Certain types of orthopedic surgery carry with them the risk of developing a blood clot in the post-operative period. Blood clots such as deep vein thrombosis (DVT) or pulmonary embolism (PE) can be life threatening. A pulmonary embolism usually happens when a DVT, often in your leg, travels to your lungs and blocks a blood vessel. This can lead to a decreased amount of oxygen circulating in the blood, it can cause lung damage and even lead to heart failure. Preventing the risk for the development of DVT or PE is imperative after surgery. Common orthopedic procedures such as total knee replacement, total hip replacement, and hip fracture surgery carry a greater risk of DVT/PE than other orthopedic procedures. Because of this, your physician will likely prescribe a pharmacologic agent to prevent the development of a blood clot after surgery. Along with pharmaceuticals, mechanical devices are also used during orthopedic surgeries. Studies have shown that these are beneficial when used as an adjunct to anticoagulation therapy with medications. During and immediately after surgery, compression stockings and pneumatic compression devices are used. Often, our physicians will recommend patients continue wearing the compression stockings for a few weeks after surgery as well. […]
In my 5 years as a physician assistant (PA), I have often been asked when I am going on to finish my schooling to become a physician. Time and time again, I have had to explain to family, friends and patients that a physician assistant is not a stepping stone to becoming a physician; it is the end-goal for those of us who chose this rewarding, challenging and fulfilling career. The physician assistant profession is growing, and PAs are a big part of the intricate health care team. Most patients are likely to be cared for by a PA at some point in their lives. So, it is important for patients to understand the specialized role of these providers. Physician assistants are considered ‘Midlevel Practitioners’ or ‘Advanced Practice Providers’. Nurse practitioners (NPs) are the other providers that fall in this category. A physician assistant is required to provide health care services under a contract with a supervising physician. Although PAs function under a supervising physician, it is usually a collaborative effort between the two providers. In certain specialties, some PAs have their own patient population and function very independently, with help from their physician only as needed. Each physician assistant’s […]
Although it seems like a simple concept, one question that we are commonly asked is when to use ice versus heat therapy to treat pain. In this post, we will discuss how each one works on a physiologic level, and when to use each one. Both heat and cold therapy are an inexpensive and easy-to-use treatment for the management of acute, chronic, and postoperative pain. These therapies are also great to use after vigorous exercise to stimulate healing. One main point to keep in mind is that ice reduces inflammation, while heat stimulates blood flow. Knowing that simple fact can help if there’s ever a question about when to use which one. Cold Therapy Cold therapy such as ice baths or ice packs are commonly used for the treatment of acute, injury provoked pain. As previously mentioned, cold therapy reduces inflammation. When the body is undergoing an inflammatory response, many chemicals are secreted and directed to the injured area. These chemicals are used to stimulate healing. While the end result is the body repairing itself, inflammatory responses can be somewhat painful. Due to the abundance of chemicals released, other symptoms such as redness, swelling, and pain are often experienced as […]
Golf may seem like a low-impact sport, but injuries are common for many golfers. As in all sports, it is extremely important to understand and execute proper mechanics when swinging a golf club as well as carrying your golf bag. Golf may not be a high cardiac sport either, but it is essential to condition your body and increase your flexibility and range of motion to prevent injuries. It is also extremely important to warm up and loosen your muscles prior to hitting the links or going to the driving range. Starting a round of golf without warming up and stretching will greatly increase your chances of injury. There can be acute injuries or overuse injuries in golf. Acute injuries usually occur after something traumatic during your swing such as hitting the ground hard or twisting your ankle too much. More commonly, overuse injuries seem to affect golfers. Common upper extremity sites of injury include the shoulder, elbow and wrist. Hand/Wrist Wrist pain does not usually occur due to the repetitive nature of the golf swing but more often it is injured acutely during the swing. This can happen when you accidently hit the ground too hard during your swing […]
Osteoporosis A major cause of disability in older adults is often due to fractures that limit mobility and interfere with activities of daily living. Fractures are common amongst elderly individuals for a multitude of reasons. One of the most common being osteoporosis. Osteoporosis is defined as a condition in which the body loses too much bone or makes too little bone, resulting in the bones becoming brittle and weak. The word osteoporosis literally means “porous bones.” You can find more information about osteoporosis by scrolling down in the “News and Events” section of the website where an article on this disorder was previously posted. Risk Factors for Decreased Bone Density As we age, our bone quality and bone mass decreases. Some non-modifiable risk factors that lead to a reduction in bone mass include: advanced age, female sex, family history of osteoporosis or hip fracture, certain metabolic disorders, and certain types of malignancies such as lymphoma or myeloma. Metabolic disorders that can lead to osteoporosis include hyperthyroidism, type 1 diabetes, vitamin D/calcium deficiency, or alcoholism to name a few. Some modifiable risk factors that lead to decreased bone mass include smoking, low calcium intake per diet, low vitamin D level […]
