PSFCA BIG33 Football Classic

Over the weekend we were a sponsor of the PSFCA BIG33 Football Classic! We had a push-up competition at our booth, met a lot of great people, and watched a fun game of football! Thank you to all who came out and supported!

Injury Prevention for High School Athletes

Some 30 million kids play some type of organized sports in the United States. More than 10 percent of them, some 3.5 million, will experience an injury at one point or another.

There are many benefits for teens who participate in sports. These benefits are immediate and extend far into the future. Playing sports on a team or individually not only provides excellent exercise opportunities but also helps to prevent obesity and chronic health problems. Sports also teaches the concepts of teamwork, discipline, strategic thinking, and improved self-confidence.

Luckily, there are ways these injuries can be prevented. Read on to learn why injuries can impact an athlete beyond the physical consequences and what steps parents in Central PA can take to keep their teen athletes’ injuries to a minimum.

Negative Effects of Injuries

When a young athlete becomes injured, it can cause significant levels of stress and setbacks for the teenager and their support system. It may affect their family, coaches and teammates. The pressure felt by the high school athlete to perform could even prolong the impact of the injury in unexpected ways, such as:

• Time “Lost” Due to Injury: The athlete not only has to deal with the injury but could lose time at school, at practice and with their friends. It’s possible they might miss a whole season.
• Shattered Expectations: Family, coaches, and the school’s community can project a lot of their expectations upon a team’s young players. An injury will immediately put a negative tinge on these hopes and aspirations.
• Lost Scholarship Opportunities: Student-athletes seeking out athletic scholarships may have their future plans fall apart when they are injured. With everything up in the air, added stress becomes part of the healing process, which isn’t good for a teenager, especially one who is trying to heal.

Athletes can obtain additional injuries that take years to fully heal because they continue to play without letting the original injury heal properly. These injuries may lead to problems during adulthood, requiring one or more future surgeries. In many cases, arthritis becomes a problem later down the road when there isn’t proper medical treatment or healing for an extended period of time.

It is essential to seek proper medical attention immediately when a sports injury occurs. To make certain the best possible healing and recovery happens, athletes, their parents and their coaches need to follow best practices, so they can get back to playing again sooner rather than later. Your athlete should strive for high school athletic injury prevention.

The Most Common Classifications of Injuries Among High School Athletes

The most common injuries for high school athletes vary. Different types of injuries depend on several factors, including the parts of the body affected and the different sports they play. Awareness of possible injuries can help us learn how to better prevent or lessen injuries in high school athletes. The most frequent types include:

• Acute injuries
• Overuse injuries
• Catastrophic sports injuries
• Concussions
• Growth plate injuries

Let’s take a look at seven of the most prevalent injuries to high school athletes and how to prevent them.

Injury 1: ACL Damage

One type of knee injury is when damage occurs to the ACL, or the anterior cruciate ligament. Considered a severe injury, this happens mostly to football players and those who participate in other contact sports. Doctors are seeing more and more adolescents and teens with ACL injuries than they saw just two decades ago.

They note young people start sports much earlier in life while pushing themselves harder than they used to so they can stay competitive. Another cause for the rise in ACL injuries in younger athletes is they focus on just one sport, which puts their knees at high risk for injury with repeated motions.

ACL injuries concern medical experts because surgery is not an easy fix for teens. It is more difficult to repair ACLs in teens than in adults. ACL reconstructive surgery in younger people can cause unevenness in the lengths of their legs or other complications. Yet opting to skip surgical repair can result in other problems such as early arthritis symptoms.

How to Prevent ACL Damage

Strengthening the knee, hips and thighs offers one way to guard against an ACL tear. Have your teen do squats, lunges and core moves to improve strength in these areas.

Proper warm-ups before athletic activity can limber up the ACL before activity. Emphasize to your teen the importance of jogging and stretching prior to games and practices.

Finally, encourage kids to keep an awareness of their knees while playing. Watch for the knee collapsing in. Have them practice keeping the knee lined up above the foot when they jump, run or stop suddenly.

Injury 2: Runner’s Knee

Runner’s knee is a blanket term used for describing conditions that affect the knee. It occurs most among runners because of overuse. They happen in athletes who do a lot of activity that requires bending of the knee, like bicycling, skiing or jumping. Runner’s knee stems from a misaligned kneecap. When it rests off track, it causes pain because it does not slide smoothly.

Signs of runner’s knee include pain and tenderness behind the kneecap or on either side of the kneecap toward the backside and middle of the knee. Also, there may be swelling of the knee. Pain will generally present when bending the knee while walking, kneeling or running. Sitting with your knees bent for a long time can spark pain as well. If left untreated, this condition can damage knee cartilage and lead to arthritis in the knee.

How to Prevent Runner’s Knee

Teens can employ a number of different tactics to guard against runner’s knee, including:

• Strengthening the knee with exercises similar to those used to prevent an ACL tear
• Changing their running gait, which could reduce stress on the knee
• Not building up running mileage too quickly
• Taking a break from exercise when knee pain flairs

Injury 3: Concussions

These are injuries to the brain of a traumatic or mild nature, depending on the severity. Concussions happen when someone takes a hit to the head or body. The blow causes forceful movement of the brain in the skull.

Signs and symptoms of concussions are divided into four different categories:

• Physical
• Cognitive
• Emotional
• Sleep-related

A headache is the most widely reported symptom of a concussion. Another symptom of a concussion is amnesia. Symptoms of concussion can also mirror depression, anxiety and attention-deficit disorders. If a teen already has any of these disorders, a concussion can make the symptoms worse and harder to control. Teens with learning impairment issues and other cognitive delays may also show the same symptoms. This also makes treatment and management of a concussion more difficult.

Concussions can occur in all sports, but they happen most frequently in girls’ soccer, basketball and volleyball, as well as boys’ football.

How to Prevent Concussions

Here are a few tips on how to prevent concussive injuries in high school athletes:

• Choose the Right Protective Gear: Make sure your teen wears the appropriate headgear for their sport. The headgear should fit properly. Don’t forget about safety equipment when participating in non-contact sports, such as biking, skateboarding, rollerblading, snowboarding or skiing. Helmets and other headgear prevent damage from concussions. Helmets and mouth guards can reduce the risk of injury to the brain.
• Stay Aware: Helmets and head protection are the first line of defense against concussions. That said, concussions can still occur because protective headgear doesn’t stop injuries. If you hit your head, your brain can still move about and get injured by skull impact, even with a helmet on. Teach your teen to make smart choices on the field that put them in less danger of sustaining a hard blow.
• Don’t Take Chances: Tell kids to avoid dangerous play. This includes recklessness or goofing off. There are rules in sports for a reason. Learning correct technical form and building skills will make concussions and all types of injuries less likely to occur.

