it’s not practical for you to relocate your current bed because you have a spouse who also needs a place to sleep, consider relocating one from a spare bedroom, buying or renting a hospital bed.

Move the things you’re going to use most often to the place where you’re going to spend most of your recovery time. Make sure your telephone, computer, remote controls and e-reader will be within reach from the seat you’ll be in for the majority of your recovery period. Make sure you have a bell or another device that you can reach easily to alert your caregiver in the event you need emergent or immediate assistance as well.

These steps will help you prepare for your surgery:

• Get the Tools You’ll Need: Depending on the hospital where you’re going to have your surgery performed and your health insurance, staff may provide you with some helpful tools before you’re discharged. These things include items such as reachers, a portable urinal, a raised toilet seat and a shoehorn that has an extra-long handle. Ask your doctor if you’ll be given these things after your anterior hip replacement. If not, ask him or her which items you’re likely to need, inquire about where you can get them and purchase them prior to your procedure.
• Make an Appointment with Your Physical Therapist: By visiting your physical therapist before your operation, you can learn exercises that can help physically prepare you for your surgery. You can also become familiar with the exercises you can do after anterior hip replacement. If you practice these moves beforehand, they’ll be easier for you to do after your surgery.
• Review Your Legal Documents: Certain risks are inherent in any surgical procedure. While anterior hip replacement surgery is not as invasive or life-threatening as many other operations, things can still go wrong. To make sure you’re prepared for any contingency, you should take some time to ensure your affairs are in order prior to having your operation. Review your will and living will. Make sure someone is legally authorized to make decisions on your behalf if you’re unable to do so yourself. Be sure to clearly communicate your wishes to your loved ones and your power of attorney. Doing so will make any decisions they may have to make easier on them.

Anterior Hip Replacement Surgery Recovery

As the less invasive approach to total hip replacement surgery, the anterior technique allows for a shorter recovery and rehabilitation time. This means patients can return to daily activities and even go back to work sooner. However, the recovery process still involves distinct phases to ensure the tissue is healing properly and that you will have maximum functionality.

Although each patient is different, there are a few things you can anticipate during the recovery process after anterior hip replacement surgery. However, your progression depends totally on your unique set of circumstances. One of the greatest advantages about recovering from an anterior approach to hip replacement as opposed to the posterior is that you won’t have to follow any specific anterior hip replacement precautions like not bending past 90 degrees or crossing your leg. This is because there is less risk of dislocation and less leg length discrepancy with the anterior technique.

After undergoing an anterior hip replacement surgery, here are some of the phases of the recovery process you can expect:

• Hospitalization: Patients undergoing the anterior approach usually only stay in the hospital for two to four days. During that time, the patient may receive their initial visit from a physical or occupational therapist. They may even encourage you to stand or walk a few steps using a walker or crutches. Movement after surgery is essential as it increases blood flow and reduces the risk of blood clots.
• Physical Therapy: Formal physical therapy will start shortly after your hospitalization. The goal is to improve muscle strength as well as increase range of motion and mobility. A unique program of exercises will be formulated to meet your specific needs. Therapists will consider any movement restrictions you have as well, so you have the safest possible recovery.

During the antererior hip replacement recovery time, your doctor and your physical therapist will work together to ensure you are on track for a successful recovery. They will be looking out to make sure you reacquire full balance, your tendons and muscles stretch properly and your muscles regain their full strength.

At first, you will have to use a cane or walker to get around. However, unlike the posterior approach, there should be less post-operative pain. In fact, many are able to bend at the waist and put weight on their leg not long after the surgery is complete. This means those who undergo an anterior hip replacement can use a cane or walker sooner. Some patients require the use of pain medication.

After a few weeks of physical therapy, most patients are able to return to functional mobility, moving freely and going about their everyday tasks. A few weeks after that, you should be able to enjoy recreational activities as well. Just remember that everyone is different, and your doctor and physical therapist will be your guide during this process. Some patients take longer to recover fully, and that’s completely okay.