What is Lyme disease? Lyme disease is tick-borne illness transmitted to humans by deer ticks. It is caused by the bacterium Borrelia burgdorferi. The tick must be present on the skin for at least 24 hours to actually transmit Lyme disease. This seems like a long time but often these ticks are so small and go unnoticed by the individual. Deer ticks are more prevalent in the Northeast and upper Midwest and are usually found in forests and wooded areas where their hosts, deer, are abundant. Over 20,000 cases of Lyme disease are reported in the United States annually. Many people worry about their canine companions contracting Lyme disease, but it is important to know that Lyme disease is an issue for humans as well. What are the symptoms of Lyme disease? Lyme disease has a very broad spectrum of symptoms and is divided into three phases: early localized, early disseminated and late disease. The first sign of Lyme disease is the characteristic skin lesion and rash associated with the tick bite. It is a red circular lesion that can grow as big as 20cm and can have a central clearing (see picture). This lesion often resembles a “bull’s eye” […]
Statistics Drug overdose deaths have increased by 300% since 1999. Opioid pain medications were the cause of 14,800 deaths in 2008 alone; more than deaths caused by cocaine and heroin abuse combined. This number has surpassed motor vehicle accidents as the leading cause of accidental death in the United States. In 2009, opioid misuse/abuse led to more than 475,000 emergency room visits. This number has since doubled in recent history. Currently, it has been reported that 100 people die from drug overdoses in the US every day. More specifically, it is reported that there are approximately 10 overdose deaths a day just in the state of Pennsylvania. In this country, people consume more opioid pain medication gram for gram, than any other country in the world. In fact, estimates have been made that in 1999, 11.5 tons of oxycodone was produced worldwide. Since that time, global pharmaceutical companies have produced more than 75 tons of oxycodone per year, of which 80% of those 75 tons are consumed in the United States! Opioid Epidemic Origin After reviewing these devastating numbers, it is easy to appreciate why this is an epidemic in the US. It is important to understand the origins […]
Hand pain, numbness and tingling is a common symptom of both carpal tunnel syndrome and cervical spine issues. It can be hard to tell the difference between the two problems. Sometimes a careful exam and assessment is required by a hand and/or spine specialist. This article will discuss the cause, symptoms and treatment of each diagnosis. It will also review some ways to tell the difference between them. CARPAL TUNNEL SYNDROME Carpal tunnel syndrome occurs when the median nerve is compressed. The median nerve travels through the wrist. It controls feeling and sensation in the thumb, index finger, middle finger and part of the ring finger. Compression of this nerve can cause numbness, tingling, pain and sometimes weakness in these areas (purple shaded area in picture). The pinky and remaining part of the ring finger are usually spared. Pain can occasionally occur in the forearm and even up into the shoulder. Some patients may complain of clumsiness. Symptoms of carpal tunnel syndrome are usually worse at night or with repetitive activity with that hand and wrist. CERVICAL RADICULOPATHY Cervical radiculopathy occurs when a cervical nerve in the spine is compressed. The cervical nerves travel through the spine. There are eight […]
Defining Degenerative Disc Disease Intervertebral disc degeneration is a very common problem among both men and women. It can be a result of the normal aging process, and is often times asymptomatic. The intervertebral discs are an integral part of the spine all the way from the neck down to the low back. They help maintain stability and alignment of the vertebral bodies (refer to diagram below) as well as help to absorb shock exerted through the spine during daily activities. Following are some risk factors associated with the development of degenerative disc disease (DDD): aging, injury or trauma to the spine, heavy and repetitive activities, and poor nutrition. There is another factor that may actually initiate or accelerate the development of DDD, and that would be smoking cigarettes. At this point in time, most people are aware of the dangers and risk factors associated with smoking, but it may not be as widely known that smoking can contribute to low back pain associated with DDD. The Two Ways that Smoking can Impact the Development of DDD The issue with smoking as it relates to the development of DDD involves nicotine, which is the main ingredient in tobacco. Nicotine is […]
What is a herniated disc? A herniated disc is when material from a vertebral disc ruptures into the spinal canal. Your spine is made of up a column of vertebrae separated by discs. Your nerves runs down behind the column of vertebral bodies and discs. You can think of the discs like a jelly donut. The outer shell (donut dough) can break open and let some of the jelly (inner disc material) stick out. The rupture of this jelly-like material into the canal can compress the nerves in the spine, causing significant leg pain, numbness, tingling and/or weakness. Herniated discs can occur anywhere along the spinal column. The most common location is in the lumbar (lower back) area, which is what the rest of this article will focus on. What are the causes and risk factors of a herniated disc? Herniated discs can be due to injury or due to the normal aging process of the spine. Different risk factors that increase your chance of having a herniated disc include male gender, genetic predisposition, obesity, repetitive heavy lifting, improper lifting mechanics, repetitive bending/twisting, prolonged/frequent driving, sedentary life and smoking. Although there are a few risk factors that cannot be avoided, […]
We have just opened a new location in the Leechburg area! It is located at 116 Main Street, Leechburg, PA 15656; and will be replacing our Spine Center Wexford location. Our Spine Doctors will be at the Leechburg location starting February 8th. We look forward to serving patients in Leechburg and surrounding areas!