Injury 4: Little League Shoulder

For baseball or softball players, constant strain and stress on the shoulder from the excessive throwing of a ball causes microscopic damage to the growth plate, which results in pain and swelling. Gymnasts incur similar damage in their wrists and body as well. Repetitive training is a significant contributing factor. Little League shoulder is considered a growth plate injury.

How to Prevent Little League Shoulder

Don’t play one sport all throughout the year. Teens need at least three months away from a sport to allow microscopic damage, a.k.a. microdamage, to growth plates to heal. Changing up physical activity routines for a couple of months every year will work out other muscle groups.

Injury 5: Ankle Sprains

Sprained ankles are so common we all know at least one person who has suffered a sprain in their lifetime. Teenage athletes commonly deal with these. Ankle sprains occur when supporting ligaments of the ankle become torn or stretched past the point they’re supposed to stretch. You can get one from running on a field and inadvertently step on a pebble or in a hole. Ankle sprains fall into the category of acute injuries.

There are three types of ankle sprains. They are classified by severity of the injury:

• Grade One: This is the least severe level of injury. Ligaments stretch just slightly. The pain felt in a Grade One sprain presents with a little soreness and perhaps a small amount of swelling.
• Grade Two: The ligaments tear, but just a small part of them. This painful sprain will remain swollen. You will be hard-pressed to put weight on your foot with a Grade Two ankle sprain.
• Grade Three: The most severe sprain, Grade Three means the ligament is completely torn. This type of sprain is incredibly painful and produces formidable swelling. Attempting to put weight on this sprain will be nearly impossible because of the severity of the injury.

How to Prevent Ankle Sprains

Instruct your teen to never skip a chance to warm up and stretch. Tell them to always do this before working out or participating in competitive sports or miscellaneous physical activity.

Teach teens to look where they walk. It sounds simple enough, but it really helps to be aware of upcoming steps. Advise them to look for surfaces that aren’t level and for cracks in the sidewalk or asphalt. They should also look out for twigs and rocks. Stepping on one of these unaware can cause ankle sprains.

Make sure teens get plenty of rest off the field. Fatigue leads to sloppiness, which ups the chances of getting injured. If they are tired, remind them to add extra vigilance and look at their surrounding walking and running surfaces. If your teen has weak ankles that sprain easily, utilize braces, tape or supportive shoes for added protection.

Injury 6: Jumper’s Knee

Jumper’s knee is when the kneecap tendon becomes injured or inflamed. The kneecap’s tendon, also known in medical terms as the “patellar tendon,” connects the kneecap to the bone in the shin. This injury is an example of overuse. Overuse refers to movements that repeat over and over, causing damage to tissue in specific parts of the body.

Basketball is a frequent culprit in jumper’s knee. In basketball, the athlete lands from jumps, switching directions suddenly, and shuffling up and down the court with countless stops and starts. All these movements contribute to jumper’s knee. They place a strain on the patellar tendon. Teens who routinely participate in volleyball, gymnastics and running place a lot of stress on their knees. Jumper’s knee is considered an overuse injury.

Common symptoms of jumper’s knee include:

• Pain that occurs below the kneecap
• Knee stiffness, especially during jumps, kneeling, walking up the stairs and squatting
• Pain when bending the knee
• Pain in the thigh muscle, or quadriceps
• Weakness in the calves or legs

How to Prevent Jumper’s Knee

Stretching is the most essential preventative for jumper’s knee. Prepare a routine for your teen to warm up and stretch out their quads, calf muscles, and hamstring muscles to head off potential injury. Set aside some extra time for your teen to stretch their legs after exerting themselves as well.

Injury 7: Quadriceps Contusions

The muscles on your leg located in the front of your thighs are called quadriceps. Quadriceps assist in flexing your hip. They also help to straighten your knees every time you run or walk. Quadriceps connect to the thighbone or femur. A straight-on hit to your thigh can give the muscle a violent shove right into the bone. When this happens, the injury can be pretty painful and severe. Quadriceps contusions are categorized as acute injuries.

You can get two types of quadriceps contusions. An intramuscular contusion occurs when a muscle becomes torn inside the lining that envelops it. An intermuscular contusion occurs when a tear happens in both the muscle and the lining that surrounds said muscle.

Teens who play sports like hockey, lacrosse, football and soccer are at an elevated risk of getting quadriceps contusions due to the constant collisions that occur in these sports. Quadriceps contusions are separated into three categories:

• Grade One: These are the least painful of the three categories. There’s a little bruising, a little pain and minor tenderness. If there is any swelling, it will be minimal. Walking isn’t hindered, nor is bending of the knee.
• Grade Two: These contusions present with more pervasive bruising. There is visible swelling and most likely quite a bit of trouble moving around. If you move, you’ll probably walk with a limp. The bruised area will be tender. Knee bending will be difficult.
• Grade Three: Contusions at Grade Three will be deep. A lot of swelling and pain will let you know you’re at Grade Three. Bending the knee will be very difficult, as will walking on your own. Knee bends will be very hard, as will attempts at straightening your injured leg.

How to Prevent Quadriceps Contusions

Invest in protective equipment that fits your teen well. When playing high-risk contact sports, make sure your child wears the required padded pants.

Remember the rules. Play by the rules of any sport, and there is a lesser chance of injury.

Tell teens to keep their physical limits in mind and exert themselves within their abilities. Knowing their limitations will decrease risks of injury. This mostly applies to recreational sports like snowboarding, skiing and skateboarding.

General Tips for Preventing Common Injuries in High School Athletes

Here are a few more injury avoidance tips for young athletes who play all kinds of sports:

• Get Adequate Sleep: Teens who don’t get enough sleep are more likely to be injured while playing sports. Teens who get at least eight hours of sleep every night have a 68% lower risk of sports injury compared to those who sleep less on a regular basis.
• Take a Day Off: Taking at least one day off from sports per week is beneficial. A young athlete’s body needs this time to recover.
• Take Breaks During Practice: Taking breaks during practice and games reduces the risk of getting injured. It will also help in fending off heat-related illnesses on the field during the warmer months.
• Stay Hydrated: Drink plenty of fluids before, during and after games and practices.
• Increase and Maintain Flexibility: Before exercise, practice or games, do some stretching. A little stretching goes a long way in preventing injuries.