By the time you reach full recovery, there should be little to no pain, especially compared to the discomfort experienced before your surgery. And you should also be able to return to full normal function. There is a risk that the hip will be less flexible than a natural hip. For example, sitting cross-legged on the floor or even simple tasks like putting on your shoes and socks may be more difficult. That’s why it’s important to continue exercising and flexibility training even after physical therapy is complete. Low-impact aerobic exercises, like swimming, biking or walking, will help keep hip muscles strong and flexible.

WHY CHOOSE THE ORTHOPEDIC INSTITUTE OF PENNSYLVANIA

If you have hip pain or you’ve lost some function in one or both of your hips, contact the Orthopedic Institute of Pennsylvania to make an appointment today. We know you have many choices when it comes to orthopedic care, which is why we’re committed to making a difference in your life by going above and beyond your expectations every day. We promise to be part of the solution to whatever health problems you’re currently having and we’ll stand by you and support you as we work through them together.

We’ve improved the lives of other people who lived with pain and the loss of joint function too long, sometimes for years, and we can do the same for you. Don’t just take our word for it, though. Read what some of our patients had to say about their experiences with us:

“I can’t thank you enough for the new life you have given me. I have not been this happy in years.” – OIP Patient

“Dr Lippe was excellent in my care! From the first time I met him, to my surgeries, he was outstanding! Dr Lippe gave me my quality of life back! I will never be able to thank him enough! The pain I was experiencing was ruining my life! But Dr Lippe and his staff were all excellent in my care!” – Patricia C.

“Dr. Frankeny has absolutely given me my life back. It has been six weeks and I am feeling great. I barely use my cane. After enduring pain for over a year and [being] barely able to walk, I cannot believe my good fortune.” – OIP Patient

You don’t have to live with hip pain or be limited by a bad hip any longer. Schedule an appointment with the Orthopedic Institute of Pennsylvania to learn what we can do for you and see why our patients love us so much. We’re excited to be part of your solution.

Stories From Our Patients

Roger B. was a police officer for nearly thirty years before he underwent double knee replacement surgery in the late 1990s. “I knew I needed to have my knees done for years before I actually had the surgery. Even though it was painful to do my normal daily activities, I had to postpone the surgery for as long as I could because my wife had suffered a series of devastating strokes and needed my help on the home front. When I realized I couldn’t tend to her the way I needed to, that’s when I knew I couldn’t put the surgery off anymore.”

“After my wife died several years ago, I resumed fishing and some of the other things I wasn’t able to do during the years leading up to her death. On one fishing trip, I stumbled on the beach and ended up twisting in a way that wasn’t natural. From that point on, I had never-ending pain in my right hip. I tried, in vain, to reduce the pain by changing the way I walked, taking over-the counter pain medication, getting shots in my hip joint, etc., but nothing helped. When I realized I couldn’t pick up my granddaughter anymore because of the pain and I couldn’t sleep for more than an hour or two at a time because of my discomfort, I knew I had to do something.”

“Living in a retirement community, I knew a lot of people who’d had hip replacement surgery due to anterior hip pain. What I didn’t realize, however, was that there were two kinds of total hip replacement surgeries, posterior and anterior hip replacement surgery. The more I learned about the two procedures and the more I thought about what I saw during my neighbors’ differing recovery times and experiences, the more I started to think that the anterior approach was right for me.”

“So, I started to look for an orthopedic surgeon who was familiar with the procedure. I met with several doctors before I found one who was experienced with anterior total hip replacement surgery. Given my doctor’s extended experience with hip replacement and the anterior approach, I decided to go through with the procedure. Moreover, I’ve got to tell you, I’m glad I did. It gave me my life back and it did so a lot faster than I thought it would.”