As a follow-up to our previous entry on the importance of good posture, we would like to introduce some basic exercises to help restore and maintain normal and optimal posture. Please note that exercise should be cleared with a physician or physical therapist before beginning any new exercise routine. These exercises should not be painful. If you have pain with any exercise that feels like more than just a stretch please stop and consult a physician or physical therapist. Peck door stretch: this stretch is to facilitate optimal shoulder positioning by lessening the tension of the muscles and tendons in the front of the shoulder. While standing in a doorway. Place hands in the lowest position shown in the picture. Look straight ahead and take a small step forward with one foot until you feel a stretch. You should feel this in your shoulders and chest. Hold for 20 seconds and do this 3 times. Next repeat this for the middle position followed by the highest position. Repeat: 3 Times Hold: 20 Seconds Complete: 1 Set Perform: 1 time per day 2. Shoulder blade squeezing (scapular retraction): this exercise can be performed all throughout the day as […]
What is Osteoporosis? Osteoporosis is a disease of the bones. It occurs when the bones lose their normal density and become more fragile or brittle. This disease increases the chances of a broken bone, especially a break without significant trauma (ie. ground level fall). What are the signs and symptoms of osteoporosis? Osteoporosis does not have any specific signs or symptoms and is often considered a “silent disease.” Most people do not know they have osteoporosis until they break a bone. The most common types of fractures due to osteoporosis are vertebral fractures, hip fractures and wrist fractures. How common is osteoporosis and who gets it? Nearly 10 million Americans have osteoporosis and even more than that have osteopenia. Osteopenia is low bone density that does not severely weaken the bones like osteoporosis does, but it does place patients at an increased risk for developing osteoporosis. Although osteoporosis can arise at any age, it is more common in the elderly population. Many people think osteoporosis is a disease only women can get, but men can get osteoporosis too. About 50% of women and 25% of men over 50 years old will sustain an osteoporotic fracture in their lifetime. What are […]
The idea of having good posture is no longer just for aesthetics. Rather, good posture is a constant pursuit of bio-mechanic perfection. Many degenerative and dysfunctional changes that our physical body goes through can be related back to non-optimal posture or poor musculoskeletal positioning over time. As Wolff’s law states, our bones will change shape to become stronger based on the stresses we apply to them. This is one major benefit of exercise, like building muscle with increased stress during weight lifting. The same goes for cardiovascular exercise. The more you condition and get your heart-rate up during exercise, the healthier your heart will function. We have to consider this idea when talking about posture. Because even though sitting at a desk is not necessarily training or exercise, we’re giving our body musculoskeletal input to sit at that desk, therefore we should be more aware of the position we are in on a daily basis. If we think about the position that our head, shoulders, spine, hips, knees and ankles are in when we sit at a desk, our body takes that information and starts to change to be better at getting into and functioning in that position. Our bodies […]
What is a “cortisone injection”? A cortisone injection, or corticosteroid injection, is a catch all term for an injection of a body part, using a derivative of a steroid/glucocorticoid and often a local anesthetic. Injecting a glucocorticoid and local anesthetic into an area of pain can be very effective in relieving the pain. In some instances it can also prevent the pain from recurring. What types of conditions can be treated with a cortisone injection? Frequently, the injection is into a painful or damaged joint. Common joints that are injected include the knee, shoulder, hip, ankle and small joints in the hands and feet. Soft tissue areas can also be injected for pain relief of common issues such as tennis elbow, golfer’s elbow, rotator cuff impingement, trigger fingers, trochanteric bursitis and many more. What is the injection actually doing? When you injure a part of your body it can cause tissue damage. This triggers an immune response in your body to try and heal the damaged tissue. Blood flow is increased to that area, delivering many different kinds of blood products and cells to aid in restoring the tissue. This is a good thing at first. But then it causes […]
Wrist pain comes in many forms: from acute injuries like tendonitis or a broken wrist (carpal) bone, to chronic injuries like carpal tunnel syndrome and arthritis. However, the most common type of wrist pain over the holiday season typically comes from repetitive use and placing unnecessary stress on your wrists. Here are a couple examples of what wrist pain suffers may do over the holiday season and how you can avoid the same fate: Carrying Too Many Grocery Bags At Once: Have you ever tried to carry too many grocery bags from the car into the house? If you’re like most people, you grab as many bags as possible – placing them in your hands, directly on your wrists and arms, and even wrapping them around your fingers – until you can’t comfortably carry any more. The problem with carrying too many groceries bags (especially in awkward ways) is that you’re placing unnecessary stress on your finger joints and wrists, and this stress and pressure can strain your tendons and ligaments and cause wrist pain. So, instead of carry in all of your grocery bags at once, we recommend making several trips with less baggage in your hands. This will […]
Have you ever looked at a body mass index (BMI) chart, often found in physician offices, and thought, “That seems unrealistic or even inaccurate?” At quick glance the charts often seem pretty rigid and show ideal weights in ranges that seem difficult to attain if one is overweight. In this article, the BMI chart will be broken down and explained in better detail so the next time you see one you might look at it a little differently. Hopefully providing a better understanding of it and allowing it to motivate you towards a healthier lifestyle. Once there is a better understanding of the chart itself, I would like to go a step further and explain why the BMI chart is so important in orthopedics. Also, I would like to discuss how it plays a major role in one of the leading causes of disability in this country, osteoarthritis (OA). Body mass index (BMI) is a measure of body fat based on the relationship between ones height versus ones weight. It is a quick and easy screening tool that places individuals into categories of underweight, healthy weight, overweight and obese in relation to their height. The BMI chart does not account for […]