Watching your young athlete play can be exhilarating and joyous. If an injury does happen, it is scary to see your child get hurt on the field. For compassionate, experienced orthopedic care and advice on how to help your high school athlete deal with an injury, contact Orthopedic Institute of Pennsylvania. We have treated kids in Central PA for injuries for years, and we can help you and your family through this difficult time.

Employee Summer Picnic!

Over the weekend, we celebrated our employees with our summer picnic at the Harrisburg Senators Game! It was an evening filled with food, fun, family, and friends! Check out some of the photos from the event!

PennLive High School Sports Award Banquet

Dr. Brown – Good Day PA

Dr. Amy Brown was featured on Good Day PA, May 24,2018 to discuss rotator cuff injuries and treatments. Check out the segment below:

https://www.dropbox.com/s/8bf1xnbnkznv96b/052418ortho.mp4?dl=0

Or visit http://www.gooddaypa.com/ to learn more!

Spine Surgery with Dr. Fernandez

We caught up with Dr. Fernandez who specializes in spine surgery and has a focus on traditional and minimally invasive techniques. Read on to learn more about what Dr. Fernandez does, and what he believes is important when it comes to treatment of spinal injuries and spinal surgery.

Dr. Fernandez attended Saint Joseph’s University before earning his medical degree at Penn State College of Medicine. He completed his general surgery internship and orthopedic residency at Penn State Milton S. Hershey Medical Center and participated in the Orthopedic and Neurosurgery Spine Fellowship at The University of Utah. While in Utah, Dr. Fernandez was appointed as a staff spine surgeon at the Salt Lake City Veterans Administration Hospital. He joined OIP in 2009.

Dr. Fernandez encompasses a holistic approach first focusing on conservative treatments when appropriate prior to recommending surgical intervention. These may include physical therapy, chiropractic care, pain management, or nutritional and weight loss programs. Dr. Fernandez focuses on creating a treatment plan that is individualized to the needs, goals, and symptoms of the patient.

            The most common presentation of injuries that Dr. Fernandez sees are those from normal wear and tear from everyday activities. Issues can result from working, playing sports, or even weeding the garden. It is common for overuse injuries to occur as well. Overuse can lead to repetitive micro trauma of the vertebrae, the intervertebral discs, or the spinal canal and can contribute to pain and increased functional limitations. In these cases, a surgery could be recommended. Dr. Fernandez is also skilled in treating trauma, tumors, and scoliosis some of which may warrant a surgery.

            If surgery is performed, Dr. Fernandez recommends approaches of recovery that best fit the patient’s needs. These often include rehabilitation, physical therapy, and regular follow up visits in the office. Dr. Fernandez encourages proper follow-up after a surgical procedure in order to ensure a healthy and safe recovery. Dr. Fernandez happily accepts all patients, and works out of several of our OIP locations.

If you, or someone you know may be considering options when it comes to a spinal injury, you can contact OIP at (717) 761-5530 to schedule an appointment with Dr. Fernandez.

Preventing Spring Yard Work Injuries

Spring is a time of energy, rejuvenation and budding life — yet also of accidents and injuries, especially in your own yard. In the U.S. alone, one person is injured from an accidental event roughly every second. Come springtime, these common yard work injuries take many forms. From slips or falls to strains, slashes, cuts and burns, nearly all spring yard work injuries are preventable.

Accidents happen, even among the most cautious individuals. If spring yard work accidents are the malady we all wish to avoid, then safety and forethought are the antidotes.

With a little prudence and a lot of care, you can ensure avoiding yard work injuries throughout the spring and beyond with these tips and tools.

Common Yard Work Injuries in Spring

We understand. After being cooped up indoors through long, listless winter months, you can’t help but plan and prep for a new, thriving lawn and garden come spring. You also may be ready to do exterior work on your home itself, from the ornamental and decorative to functional repairs or much-needed makeovers.

Yet folks are most prone to accidents when they rush or underestimate the thoroughness of their yard-work tasks. Ensure you don’t fall prey to the following standard springtime injuries, ranging from the inconvenient to the severe and everything in between.

Common Yard Work Injury: Straining or Pulling Muscles

When it comes to yard work, there are few injuries as prevalent as strained or pulled muscles. Strained muscles don’t discriminate. They affect people of all ages, fitness levels and physical builds, often striking inflexible or improperly stretched muscles groups that displayed no prior signs of rigidity.

For spring yard work, consider all the tasks that require bending, pulling and shifting body positions. From digging new garden beds to clearing and raking debris to pulling weeds to pushing heavy lawnmowers, strained and pulled muscles can occur across the gamut of yard work activities.

The lower and upper back, as well as shoulders and hips, are the most prone to pulls and strains. Shoulder pain or hands shaking after mowing your lawn is common, but listen to your body as you work. Never overexert yourself or rush to get yard work done at the expense of your health.

Common Yard Work Injury: Ladder or Roof Falls

Spring yard or housework often means pulling out the ladder. Correctly using a ladder to clean gutters or prune dead or diseased tree limbs will not only ensure the smooth accomplishment of yard projects but also keep them injury free.

After all, more than 164,000 people are injured from falling off a ladder, with an accompanying and pricey emergency room visit promptly following. Ladder injuries can cause mild to serious problems, such as bruises and broken bones or concussions and spinal damage.

Many people conduct roof work once spring’s warm weather arrives. Whether the job includes clearing debris after a storm or conducting a roofing material maintenance check-up, roofs can be cumbersome to maneuver around for even short periods of time.

Ladder and roof falls are most prevalent when ladders are set up improperly, propped on uneven ground or placed in unstable environments. What’s more, using old or ill-maintained ladders without proper safety features and extensions further encourages an accident to occur. Keep young children out of a fixed ladder’s reach as well so no climbing and goofing around can happen, even on the most secure-seeming ladders.

Common Yard Work Injury: Lawnmower Burns or Cuts

It’s a satisfying feeling to get outside and rev up the lawnmower after winter has kept it dormant. Growing that dream green lawn is a pivotal piece of spring yard work and something many people look forward to undertaking. Few operations stand as crucial in this process as mowing and trimming fresh and healthy grass.