17th Annual Dauphin County 50plus Expo

OIP is very excited to be participating again as a Sponsor and Exhibitor of the 17th Annual Dauphin County 50plus Expo, held at the Hershey Lodge, 325 University Drive, Hershey, PA, on Tuesday, May 31st, from 9:00 am – 2:00 pm.

Please stop by our booth (152-153) and say “hi!.”

Free Health Screening:   OIP will be providing Heel Scans for Bone Density.

Door Prize:  Be sure to register for a chance to win our door prize!  We are giving away an OIP branded gift basket including OIP Apparel, Gift Card, and First Aid Kit.

Exhibitor Map and Listing:  Download a copy of the Exhibitor Map and Exhibitor Listing in PDF.

For more information about the Dauphin County 50plus EXPO, visit www.50plusexpopa.com.

OIP Tops Patient Satisfaction Scores!

OIP voluntarily participates in a national patient satisfaction survey distributed by Talksoft / MedStatix.

We are proud to say that our results in the first quarter exceed the national standards in:

• • “Staff works together well.”
  • “Patients receive respect by scheduling staff.”
  • “My privacy is respected.”
  • “The doctors clearly explained procedures.”

 “2015 Top Performers”

Four of our doctors received “2015 Top Performer” results in this national survey.

We are proud of Doctors:

• Steven B. Wolf, M.D.
• William W. DeMuth, M.D., F.A.C.S.
• Brett A. Himmelwright, D.O.
• John R. Frankeny, M.D.

Avoid Common Winter Injuries With These Helpful Tips

If you’ve experienced an injury or pain while performing a wintertime activity, you are not alone. Personal injury during winter is likely to occur from performing simple activities, especially if you aren’t prepared to prevent an incident. From your back, shoulder and neck to joints and knees, pain and injury in these areas are commonplace during the winter.

The good news? Preventing winter injuries is possible, and you can enjoy the season without unnecessary pain and stiffness. Read on to discover information about winter back injuries, winter shoulder injuries, and — most importantly — health and safety tips to avoid any orthopedic winter injuries.

What Are the Most Common Winter Injuries?

Winter weather conditions bring with them a variety of potential risks for personal injury, as well as injury to others. Some of the most common winter incidents that lead to personal injury include:

• Falling on ice and snow
• Experiencing muscle strain from shoveling snow or scraping ice off the car
• Driving and motor vehicle collisions
• Accidents while playing winter sports and activities

Not all incidents will cause severe injury, but some winter accidents can be quite serious, especially for certain age groups and for people suffering from previous injuries.

Slipping and Falling on Ice and Snow

Slipping and falling on ice can be a scary experience. Ice can be difficult to see both at night and during the day. What looks like water pooled on the pavement can actually be a sheet of ice. You could step off the curb and right onto a slippery ice patch. When this happens, severe injury can occur if you fall to the ground. You may be able to recover and only skid briefly, but even if you don’t end up falling, you can wrench your back or experience another kind of injury in your attempt to recover.

Anyone is in danger of injuring themselves by falling or slipping on ice or snow, but seniors are especially at risk. In fact, according to the CDC, falls are the leading cause of injury among older Americans, and winter weather conditions only exacerbate that concern.

There are a variety of potential injuries that can occur from falls on ice, but the most common include the following:

• Bruises
• Head or brain injuries, including concussions
• Ankle strains and twists, and other kinds of muscle sprains and ligament strains
• Broken bones, most commonly hip and wrist fractures
• Back injuries, including spinal compression fractures
• Injuries to the spinal cord

Prevention is always the best method to avoid a slip or fall on icy days, and there are a few things you can try to keep you and your family safer:

• Wear proper footwear made for icy and snowy conditions.
• Keep your stride shorter and avoid long steps.
• Slow things down — try not to rush or run outdoors.
• Keep de-icer or sand on hand for when things get slippery around your house.
• In case of injury, always have your cell phone handy.
• If you need to do outdoor chores, take your time and don’t hurry.