According to recent studies, child pedestrian accidents are the #1 cause of Halloween-related injuries. For this reason, we believe you should know some basic Halloween safety tips to keep your kids safe, healthy, and happy this Halloween season (and for many more to come). Halloween Safety Tip #1 – Make-Up Over Masks: Masks are fun, but they have a tendency of limiting or blocking your child's vision. Instead, consider non-toxic makeup, so your child can see curbs, steps, and other trick-or-treaters. Halloween Safety Tip #2 – Properly Fitted Costumes: It's important to make sure costumes and shoes fit well, so you can help protect your child from tripping accidents, getting entangled on Halloween decorations, or coming in contact with open flames from sources like jack-o-lanterns. Halloween Safety Tip #3 – Bright & Reflective Tools and Materials: Since most kids trick-or-treat at or around dusk, it's smart to have your kids wear bright costumes when possible, and always carry a flashlight or glow stick. You can even consider reflective tape on their costumes and trick-or-treat bags to make sure others can see them (walkers and drivers). Halloween Safety Tip #4 – Smart Accessories: Accessories complete an outfit and are a blast […]
The changes in color and scenery make fall a beautiful time of year here in Western PA. But with that change comes the falling of leaves and the potential for shoulder, back, and ankle injuries to occur. So, to help you enjoy this unavoidable autumn activity, here are five ways to take care of yourself and prevent injuries before they strike and ruin your fall: Warm Up – it's important to warm up your muscles with some light exercise and dynamic stretching before beginning any activity. Raking leaves is no exception. Some easy warm ups include walking, jogging, performing jumping jacks, or marching in place. Start off easy and continue for 5-10 minutes. This will get your heart pumping, your blood flowing, and your muscles loosened up and ready for any activity. Use Proper Equipment – it's smart to use the proper equipment and avoid unnecessary injuries. For example, wearing gloves can help you prevent your hands from getting irritated and forming blisters. Wearing non-slip shoes can help you avoid nasty falls and ankle sprains on wet leaves. An ergonomic rake can save your back from straining and your shoulders from rolling forward. Practice Good Technique – there are several […]
The most common and feared injury in sports like football, soccer, and basketball – where you're twisting and turning, accelerating and decelerating, jumping, pivoting, and changing direction – is the ACL injury. In short, the ACL (anterior cruciate ligament) plays a critical role in stabilizing your knee joint. While any injury on the field or court is an unexpected accident, there are ways to prevent an ALC injury (or at least lessen your chances of injury). Here are 5 ways to help keep your ACL safe and healthy: Be Aware Of Your Knee Placement Being aware of your body alignment is the first line of defense when it comes to preventing injury. In the case of protecting your ACL, you want to align your hips over your knees and your knees over your ankles. No matter what you're doing – standing, cutting, jumping, etc. – this alignment is crucial in keeping your ligaments safe. For example, if you let your knees turn inward when changing direction (think suicide runs), you put unnecessary strain on your knee joint and ACL. Keep your knee under your hips and over your ankles, and you'll stay safe Warm Up Before Your Activity It's smart […]
The knee joint is a very complex joint. It is a common cause of pain for all people of all ages. There are many causes of knee pain ranging from acute/traumatic injuries to chronic wear and tear of the joint. This article will briefly discuss some of the more common causes of knee pain that may require orthopedic evaluation. Ligamentous Injury The knee is made up of many different structures. The ligamentous structures include the ACL, PCL, MCL, and LCL. These structures help keep the knee structurally stable and help it function properly. These ligamentous structures are commonly injured due to high impact injuries. They are very common in athletes, but can also occur in any age group from falls, motor vehicle accidents, etc. These injuries can range anywhere from mild sprains to complete tears and are treated according to complexity. Depending on the structure that is injured, the location of the pain can vary. Quite often, conservative treatment, including rest, ice, elevation, physical therapy and/or bracing, will help these types of injuries. Occasionally surgical intervention is required if there is a complete tear of one of the above structures. Meniscus Tear The menisci are 2 c-shaped structures that act […]
Chronic pain – the type of pain that can stay with us for months, years, and even decades – effects most Americans at some point in their lives. And chronic pain does not discriminate. Athletes, desk jockeys, and even stay-at-home parents can all experience this type of pain. For example, basketball players who are constantly lifting their arms overhead may experience chronic shoulder pain, while employees who sit at a desk all day may suffer from constant back pain, and soccer moms who drive all over kingdom come may endure lingering knee pain. But why? Why does this pain occur, and why does this pain persist and haunt us? Sometimes it's a structural issue, and if that's the case, we're here to help. But more often than not, chronic pain stems from muscle imbalance. You see, our muscles move our bodies by contracting and relaxing. For instance, if I want to bring a glass of water to my lips, my biceps muscles will contract and my triceps muscles will relax. The result is my arm bending at the elbow and the glass of water coming closer to my lips. The opposite is true as well. When I want to place […]
Rotator cuff injuries don’t just happen to athletes. They’re a common – and potentially life-changing – problem for adults of all ages. A rotator cuff injury may start as a dull ache in your shoulder, but it can quickly progress into a painful, hard-to-heal problem affecting your sleep and limiting your daily activity. Join Spiro N. Papas, MD, UPMC Orthopaedic Care, Three Rivers Orthopedic Associates-UPMC, in a discussion about the latest advancements and treatment options available for rotator cuff repair and shoulder replacement. Wednesday, October 12, 2016 5:00 p.m. to 7:30 p.m. 5 p.m. – Free screenings and light refreshments 6 p.m. – Presentation UPMC St. Margaret Conference Centers A, B, and C 815 Freeport Road Pittsburgh, PA 15215 Reservations are required. Call 1-866-939-RSVP (7787), or visit UPMC.com/Classes. Free health screenings. Parking will be validated.