Yet lawnmowers present a range of safety hazards, especially right after their winter hibernation. Engines are prone to stalling due to:

• Improper, stale fuel
• Rusted spark plugs
• Damaged carburetors

What’s more, a lawnmower’s blades are likely to be dull and offset from lack of care in the offseason.

Reviewing and addressing these concerns has been known to cause many injuries, from cuts when sharpening lawnmower blades to amputating toes and fingers. Ricocheting debris is another primary lawnmower injury concern. When using a lawnmower in early spring, yards are often littered with rocks, clumps and other materials that momentarily jam a lawnmower, only to shoot out unexpectedly.

Lawnmower engines and exhaust can also reach surprisingly high temperatures. A recently used lawnmower will need time to rest and cool and should not be touched. Furthermore, if you run out of fuel while using a lawnmower, give the machine a proper rest period before you add any new gasoline to the tank to avoid burns and fires.

Common Yard Work Injury: Tractor Woes

From compact utility tractors to large agricultural units, tractors are another common source of yard work injuries. They’re similar to lawnmowers in that many overlook basic safety and maintenance elements, mainly for personal units used to maintain private, residential acres.

Tractor injuries include muscle strains, bruises, bone fractures and breaks due to rollovers, collisions or attempting to fix entangled parts. Rollovers account for the majority of tractor-related injuries, occuring when tractors are driven in hazardous weather conditions or maneuvered across uneven terrain.

When tractor gears, pulleys, chains and other mechanical systems become locked or entangled, many are tempted to solve the problem immediately, whether or not the proper tools and safety gear are available. Hands and fingers can quickly get caught in jerky systems or trapped inside machine parts, leading to further critical injuries.

Common Yard Work Injury: Hedge Clipper Cuts and Slices

Trimming and pruning landscaping is another spring yard necessity. Yet hedge clippers themselves can be sharp and heavy objects with a number of safety concerns during spring use.

From manual clippers to more contemporary battery-powered tools, yards with large bushes and hedges often require a hedge-clipping routine. Cuts and lacerations usually take place when mishandling or losing control over a clipper. This is especially common with older, rusty or poorly maintained trimmers without smooth, even applications or designs that are clunky to handle. Young children are especially prone to clipper cuts, unfamiliar with the tool and its proper handling.

In the most extreme cases, fingers and toes can be severely sliced or even amputated in the event of a hedge trimmer injury. People have lost control over electric or battery-powered clippers and subsequently dropped their tools onto limbs. Still others have been injured due to a device or manufacturing glitch causing the tool to run uncontrollably.

Common Yard Work Injury: Chainsaw Issues

Like hedge clippers, chainsaws are a necessity for yards and landscapes with heavy bramble, thick, woody shrubs and dense treelines. They can also be hefty to operate and dangerous in negligent hands, needing maintenance care and attention to run accurately and minimize the risk of injuries.

In lucky cases, chainsaw-related injuries include muscle cramps from handling the tool too long, as well as strains and spasms that result from chainsaw’s vigorous vibrations. Chainsaws come in various sizes and power levels, and not using the appropriate one for the job is a sure way to set yourself up for this kind of muscle strain.

In severe cases, individuals lose control of chainsaws and risk grave bodily harm. Chainsaws should always remain out of reach from pets and children whether in use or not, plus securely stored when off.

Common Yard Work Injury: Insect Stings

Spring brings out new flowers, grasses and plantings — but it also brings out the bugs. While the vast majority of insect life hanging out in your yard is harmless — if not beneficial — stings and bites are common springtime ailments that can lead to more severe complications.

Note how your body reacts to various insect and bug stings, such as painful and swollen muscles or allergic reactions. The most common spring-insect stings come from:

• Bees
• Wasps
• Hornets

Ant bites are also standard, as are budding mosquito and fly populations.

Doing yard work can inadvertently bring you into direct contact with insect homes and hives. As with everything on this list, use caution when working with insects to avoid any significant harm — to yourself and your beloved yard.

Spring Yard Work Safety Tips

Avoiding yard work injuries is as much about patience and proactivity as it is common sense. The surest way to prevent injuries when working outside this spring is to take your time with any planned or pop-up projects. Take inventory of tools and equipment. Survey the condition of all manual or battery-powered devices you plan to use, and conduct maintenance on them beforehand. Set up a proper, contained workspace and only go outside in good weather conditions.

Most importantly, listen to your body. Fatigue and pains are not signs of weakness or project inconveniences but direct messages from your nerves to lighten it up just a little. You can further prevent yard work injuries by following these safety tips and procedures.

Wear Proper Yard Work Gear

Regardless of the outdoor activity or thr project you plan to take on, you must wear the appropriate safety gear. Not doing so significantly increases your likelihood of injury, especially with do-it-yourself yard projects.

In fact, experts often see injuries occur as a direct result of people assuming protective gear wasn’t necessary for their “small” outdoor tasks. Those injured cite the fact they don’t see others around them wearing safety or protective clothing, from next-door neighbors to on popular renovation TV shows. In avoiding yard work injuries, make sure to slip on the following gear the next time you’re outside.

• Closed-Toe Shoes. Sandals and flip-flops are notoriously poor choices for yard work. Wearing closed-toe shoes is especially keen when doing activities like mowing the lawn or climbing ladders, as they’re far less likely to slide and shift and have your foot pop out.
• Slip-Resistant Footwear. Take the extra step and buy slip-resistant workboots or shoes. This specialty footwear comes designed with adhesive outsoles and tripguard ridging for the safest possible design. Some brands even carry OSHA-approved safety stamps that are industry leaders for ladder-climbing and rooftop work.
• Long Pants. Wearing long pants seems obvious, but it’s a common oversight on a warm spring work day. Shorts simply won’t protect you from cuts, scrapes and ricocheting debris.
• Gloves. Wear gloves during yard work as a final protective layer. You can choose from rubber or leather, insulated and Kevlar-reinforced. Since your hands are likely doing most of the work, make sure you have them covered.

Read Machine Manuals

Another obvious yet overlooked safety procedure? Reading the manual for all tools and equipment required for your yard work. They may not be page turners, but manuals are essential to know the operational and caretaking ins and outs of yard tools.

You can even brush up on machine manuals in the offseason. That way, once spring arrives, you can dive into your residential projects and save yourself time without skirting any safety precautions.

Use Ergonomic Tools Whenever Possible

Ergonomic tools are designed to be as comfortable and user-friendly as possible. When handled correctly, they significantly decrease the forces on your body that come with operating electrical power tools.