Unfortunately, even with the best preventative measures, accidents happen. Skeletal and muscular issues arise every winter when people fall on ice or snow. If the fall is serious, you may need to call 9-1-1 or go to the ER immediately.

However, some people are unaware that they have a severe injury. This may be because they don’t feel the effects of the fall immediately, or they believe their pain and discomfort will pass with time. Symptoms like pain or swelling should not be ignored, and it’s important to seek the advice of a medical professional to assess your condition.

At OIP, we offer patients a 24/7 walk-in injury clinic for orthopedic emergencies such as falling on ice. Often, the waits are less than what you’d experience at an emergency room, and you will be able to get the specialized care of an orthopedic doctor trained to treat musculoskeletal injuries. In many instances, patients who go to the ER receive recommendations for them to seek out orthopedic specialists after the fact.

If you experience an injury on the ice or snow, whether it’s from slipping and falling or from attempting to prevent a fall, make an appointment with a specialist at OIP as soon as possible to determine if there is a serious injury. They will also be able to offer an effective treatment plan that meets your individual needs.

Shoveling Snow

One of the most loathsome winter jobs is shoveling the driveway and sidewalk. It can take a long time and require a lot of physical exertion. The low temperatures make the task of shoveling snow even more unpleasant. The repetitive actions of twisting and lifting while shoveling can cause severe strain on the body. All it takes is one muscle to be pulled the wrong way for your back, neck or shoulders to seize up.

Snow shoveling can be a potentially risky duty that can cause severe injury. A national study found that over the course of eleven years, there was an average of 11,500 emergency room visits due to snow shoveling injuries. The most common injuries reported were soft tissue injuries mostly to the lower back region. Among the remaining injury reports, lacerations and fractures were also reported, including injuries to the hands, arms and head.

Driving and Collisions

Most of us must continue to work and carry on with our normal, everyday activities even in snowy winter weather conditions. But if you aren’t prepared for winter driving conditions and don’t take the proper safety precautions, you can put yourself and others at risk. A study found that over a period of ten years, there were over 445,000 people injured as a result of weather-related vehicle collisions. The winter weather brings with it all kinds of potentially hazardous road conditions, such as:

• Wet pavement
• Sleet and slush
• Full coverings of snow and ice

Falling or Colliding During Winter Activities

One of the most enjoyable parts of winter is the fun you and your family can have with all kinds of winter activities and sports. From ice hockey and skating to skiing and snowboarding, there are plenty of ways to stay active and have fun in the winter. For kids especially, sledding and tobogganing are some of the best childhood memories of their winter seasons.

These winter activities can be quite risky if you aren’t practicing safety. Falls and collisions in many winter activities can cause several forms of injury. Broken bones and stiff muscles and joints are some of the most frequently reported injuries when it comes to outdoor sports and activities. Running outdoors along the sidewalk or on trails can also pose safety risks if the pavement isn’t salted and the trails aren’t properly cleared.

Types of Winter Injuries

These incidents produce various types of injuries, which can range from mild and easily treatable to severe and long-term. Some of the resultant injuries from these winter accidents most commonly include:

• Head injuries
• Shoulder injuries
• Back injuries
• Neck pain and tension
• Knee joint pain and soreness
• Wrist sprains
• Elbow fractures and dislocation
• Ankle sprains and strains
• Hip fracture and soreness

Head Injuries

Head injuries occur during the winter as a result of any number of incidents. Most commonly, falling on ice and hitting your head on the pavement can lead to a potentially serious brain injury. If this occurs, it will need immediate treatment by a physician. A brain injury can be difficult to treat, and often the symptoms won’t be noticed until long after the injury has occurred.

Head injuries can occur during winter activities like tobogganing, snowboarding and skiing, or one can also occur as a result of a motor vehicle collision, which has the potential to lead to serious long-term health consequences.

Shoulder Injuries

Shoulder injuries commonly occur when you fall on icy pavement. When your shoulder meets contact with the hard ice-covered pavement, dislocation can occur. This damage to the shoulder joint can be quite severe and leave you suffering from soreness and bruising for a long time afterward.