25-year-old German Olympic gymnast, Andreas Toba, becomes a country's hero after tearing his ACL during the men's floor event, and then hours later completing his pommel horse event to help Germany advance to the next round! Even though Germany finished 7th in the team all-around and did not medal, this act of bravery will go in history and Toba will always be recognized for his legendary performance to help his team qualify. Unfortunately, injuries like this happen every day to local athletes. Most are not attempting world-record breaking feats. Instead, most injuries like this happen to good kids who are just trying to play their game and give it their all. When injuries like this happen, you can trust UPMC – St. Margaret's and our team of talented, board-certified surgeons (who use the latest treatment options and medical advances) to be here to help you safely get back to the sport or activity you love so dearly – whether you're playing for your local school or training to be an Olympic hero someday!
Did you know that 1 in 10 Olympians will get hurt during the games? According to a study at the University of Oslo in Norway, about three quarters of the injuries occur during some phase of competition and one quarter occur during warm-ups or on-site training. In addition, the study shows that Summer athletes tend to injury their legs, while winter athletes tend to injury their head. So, which athletes get injured the most? According to the study, the Top 3 Summer Olympic injuries go to: Soccer Taekwondo Field Hockey Basketball and Track & Field came in 8th and 9th place, respectively; and gymnastics ended up 18th on the list. If you're a future Olympic hopeful (or just a weekend warrior) and find yourself battling injury, why not seek the best medical help you can? Here at UPMC – St. Margaret's we're here to help you on your road to recovery and greatness!
Pokémon Go is a new smart phone game that has taken the world by storm with tens of millions of users from around the globe playing on a daily basis. In short, it's an augmented reality game that allows you to look at your screen and see Pokémon hanging around in real life locations – from your backyard to Kennywood Park to anywhere in the world. The game has received massive publicity since its inception, including some negative PR about people straining and spraining ankles and even breaking bones! Of course, these types of accidents can be avoided with some simple precautions. Here are three common sense safeguards you can take to prevent injuring yourself if you play this mega-popular game: #1: Watch Where You're Going! It's important to always keep your eyes where you're walking and not looking down at your screen on the game. Not doing so can cause you to walk into other people, oncoming traffic, or simply trip over a curb. Keep your eyes up while you walk and stop in a safe spot while searching for Pokémon. Naturally, this precaution also applies to texting while you walk. The bottom line is: watch where you're going […]
No one enjoys the aging process – especially athletes! After all, athletes, no matter what age they are, enjoy getting out on the field, court, rink, etc. and playing the game they love so much. What's even worse for athletes, however, is the fact that our bodies begin to break down as we age, and this “break down” increases the likelihood of injury. Injury that can put an athlete on the “side lines” and out of commission until the injury heals – which also takes longer as we age. So, the question becomes why – why are athletes more prone to injury? The first reason is rather obvious. Athletes tend to put more strain and stress on their bodies in an attempt to continue doing what they love. But it's more than that. There are actually four physical changes in our bodies that cause aging athletes to be more susceptible to injuries. You see, as we age: Our maximum heart rate decreases and we see an overall decline in maximum cardiac output, or the amount of blood the heart can pump. These two heart-related factors limit athletic performance and our body's ability to heal itself at the rapid rate it […]
The first arthroscopy (a minimally invasive surgery technique we use to see inside a joint) was performed in the early 1900's. Since then, technological advances have allowed the medical community to create new and better minimally invasive techniques to help patients heal faster with less pain. Common arthroscopic surgeries are performed on the shoulder joint and knee joint, but those aren't the only locations arthroscopic surgery can be performed. This minimally invasive technique can also be performed on the wrist joint and ankle joint. Not only is this type of surgery extremely beneficial for professional athletes who injure themselves and need to get back on the field, court, etc. as soon as possible, arthroscopic surgery is also beneficial for anyone who needs help repairing his or her joints. From young athletes to stay at home mothers and everyone in between, the benefits of minimally invasive surgery are massive and widespread. The main benefit of minimally invasive surgery is that it causes less damage to the structures inside the body (i.e. soft tissue, bones, cartilage) than traditional open surgeries do. This decrease in trauma allows for a faster recovery and shorter hospital stays. Usually, with arthroscopic surgery, a hospital stay is […]
Obesity can pose many problems when it comes to orthopedic issues and orthopedic surgery. Not only can obesity worsen or accelerate the progression of many orthopedic conditions, such as arthritis, but obesity is also associated with an increase in surgical complications. Obesity is defined as a BMI (Body Mass Index) greater than 30 and extreme obesity is defined as a BMI of greater than 40. The higher your BMI, the more complications that can arise surrounding surgery. (Please see chart at end of article to calculate your BMI). Obesity, mainly extreme obesity (BMI>40), puts you at a much higher risk of complications both intra-operatively and post-operatively. Intra-operative complications associated with obesity include difficult anesthesia intubation, nerve/vessel damage due to decreased visibility, and increased surgical time due to a more technically difficult procedure. Other serious complications that can arise surrounding surgery include poor wound healing, surgical wound infection, failed orthopedic hardware, heart attack, stroke, blood clots, and longer recovery time. These are all complications that must be taken into consideration prior to undergoing a total joint surgery for any patient, but especially for those with a BMI greater than 40. So this all begs the question: if an obese patient is […]