Other bodily risk factors ergonomics account for include:

• Healthier posture when using tools
• Less wear from repetitive and high-force motions
• Lowering the impact of a device on your body
• Any hand-arm vibrations

Altogether, you can’t beat the engineering of ergonomic tools to prevent injuries and keep you feeling great.

Maintain Proper Ladder Safety

Ladder safety is paramount to prevent dangerous falls. Luckily, there are a number of assessments you can enact on your household ladder to guarantee it’s up for yard work:

• Check all ladder safety features and devices for quality and condition.
• Wipe excess moisture or dirt off all ladder rungs before using.
• Only place ladders on smooth, uniform ground surfaces.
• Incline your ladder at appropriate, safe angles, be it a single or extension ladder.
• Do not attempt to move or shift the ladder while you or anyone else is on it.

In addition, only use a ladder during temperate weather, ideally during the day or in a well-lit night workspace. Employ ladders meant for the specific job type on hand, and don’t overextend your ladder’s height by propping it on any objects.

Last but not least, always use the three-points-of-contact rule. That is, keep three points of bodily contact on the ladder at all times, whether that’s two hands and one foot or two feet and one hand.

Take Breaks

There’s no need to strain yourself working out in the yard. Doing so will not only court physical injuries, like knee, wrist or back pain, but also result in mental strain and fatigue, as well. Plus, you’re far less likely to do quality work in your yard if rushed or stressed for time or generally feeling poorly.

Hot or humid spring days, in particular, mean slowing down and planning ahead. It’s your space, and at the end of the day, you’re the boss. Take care not to push yourself to the point of injury.

Stretch Before and After Yard Work

Long hours weeding and planting garden beds or pushing heavy mowers will take their toll on muscles and joints. The simplest solution? Stretch before heading out and right after you’ve wrapped up.

Stretching does wonders for the body, including preparing it for the movements done while working in the yard and cooling it down once finished. Take care not to stretch for too long, though. Prolonged static stretches, such as those exceeding 60 seconds, can actually pull muscles and increase the likelihood of contractions, strains and tears.

Opt for three rounds of 20-second stretches targeting one or two muscle groups at a time, such as hamstrings, shoulders, hips and the lower back. Increase circulation and loosen hands, wrists and legs by shaking them out leisurely before and periodically during yard work.

What To Do in the Event of an Injury

Even with proper care and preparation, injuries happen. Don’t let additional problems compound by ignoring or neglecting pains, cuts or aches if they occur, and never be afraid to consult with an expert if physical ailments continue.

Stop Working After a Yard Injury

To prevent minor injuries from becoming major ones, hit pause on yard work as soon as you experience any impairment. Assess the situation for immediate pains and swelling. Take care of the most pressing concern first, such as open cuts from yard tools or blades.

If possible, try to avoid doing yard work when home alone. Having someone else around ensures immediate help is available in the event of an injury.

Apply Ice to Your Yard Injury

Have an ice or cold pack read in the freezer to apply to any swollen or affected areas. Keep the ice pack on hand for the next 48-72 hours, icing inflammation for no longer than 20-minute periods. Reuse the pack at multiple intervals throughout the day.

Clean and Bandage Wounds Incurred in the Yard

If experiencing open cuts or nicks that are bleeding, thoroughly clean the wound and wrap in a bandage. Swap out old for new dressings roughly every 24 hours.

Seek Pain Relief for Your Yard Work

If necessary, take mild pain-relief medications like ibuprofen or aspirin. Follow all label instructions and keep stored in a cool, dry but readily accessible place.

Orthopedic Solutions for Spring Yard Work Injuries

For pain relief and care that goes beyond what you can achieve on your own, consider orthopedic services after a spring yard injury. Utilizing these specialty services post-injury will not only encourage a smoother recovery — they guarantee holistic treatment while delivering peace of mind. Consider using our orthopedic specialists’ resources for preventing a spring yard work injury.

Professional Expertise

Consulting with an orthopedic medical profession will ensure the right diagnosis and treatment for any physical injury, big or small. There are nearly a dozen orthopedic subspecialties as well, meaning whatever area of your body has sustained an injury will be matched with an expert in that field. Ultimately, you get the right health and wellness decision to put your mind — and body — at ease.

Physical Therapy

For more severe injuries, physical therapy is a helpful consideration. Both short and long-term physical therapy options exist. Your orthopedic doctor and physical therapists can package individualized treatments to target your health needs, from restrengthening soft tissue to joint mobilization.

Medical Acupuncture

Medical acupuncture has a long and scientifically accredited history for pain relief and management. It is a safe and effective procedure that promotes your body’s own natural healing processes, synthesizing eastern and western medical traditions. Many orthopedic practices have medical acupuncture services you can look into, especially if experiencing long-term pain well after a yard work injury.

Cortisone or PRP Injections

For severe, recurring pain or inflammation that’s affected the quality of your daily life, orthopedic doctors may suggest cortisone injections or other targeted spot treatments, such as platelet-rich plasma (PRP).

These injections encourage a direct and rapid alternative treatment for physically injuries and chronic pain. They’re often an option when other treatments aren’t seeing the desired, effective results, or the pain you experience from an injury is fundamentally affecting the way you live your life.

Interventional Pain Management and Care

The most serious orthopedic care might blend treatment styles. After a severe yard-related injury — such as a bad fall or torn rotator cuff — you may need a combination of conservative and advanced treatments to not only manage but address and heal lasting damage.

Visit the Orthopedic Experts Across Central Pennsylvania for Your Yard Injury

When it comes to addressing, managing and healing yard work-related injuries, you don’t have to look far. The Orthopedic Institute of Pennsylvania (OIP) has eight locations throughout Central Pennsylvania to bring the quality care and knowledge you need in the event of an injury.

We know the toll pain can take on your life. We also know you don’t have to live with it. With over 40 board-certified orthopedics and physicians assistants in our network, we give you the expertise, specialization and attention your injury requires.

View our orthopedic providers today, and learn more about the complete musculoskeletal system services offered at OIP.

Should I Visit an Urgent Care Center or an Emergency Room?

-Differences in Wait Times
-Differences in Costs
-When You Should Go to the ER

You may recall a time in your life where you woke up in the morning with a sore throat. You couldn’t afford to take time off work, so you forced yourself to make it through the day. After work, your symptoms got worse. You developed a fever and felt run-down. Your primary doctor’s office was already closed, and you wondered if you should go to an urgent care center or stay home. Part of you was worried you had a serious illness that might require emergency care.