A torn rotator cuff can happen as the result of repetitive overhead motions from winter sports or shoveling snow. This muscle tear can leave you feeling sore and stiff and may result in a chronic injury as well.

Back Injuries

There are plenty of winter incidents and activities that can cause a back injury. The most common injury associated with shoveling snow is to the back, specifically the lower back. Back injuries can also be the result of a serious fall on the icy pavement or on the stairs. Falls during winter sports and activities can also result in a back injury.

Another common way to injure your back during the winter time is by scraping your car’s windshield to remove ice and snow. The bending and leaning motion your body performs while reaching across to scrape the ice can result in pulled and strained back muscles.

Depending on the level of severity, treating a back injury with heat may help to relax sore muscles. An injury that is caused by a fall on ice may damage your spine, so treatment by a physician will be required.

Neck Injuries

Like back and shoulder injuries, neck injuries can occur due to a number of different winter incidents. The repetitive motion of shoveling snow can certainly lead to stiffness and soreness in the neck muscles. Neck injuries can also happen when scraping snow and ice from your car’s windshield when your muscles become strained from leaning and reaching.

These injuries can usually be treated with a heating pad to relax tense neck muscles. If a neck injury is caused by a fall or a motor vehicle collision, it should be treated at the emergency room.

Knee Pain and Strain

High-impact winter sports can be very damaging to your knees over a period of time. This type of injury usually occurs while performing activities and sports such as skiing and snowboarding, where your knees are absorbing the shock of hard landings. Running outdoors on pavement can also cause a similar injury to your knees. The best thing to do with a knee injury is to take it easy until it heals, avoiding any high-impact activities.

Wrist Fractures and Strains

A fall on the icy pavement can cause wrist injuries such as fractures and strains. When you take a fall, your natural instinct is to extend your arms and brace your fall with your hands. The impact of the fall on your hands can cause a severe wrist strain or even fracture.

The result can be a serious injury if not treated properly. Your wrist may heal improperly, which could lead to chronic pain later in life.

Elbow Injuries

Like wrist injuries, elbow injuries can also arise from a fall on icy pavement. When you extend your arms to brace your fall, not only do your wrists take the impact but your elbows do as well. Your elbow could become dislocated if the impact is so significant that it pops your bone out of position. Otherwise, a more potentially severe injury could be an elbow fracture. This can lead to long-term pain if not treated properly.

Ankle Strain

Falls on slippery, icy pavement can also cause ankle injuries. When you struggle to recover your balance after slipping on ice, you can easily roll and twist your ankle. This may end up being a muscle injury whereby the tendon has been strained. Otherwise, a certain type of fracture in the ankle bone can result if more impact has been felt. This type of fracture can be caused not only by a fall on iced-over sidewalks, but also due to winter sports injuries.

Hip Fracture

Slips and falls on icy roads and sidewalks can result in many different types of broken bones, fractures and injuries. But one of the more severe injuries occurs when a fall is so hard and sudden that it fractures the hip bone. This can be a very difficult injury to repair, and it can also cause chronic, long-term pain. This injury especially affects seniors who are predisposed to osteoporosis or previous hip injuries. This injury should certainly be treated as an emergency by a physician.

Age Groups and Demographics Most Affected

Certain incidents and their resulting injuries may affect certain age groups more than others. It’s important to apply appropriate safety measures, so everyone can stay safe during the winter.

Children

Children are susceptible to falls. They can easily fall and injure themselves if they can’t reach handrails or don’t have proper balance. If your child experiences a fall, it’s important to first assess their head for any injuries and then check for elsewhere, like wrists and elbows.

Children especially enjoy their time sledding and tobogganing, which can put them at risk for injury. Be sure to always supervise kids during winter activities and provide them with helmets to protect their heads.