Shoulder pain can stem from a variety of problems. For example, teenage athletes who play basketball may experience shoulder pain because they are constantly using their shoulders and arms to shoot, pass, and dribble the ball. You don't have to be an athlete to experience shoulder pain or discomfort, though. You can experience shoulder pain from sleeping on your side for too long, using your keyboard and mouse in a poor ergonomic position, or falling directly on your shoulder or grabbing something while falling. The shoulder muscles (i.e. deltoid muscles) are rarely to blame. The real underlying issue most commonly comes from an injury or complication with your rotator cuff muscles. The rotator cuff muscles are made up of four relatively small muscles that connect to your humerus bone (the large bone in your upper arm) and help your shoulder joint flex, extend, adduct, abduct, and rotate. The rotator cuff muscles are critical for shoulder movement, and since they are secondary muscles that get less attention than bigger muscles, like your deltoid, pectoral, and latissimus dorsi muscles, they are more prone to injury. How do you prevent shoulder pain? One of the easiest ways to prevent shoulder pain before it […]
Congratulations to Dr. Edward J. McClain, III, and Dr. Vincent J. Silvaggio on being named as one of our region's Best Doctors in Orthopaedics. The list, which is compiled by Best Doctors of America, Inc., is a selection of the regions' top physicians who earn the consensus support of their peers and who meet additional qualification criteria. Dr. McClain currently serves as the Medical Director of Three Rivers Orthopedic Associates – UPMC and as a Clinical Assistant Professor of Orthopaedic Surgery, at the University of Pittsburgh. He specializes in Total Joint Surgery; MIS Surgery; Arthroscopy; and Revision Joint Surgery. Dr. Silvaggio serves as the Chairman of the Department of Orthopaedic Surgery and the Chief of Surgical Services at UPMC St. Margaret, and as a Clinical Assistant Professor of Orthopaedic Surgery, at the University of Pittsburgh. He specializes in Spine Surgery. Once again, we congratulate Dr. McClain and Dr. Silvaggio on this achievement! (You can find the entire list of Best Doctors in the May 2016 issue of Pittsburgh Magazine).
Hamstring injuries can slow you down and force you to miss training time, or they can take you out of commission for months on end. That's why learning how to care for and prevent hamstring injuries should be a major focal point for any serious athlete. To keep you going strong this season, here are three common practices to avoid at all costs so you can keep your hamstrings safe and healthy. DON'T Go from “Zero to Sixty” Cold muscles, muscles that haven't been warmed up and lack sufficient blood flow, have a higher likelihood of being injured. Properly warming your muscles before you train or play is very important. A good warm up starts with moving your body (i.e. jogging, jumping jacks, etc.) and performing some gentle stretches. Once you've properly warmed up, you can start to increase the intensity of your warm up until you've reached the level of intensity you'll be training or playing at. It's important not go from “zero to sixty” in your intensity. Doing so puts unnecessary strain on your muscles, tendons, and ligaments. This pressure and torque is what causes your muscles and ligaments to strain, sprain, and tear. DON'T Perform Static Stretches Beforehand […]
It's that time of year again. The sun is peeking out from behind the clouds, eagerly waiting to shine bright. The birds are singing (and waking me up in the morning). And the ground is thawing out and ready to be pampered and planted. That's right: gardening season is upon us! However, while gardening is relaxing and enjoyable, it can be hard on your body. Specifically, your hands, wrists, knees, and back. So, to help you stay healthy and happy this Spring, we wanted to give you five smart tips to keep you safe while playing in your garden. Tip #1: Warm Up Before Working Hard Gardening is a full-body workout, and just like going to the gym or playing a sport, we recommend you warm up your muscles before you get your hands dirty. Nothing fancy. A simple warm up can be walking around your yard or your neighborhood for 10 minutes. In fact, this is a great warm up because you can simultaneously begin to brainstorm ideas of how you want your garden to look. Tip #2: Smart Work Is Often Better Than Hard Work Gardening sometimes requires you to lift and move heavy objects (plants, dirt, wheel […]
By: Spiro Papas, MD Rotator cuff problems are very common and can result from degenerative tears of the rotator cuff or traumatic events can cause tears to the rotator cuff. Many patients can have a combination of both. These can occur in both males and females over the age of 40, but can also occur in younger age groups where there is a great strain to the rotator cuff because of activity. The rotator cuff is made of four muscles that attach to the humerus in a circumferential pattern as seen in the anatomic drawing. The rotator cuff muscles are important for stabilizing the shoulder and initiating motion so the bigger muscles around the shoulder can actively participate in the proper motions of the shoulder. When an injury occurs to the rotator cuff muscles, either a strain or even a tear of one or more of the muscles, there is an imbalance in shoulder function. The larger the tear and the more rotator cuff tendons that are involved, the greater the problem. Small injuries and strains can often be treated with physical therapy, injections, along with medications. Significant disruptions in the rotator cuff often require surgical repair. Significant advances have […]