Or, perhaps there was a time when you stubbed your big toe on an end table. You were pretty sure you had broken your toe, but you weren’t sure if you needed medical attention right away, or at all.

Sometimes it can be difficult to tell if an illness or injury requires a trip to the emergency room. You may not live close to an ER or have the funds to cover the cost of hospital medical bills. How do know if your injury requires emergency care, or if an urgent care clinic would suffice?

Lots of Americans visit the emergency room every year, and often unnecessarily. In 2014, 141.4 million Americans went to the emergency room, 1.8 million were admitted to critical care and 7.9 percent of the visits resulted in hospital admission, according to the Centers for Disease Control and Prevention (CDC). At least30 percent of emergency department visits in the U.S. are non-urgent.

As you’ll see, it is not always necessary to rush to an emergency room after an injury or while experiencing illness. However, sometimes a trip to the ER is a smart move, and it’s important to know the difference.

To help you determine if an illness or injury requires emergency medical attention, we will look at the signs of a serious medical condition or injury. We will also explore the differences between urgent care centers and emergency rooms regarding cost and wait times to help you figure out if an ER trip is ultimately worth the time and money.

What’s the Difference Between an Urgent Care Center and an Emergency Room?

The idea of urgent care centers came to fruition in the 1970s when physicians began opening practices to suit patients with non-emergency, but pressing medical matters. Critical care practices allowed patients to seek medical care outside of regular doctor’s office hours. There are currently more than 7500 urgent care centers in the United States.

Emergency care is a bit older than urgent care. While there have been methods to provide emergency care since the earliest days of medicine, emergency medicine did not become a specialty until the 1960s. Before the 60s, emergency care patients were seen by whoever was available. This means someone who needed to meet with a specialist would have been seen by any physician regardless of their medical background.

Developments in medical knowledge and technology helped medical professionals recognize a need for specialized emergency care. In 2012 there were 3930 emergency departments in the U.S., and in 2017 there were 34,816 emergency physicians certified by the American Board of Emergency Medicine (ABEM).

In general, if your injury or illness is not life-threatening, you can save time and money by visiting an urgent care center. However, if you’re experiencing symptoms of a life-threatening condition like a stroke or heart attack, you do not want to waste any time. Call 911 or head straight to the nearest emergency room. In general, these two facilities differ for three significant reasons: services, wait times and cost.

1. Urgent Care Services vs. ER

An urgent care center is a medical facility that usually offers evening and weekend hours. Many patients visit an urgent care clinic for convenience, and appointments are not necessary. Some may stop in at an urgent care clinic if their regular family doctor is not available. Urgent care is an excellent option for patients who need non-emergency medical attention outside of their regular physician’s office hours.

At an urgent care center, services are provided under the direction of an allopathic or osteopathic physician. Both allopathic and osteopathic physicians are fully trained in diagnosing and treating illnesses and disorders. Both can also prescribe medication, perform surgery and practice specialties. However, osteopathic doctors receive specialized training in areas such as osteopathic manipulative treatment (OMT), and they may emphasize preventive care.

How do you know if you should go to an urgent care center or wait to see your regular doctor? If you need immediate treatment for an illness or injury that is not life-threatening, you should consider visiting your nearest urgent care center. Most urgent care centers are open seven days a week, including holidays, between 8 a.m. and 9 p.m. Some centers may close earlier on weekends, however.

Whether you need to visit an urgent care center depends on your symptoms and the severity of your condition. Here are common illnesses and injuries that likely do not require an ER visit, but should be treated by a physician, as they could lead to complications if left untreated:

• Flu, cold or allergy symptoms
• Ear, eye or sinus infections or pain
• Insect bites
• Bronchitis
• Sprains or broken bones of the wrist, hand, ankle or foot
• A sore throat
• Minor cuts or burns
• Vomiting
• Diarrhea
• Nausea
• Asthma
• Minor back pain
• Urinary tract infections
• Minor allergic reactions
• A slight headache
• Any infection

Services commonly offered by urgent care centers include:

• X-rays
• Simple lab tests
• Stitching for minor cuts
• Treatments for infections, cold and flu
• Casting
• Physicals
• Employment drug-testing
• Pain management medication
• Vaccinations

If you or your loved one are experiencing life-threatening symptoms or have been in an accident, do not waste time going to an urgent care center. Instead, call 911 and get to an emergency room immediately. Unlike urgent care centers, emergency departments have almost everything they need to diagnose and treat any illness or injury. The job of an emergency department is to save lives.

Emergency rooms are open 24 hours a day, seven days a week. It is a smart idea to go to the emergency room if you are experiencing any of the following:

• High fever that medicine cannot bring down
• Injury to neck or spine
• Poisoning
• Head injury
• Major burns
• Heart attack
• Seizures
• Stroke
• Broken bones that have punctured the skin
• Paralysis
• Severe pain anywhere in the body
• Any severe injury
• Unconsciousness
• Deep wounds
• Coughing or vomiting blood
• Major allergic reactions
• Uncontrollable vomiting or diarrhea
• Drug or alcohol overdose
• Suicidal thoughts
• Electrical shock
• Bleeding that will not stop

In the ER, you can expect access to the following diagnostic tools and treatments, some of which are not available in urgent care clinics or your primary doctor’s office:

• MRIs
• CT scans
• Operating rooms
• Ultrasounds
• Labwork
• X-rays
• Treatments and medication
• Orthopedic equipment
• Cardiac monitoring
• Anesthesia

Depending on your health concern and treatment procedure, you might also have to stay overnight in a hospital — you likely will not find beds in an urgent care clinic. Many emergency departments also have physicians with various backgrounds and specialties on-staff at all times, unlike urgent care centers.

Of course, there is always an exception to the rules. Some patients may visit an ER in the middle of the night when urgent care centers are closed even if they are not experiencing severe symptoms. Although you are free to visit the emergency room whenever you wish, realize emergency room visits are very costly, and your insurance may not cover the care you receive — especially if it is not an actual emergency. If you are uncertain about what to do, never hesitate to call your healthcare provider and ask questions.

2. Urgent Care Wait Times vs. ER

Wait times in emergency rooms and urgent care centers can vary greatly depending on many circumstances. Generally, if you go to an urgent care center, you will be seen quicker than if you went to an emergency room. According to a 2015 survey conducted by the Urgent Care Association of America, the average urgent care wait time is 30 minutes or less, and most patients were treated in 60 minutes or less.