Seniors

Like children, seniors are also at a higher risk of slipping and falling on icy pavement. Seniors can easily lose their footing and take a fall that can put them in severe danger. Seniors who have suffered in the past from hip injuries could further damage their hips or back. Seniors should be accompanied and helped down driveways and across parking lots to ensure they are stable and have the support to walk safely. Seniors with mobility issues may want to consider motorized scooters during the winter months for extra safety precautions.

Adults With Previous Medical Conditions

Adults with previous back, neck and shoulder injuries are also at risk to be severely injured in any of these winter incidents. A slip or a fall can trigger a past injury and can cause further damage. Additionally, adults with a predisposition to osteoporosis are also at higher risk for broken and fractured bones if involved in a collision or a fall.

Active Adults

Adults who remain active throughout the winter months are also at greater risk for injuries if proper safety precautions aren’t followed. Adults who ski and snowboard should be advised that, without the proper equipment, they can be at risk for head injuries as well as neck, shoulder, knee and ankle injuries.

People who run in the winter should be advised to use properly cleared and salted trails and sidewalks, so they don’t risk slipping and falling.

Winter Injury Prevention Tips

Though many of these winter accidents can be quite common, they are easy enough to prevent by following specific steps.

• Thoroughly and regularly salt driveways, sidewalks and stairs
• Walk carefully across parking lots and provide children and seniors with additional support
• Stretch before performing any physical exercise
• Stay hydrated while exercising and shoveling snow
• Ensure proper footing when shoveling snow or scraping ice off the car
• Wear a helmet and protective equipment during winter sports
• Always supervise children playing outdoors in the snow
• Before shoveling or scraping, make sure to properly stretch

Most businesses and shopping centers take precautions to salt their parking lots and sidewalks once winter hits. Even still, patches may be missed or ice may have formed since the last salting. When rushing into stores and shopping centers, slow down and take your time to carefully walk across the parking lot. Look for areas that have been clearly salted or do not appear wet. Hold onto children and seniors to help stabilize them as you walk across the parking lot or driveway and indoors.

For back injury prevention, it is advised to stretch lightly at first, then move into a deeper stretch. If you are going to be shoveling snow, then it’s important to stay well-hydrated and take frequent breaks so as not to exhaust your body and muscles.

When performing winter sports and activities, be sure to always have the proper protective equipment, like helmets, to prevent head and other serious injuries. If you have access to a gym or can use a treadmill at home, it will prevent any risk of slipping and falling while running outdoors during the winter.

If you choose to run outdoors, go with a buddy and be sure one of you carries a cell phone to call for help in the event of an injury. Familiarize yourself with your running route ahead of time to ensure it’s an area that has been salted and cleared of ice and snow.

Winter Driving Safety Tips

Winter weather can make driving more difficult, which means it can put yourself and others at risk of injury. In order to prevent motor vehicle collisions, follow these winter driving safety tips:

• Have proper winter-grade tires installed on your car
• Store an ice scraper in your car
• Keep windshield washer fluid full
• Have your vehicle inspected, especially breaks
• Have a winter safety kit in your trunk, including a high-visibility safety vest, gloves and jumper cables
• Keep a first aid kit in your car
• Never drive without a cellphone
• Limit the time spent driving in the dark

What To Do If You Suffer a Winter Injury

If you or a family member suffers a winter injury, it’s important to first assess the severity level. Sometimes muscle injuries can be treated with ibuprofen and by applying ice or a heating pad (whichever is more comfortable) or taking a warm bath. However, more severe injuries will need to be treated immediately by a professional. If you suspect broken or fractured bones or a head injury, report it to a physician right away, visit the emergency room or visit your orthopedic injury clinic.

Educate yourself and your family about the potential incidents and accidents that can occur during the winter, and you’ll be much more prepared to prevent them. If a serious injury occurs, be sure to contact OIP to schedule an appointment with a doctor who can treat you for your specific injuries. Follow these winter injury prevention tips, and you can enjoy a happy and safe winter season.