Technology has come a long way over the past decade, and it's exciting to live in a time where you can access entertainment anywhere you go, even at the gym. However, some physicians in the medical community have some real concerns about their clients watching movies or playing games on the phone or tablet while exercising. Dr. Patrick Smith, a UPMC-St. Margaret's Hospital Orthopaedic Doctor Specializing in Spine Care, recently stated, “While we encourage all of our patients to stay active, we also encourage them to stay focused and maintain good form while exercising. Watching movies, texting, and playing games has become an increasing issue that we educate our patients on.” The problem doesn't lie with the entertainment itself. In fact, distracting your mind with some quality entertainment can actually improve and increase performance, motivation, and consistency. The bad behavior lies with “how” you're consuming your music, show, game, etc. “The hidden danger in watching or playing on your phone or tablet is the unnecessary stress and pressure you can place on your neck,” adds Dr. Smith. “When you look down at your digital device, you're actually hyper-flexing your cervical spine. Prolonged periods looking down at your phone or tablet […]
According to the Journal of Wound Care, “there is clear clinical evidence that smokers are more likely to develop postoperative wound-related complications.” These complications include: Delayed healing time Increased chance of wound infection Increased chance of wound dehiscence (rupture along the incision line) Increased chance of tissue necrosis (irreversible death of the tissue) You may be curious as to why smoking slows healing and recovery time. While there are numerous reasons, there are two main answers to this question. First, toxins. According to the American Lung Association, “There are approximately 600 ingredients in cigarettes. When burned, they create more than 7,000 chemicals. At least 69 of these chemicals are known to cause cancer, and many are poisonous.” These 7,000 toxins are foreign to the body, so the body fights back to eliminate the toxins and heal the damaged tissue. Since smokers' bodies are constantly fighting these toxins, their immune systems are in constant chaos. This day-to-day battle slows the body's ability to heal itself, especially when the body is fighting a battle on two fronts, i.e. fighting the toxins in cigarettes while trying to heal after having surgery. Think of it like a war between multiple countries. You only have […]
Hockey is considered a “collision” sport, and for good reason. Injuries occur from not only slamming into other players at high speeds, they can also occur from getting smacked with other players’ sticks, being thrown and smashed into the boards, and having a solid, hefty object (the puck) being catapulted into your body. If that weren’t enough, non-contact injuries can also occur from falling on the ice. For example, gamekeeper's thumb is a condition where a player's thumb is bent backwards during a fall (or strained while gripping their stick during a fall). One of the most common types of hockey injuries occurs in the shoulder joint. It's no surprise, since a player's shoulders take the brunt of the impact when falling, checking, and slamming into the boards. In addition, more than 63,000 hockey-related injuries are medically treated each year, and include everything from deep muscle bruising and muscle pulls to concussions and dislocations. As you can see, while hockey can be fun and exciting to watch, it can be a violent and devastating sport to play. Good equipment is only the starting point to safer ice hockey. Rule changes and better enforcement of existing rules have come a long […]
Basketball is an extremely fun, fast-paced sport to play, and it’s one of the few sports you can enjoy in your youth AND as you get older. However, the explosive movements and constant turning and cutting can make basketball a sport riddled with potential foot and ankle injuries. The most common basketball injuries are to the foot, ankle, and knee. Ankle sprains, foot fractures, torn knee ligaments, and jammed fingers lead the way, but there are numerous other types of injuries. These injuries can range from stress fractures in the lower leg to facial lacerations. Preventing and lessening the likelihood of injury in basketball, like all sports, comes down to maintaining a regular cardiovascular and resistance training routine, so you can increase and/or maintain your strength, flexibility, and endurance. In addition, support braces (especially ankle and knee braces) may help safeguard you against unforeseen injuries. This is especially true if you’ve previously injured or weakened an area. With that said, if you do get hurt while playing basketball, it's important that you respond quickly and appropriately. Here are three steps to follow if you find yourself injured on the court: Step #1: Listen to your body and stop playing. Pushing […]
Skiing is a fun, exciting sport that the entire family can enjoy together. However, like any activity, injures can and do occur. That's why it's important to know what to do when you find yourself knee-deep in snow and tending to an injury (yours or a loved ones). The most common of all skiing injuries is when the lower leg and foot twists outwards and puts extreme pressure on the Medial Collateral Ligament (MCL) on the inside of the knee. Luckily, this injury isn't as serious as it sounds. However, seeking medical attention is suggested. A far worse injury, and one that is quite common, is when the knee experiences a traumatic twisting force and hyperextends to strain or tear the Anterior Cruciate Ligament (ACL). This often occurs when a skier lands a jump, hits a mogul the wrong way, or twists when they fall. In addition to knee injuries, shoulder injuries are prevalent in skiers. Shoulder injuries most often occur when the skier puts their arm(s) out to break their fall – causing the shoulder joint to dislocate, the muscles or ligaments holding the joint together to tear or sprain, or the bones around the joint to break and […]
You can wear all the right equipment to keep you safe. You can follow an innocent training program and have proper form. You can do everything right. But sometimes “stuff happens.” Things go wrong. And you can still get injured. So, if that does happen and you do get hurt, it's important that you respond quickly and appropriately so you can safely return to your sport (and grow older with as little pain as possible). Here are 3 steps to follow if you get injured: Step #1: Listen to your body and stop the activity. Pushing through the pain may sound like a good idea, but it's one of the worst mistakes you can make. If you're truly injured and in pain, stop what you're doing and move onto Step #2! Step #2: Assess the injury and either care for the injury yourself or seek professional help. If you're in severe pain, your body is disabled in any way, or you experience numbness – consult a doctor immediately. Or, if you've injured an eye, you experience bleeding, immediate swelling, or immediate bruising, have an extremity that appears to be shorter than usual or in an “unnatural position”, or if you […]