On the contrary, emergency rooms take care of patients with the most life-threatening conditions first. So, if you go to the ER with only a sore throat, it may be a long time before you are back home in bed.

When a patient arrives in the ER, a triage nurse evaluates the severity of their condition. Those who are severely ill or injured are the priority in an emergency room, and patients with mild or minor ailments are left to wait.Treatment times are also longer for patients in emergency rooms. According to the CDC,thefive triage levels are as follows:

1. Immediate
2. Emergent
3. Urgent
4. Semi-urgent
5. Nonurgent

The CDC also reported the time difference for different triage levels. For example, those considered to be in need of immediate care were to be seen in less than a minute, whereas as semi-urgent patients were triaged as needing to be seen within one to two hours. Nonurgent patients were triaged to be seen between two and 24 hours — thus one of the reasons to avoid the ER for the common cold.

Between 2010 and 2011, the average wait time in the emergency room was 30 minutes, and treatment time was 90 minutes or longer. For those in need of immediate attention, the median wait time was 12 minutes. However, if your condition would worsen while waiting in the ER, do not hesitate to speak to the hospital staff and let your situation be known.

Where you live affects wait times, too. In 2009, the CDC found that the average wait time in urban areas was 62.4 minutes. Outside of metropolitan areas, the average wait time was 40 minutes.

As you can see, if your illness or injury is not life-threatening, you could save a lot of time by visiting an urgent care clinic instead of going to the ER. However, sometimes unfortunate events happen, and your health is not something you ever want to risk. If you have any doubt in your mind about the severity of your or your loved one’s condition, it might be best to play it safe and head to the ER. If there’s time, you can also call a nurse and ask for a professional opinion.

3. Urgent Care Cost vs. ER

An emergency room visit is considerably more expensive than a trip to an urgent care center. Most urgent care centers accept insurance and cost around the same as a visit to a primary care doctor. The average price for a trip to an urgent care center is around $150. By contrast, the average cost for an emergency room visit ranges from $300 to $500. Depending on your condition, emergency room medical bills can easily surpass $1000.

A study published in 2013 found that out of 76.6 million emergency department visits, charges for an upper respiratory infection ranged from $740 to $3347. The median expense for all standard conditions such as sprains, back problems and urinary tract infections was $1233 in the ER.

Consider how Medica, a health plan company, calculated costs based on claims made to the Medica Choice Network. Here are the differences they found between urgent care centers and emergency rooms:

• Allergies: $200 for urgent care and $733 in the ER

• Acute Bronchitis:$242 for urgent care and $1074 in the ER

• Earache: $229 for urgent care and $779 in the ER

• Pink Eye:$184 for urgent care and $621 in the ER

• Strep Throat:$231 for urgent care and $1043 in the ER

Many non-life-threatening illnesses, like an upper respiratory infection, for example, can be treated at an urgent care center. Why pay for emergency care if you don’t need it? However, if you are struggling to breathe, you may need emergency attention. Theurgent care center staff will send you to the emergency room if needed.

The downside to going to an urgent care center first when you should be going to the ER is that you lose precious time between trips. Sometimes, depending on the severity of an illness or injury, time is far more important than money.

Why are emergency rooms so expensive? It is the price a patient pays for 24/7 care and emergency equipment on-hand.Also, depending on your insurance plan, a trip to the ER may or may not be covered entirely — another reason to weigh the pros and cons in non-life-threatening situations.

How Do You Know When to Go to the ER?

We covered a lot of factors to consider when deciding whether you should go to an urgent care center or an emergency room. Keep in mind that if you or a loved one are experiencing life-threatening symptoms, you should not hesitate to get emergency medical attention immediately.

Some symptoms, like prolonged vomiting, might not seem like a life-threatening symptom but could lead to serious complications, like dehydration. Know what to look out for and when to recognize a medical emergency. Signs of a medical emergency include:

• Uncontrollable bleeding
• Difficulty breathing
• Chest pain
• Choking
• Coughing or vomiting blood
• Loss of consciousness
• Sudden severe pain
• Severe vomiting
• A broken bone that pierces through the skin

The following conditions are common causes of death or health complications and require immediate attention. If you suspect any of the following, do not wait and get to an ER:

• Heart Attack:About 735,000 Americans suffer a heart attack every year, according to the CDC. With a heart attack, it’s important not to ignore the early warning signs of chest pain or discomfort, pain in the arms, jaw or back, shortness of breath, cold sweats and nausea. Although you can experience chest pain for various other reasons, consider the risk factors. If you have high blood pressure, high cholesterol and if you smoke, you don’t want to take a chance with chest pain.

• Stroke:More than 795,000 Americans have a stroke every year. High blood pressure, high cholesterol, diabetes, obesity and smoking are the leading risk factors. The primary signs of a stroke include numbness in the face or limbs, sudden confusion or trouble speaking, sudden severe headache, and difficulty seeing and walking.

• Dehydration:Mostly a concern for young children and the elderly, dehydration can occur if a person cannot keep down fluids or has had severe diarrhea or vomiting for hours. Dehydration requires immediate attention because fluids are needed for your body to carry out routine functions. Symptoms in young children include dry mouth and no tears when crying. Adults may experience dark-colored urine, fatigue, confusion and extreme thirst. Remember, dehydration can happen to anyone.

• Severe Head Injury:Loss of consciousness, persistent headaches or a headache that worsens, repeated vomiting or nausea, convulsions, loss of coordination, inability to wake from sleep, slurred speech and severe confusion are all symptoms of a traumatic brain injury. Brain injuries may result from a fall, car accident, violence or a sports injury. A severe injury could lead to a coma or brain death, so it’s vital to get emergency care.

Still not sure when to go to the ER? Ask yourself if your condition is fatal. If the answer is yes, go to the ER. If your situation is not severe enough to warrant immediate medical attention but still requires prompt care, visit an urgent care clinic. If your condition is mild enough to wait a day or two, schedule an appointment with your primary care doctor. Your primary care doctor has your medical information on file and will keep a record of your visits, unlike an urgent care center.

Walk-Ins Welcome at OIP

If you live in central Pennsylvania and have experienced an orthopedic injury such a strain, sprain, fracture or dislocation, stop in at the Orthopedic Institute of Pennsylvania (OIP) today. There is no need to take your orthopedic injury to the ER when you can go to OIP and receive the highest-quality emergency orthopedic care.

As the region’s first orthopedic injury clinic, we are here to help you — no appointment needed. Our knowledgeable, compassionate team is ready to diagnose and treat your injury, saving you the time and expense of going to the ER. At OIP you can expect:

• A shorter wait time than the ER
• A visit with an orthopedic specialist if needed
• Typically lower copays than the ER
• Comprehensive care on-site from X-ray diagnostics to cast application
• Lowest-cost orthopedic emergency care in central PA

We commonly treat:

• Hamstring pulls
• Ligament injuries
• Tailbone injuries
• Shoulder or knee dislocation
• Fractures or broken bones

How do you know what type of injury you have? First, let’s look at strains and sprains.

A sprain is a ligament tear or stretch, and a strain is a muscle or tendon tear or stretch. Ligaments connect bones to bones at the joints, while tendons connect bones to muscle.A sprain might occur when a person twists or falls— ankle sprains are the most common type.

Strains are commonly experienced by athletes who do the same motion repetitively like lifting weights or playing tennis. Both sprains and strains show the following symptoms:

• Inflammation
• Pain
• Bruising

Broken bones or fractures occur when too much force is applied to them. Car accidents or hard hits by any object can cause a broken bone. Broken bones are very painful and include symptoms such as:

• Swelling or bruising over the bone
• Deformity
• Pain that gets worse when moved or pressure is applied
• Inability to use the fractured area

A dislocated shoulder or knee may result from a sports injury, fall or accident and is when the bone pops out of the joint. You might experience:

• Visible deformity
• Swelling or bruising
• Severe pain
• Inability to move the dislocated area

Visit or Contact OIP for Your Orthopedic Injury

If you suffered an orthopedic injury, do not hesitate to reach out to OIP for immediate care. We participate with many conventional healthcare providers and accept various payment methods to ensure exceptional care is within your reach. We have three urgent care locations in the Harrisburg region to make urgent orthopedic care as convenient for our central PA patients as possible.

With a longstanding reputation for excellence and a healthcare team who cares, our patients know they can depend on us for the help they need. Contact OIP today for more information, or stop in at one of our locations for urgent assistance. Need orthopedic advice beyond office hours? Call 855-OUCH-OIP.

Employee of the Week: Cherie Bartles

OIP has decided to recognize some of our longest working employees. Without these incredible employees we would not be who we are today.

This week we would like to recognize Cherie Bartles for her amazing contributions to OIP! She currently serves as Patient Support Team Supervisor for OIP. Here she is pictured with Dr. Richard Patterson and his wife, Mary Eleanor. We caught up with Cherie and were able to conduct a Q&A session with her.

Q&A with Cherie:

• What has been the most rewarding part of working at OIP?

“Helping patients during my years as a medical assistant with Dr. Richard Patterson and Dr. Alexander Kalenak.”

• What was it like working at OIP 40+ years ago?

“I felt really young! LOL. I liked the small, more personal practice. At the time I started, it was much more relaxed and less stressful.”

• What have been your favorite changes at OIP in the last 40+ years?

“Change is good and we need this as we grow, both personally and professionally. I can’t say I have favorite changes. I just have watched this practice grow and grow and I am proud to be a part of that process.”

• What makes for a great day at work?

“In my role as a supervisor on the administrative team, I have to say it makes me happy to be able to make a difference and make my employees happy, as well, if at all possible.”

• What is your favorite vacation spot? Why?

“St John, VI because it is so peaceful and beautiful.”

• Who has been the most influential person in your life?

“In my personal life, my mother. I miss her so much, especially when I need someone to help me sort things out. In my professional life, Dr. Richard Patterson pictured here with his wife, Mary Eleanor and, of course, me! They are both very dear friends of mine to this day.” 

Swimming Injuries

Whether you are a competitive swimmer, or someone who swims for leisure, injuries can occur at any stage. With elite swimmers training more than five miles per day, it is likely that a competitive swimmer will experience some type of injury throughout their career. It is common that injuries can come from overuse, or anything that involves the shoulder.

Below are some of the most common injuries involved with swimming. You can find descriptions to each, so you know what it is, and what symptoms to look for if you have an injury.

• Irritation and inflammation in the shoulders: also known as shoulder bursitis. A bursitis is inflammation of a bursa. Injury or inflammation of a bursa around the shoulder joint causes shoulder bursitis.
  • Symptoms include: swelling, tenderness and pain with motion of the tissues in the affected area
• Rotator Cuff tendonitis or tears: a rotator cuff tear is a tear in the tissues connecting muscle to bone (tendons) around the shoulder joint. If you have tendinitis, it means that your tendons are inflamed or irritated.
  • Symptoms include: shoulder pain and weakness
• Shoulder impingement syndrome, is caused by inflammation from repetitive shoulder activities. Injury and aging are other causes.
  • Pain may be consistent and increase with lifting or reaching movements
• Tears in the Cartilage around the shoulder socket: also known as labral tear of the shoulder. The labrum is a piece of fibrocartilage (rubbery tissue) attached to the rim of the shoulder socket that helps keep the ball of the joint in place. When this cartilage is torn, it is called a labral tear.
  • Symptoms include: a catching or locking feeling when you move your shoulder, pain during daily activities and the shoulder may feel unstable.
• Neck and low back pain: this can be caused by repetitive stress. If you fail to roll your body as a whole unit while swimming can create torsional strain at the point where the lumbar spine meets your pelvis.
• Knee injuries due to breaststroker’s knee: Breaststroker’s knee can come from the tension that increases during the kicking phase, from the force generated on the inside of the knee which can cause problems to the Medial Collateral Ligament.

Other injuries that aren’t as common, but still happen from time to time include concussions and neck injuries. If you don’t pay careful attention to your surroundings while swimming, head collisions with other swimmers can lead to these injuries.

In order to prevent/ treat injuries as best as possible, you can follow these guides:

• Communicate that you have an injury with your coaches/ parents before it gets worst
• Practice good techniques in order to avoid tears
• Don’t continue to do strokes that are causing you pain
• Strengthen your core
• Do alternative training such as; kicking with shoulder pain, or pulling with lower body pain
• Take time to rest and recover when necessary
• Consult your doctor, trainers, etc. before going back to training

If you are an active swimmer, it is best to follow these recommendations in order to prevent an injury. If you feel that you have experienced or are experiencing any of these problems, please contact OIP so we can set you up with a provider to take care of your needs!