There are roughly 144,000 ski-related injuries per year that present to hospital Emergency Rooms and physician's offices. There are also 148,000 snowboarding injuries that present in any given year. Most of these injuries have to do with upper extremity injuries trying to prevent a fall or cushion a fall with the arms creating sprains, fractures and dislocations of the upper extremities. These injuries can involve the shoulders, elbows and often the digits of the hands. The other common area involves the lower extremity with fractures of the lower extremities and sprains and ligament injuries to the knee. The knee is the most common area to injure in the lower extremities. This involves often ACL an MCL ligament injuries. The third category can involve head injuries which can be the most serious. There are three main areas in preventing injuries. The first involves one's general fitness. Warming up before skiing activity is important in that warm muscles tend to have less injuries than cold muscles. Hydration is particularly important when skiing at high altitudes particularly avoiding altitude sickness. Most injuries occur during the last run of the day. When fatigue sets in, there is a greater risk of an injury. This […]
Dr. Paul Resnick retired this year on June 1st, 2015. Dr. Resnick went to Medical School at Case Western University in Ohio, did an internship and a one-year rheumatology fellowship through Georgetown University in Washington, and a hand surgery fellowship in Colorado before returning back home to Pittsburgh. It was then Dr. Resnick started and ran his own practice from 1981-1993 before eventually joining Three Rivers Orthopedic Associates in 1994 as a partner out of the St Margaret campus. In addition to serving as a Clinical Assistant Professor at the University of Pittsburgh and receiving a “Golden Apple” for excellence in teaching, Dr. Resnick loves practical jokes, antiques and the Minnesota Wild. “He was always the doc we went to when we needed a good laugh. After all he was the “BEST” doctor in the whole world!” says Practice Manager, Chris Ieraci. Now, Dr. Resnick enjoys spending time in their vacation home in the Adirondack Mountains in upstate New York with his wife, Nancy, and their son, Ben.
After suffering with back pain for 17 years, 52 Year-Old Lawyer, David Trautman, decided to undergo surgery in May of this year with Dr. Silvaggio of Three Rivers Orthopedic Associates UPMC to see if he could find some relief. In a recent article from North Hills Monthly, Mr Trautman said, “In 1996, I ruptured a disc and had a micro-discectomy, which provided some relief, and a year later, I had a second micro-discectomy, which also kind of helped, but the pain never really went away. My back continued to slowly deteriorate, and I underwent conservative treatments for a number of years, including physical therapy and steroidal injections, but any relief was only temporary. At Christmas last year, I was playing Santa's helper, and I wrenched my back and ended up in the hospital on IV painkillers. My back continued to deteriorate over the next five months, but I had too much going on to have back surgery. I retired from the Army on May 2, 2015 and scheduled surgery with Dr. Silvaggio on May 18.” The article continues, “Since his surgery in May, Mr. Trautman has made an impressive recovery. ‘My left leg is at 100 percent, and I have […]
Our own Dr. Vincent Silvaggio is featured in this month’s North Hills Monthly (November Edition). In the article, you can learn about the many benefits of being a resident of the North Hills with any type of orthopedic condition (that you may or may not realize you have available to you). In addition, the article includes two successful orthopedic case studies. Dr. Silvaggio states in the article that one of those benefits is: “We have surgeons who specialize in all areas of orthopedic surgery. We're a community hospital that provides specialized care.” Read the entire article here and learn what UPMC can do for you.
UPMC has recently built a brand new, state-of-the-art Spine Center located on Route 19 in Wexford across from the Walnut Grill Restaurant and is unlike any other facility in the country! Parking is FREE and is located close to the building. The registration process is fast, easy, and headache-free with our new registration kiosks that allow you to register yourself and quickly check in WITHOUT waiting! Our Rehab Services and Recovery Center is located on the first floor, so anyone who is in need of treatment will have easy access without having to go anywhere else. An on-site imaging department gives you access to x-rays and MRI’s, so that you can get everything you need in one location! The newest technology specifically designed to care for spinal conditions and injuries AND access to the best doctors in the city makes our new facility the ONLY choice for your spinal care needs. If you or a loved one is suffering from neck or back pain, then set up an appointment today by calling us at 412-782-3990.
The marriage between UPMC’s Teleconsult Center at Northwest Hospital and UPMC’s Three Rivers Orthopedic Associates’ spine surgeons is a match made in medical heaven. This new UPMC initiative will allow patients in the northern-most parts of Pennsylvania (as well as parts of New York and Ohio) to receive the spinal care they need without having to drive hours-on-end to see the best, most experienced spine doctors. How does tele-consulting work? First, patients who are referred by their PCP for having neck and back problems will book an appointment with Three Rivers Orthopedics for a Teleconsult at Northwest Hospital. Next, patients will be checked in and have their vitals taken by the caring and compassionate staff at UPMC’s Northwest Hospital. Then, with the assistance of the knowledgeable Northwest staff, patients will be seen by our doctors as if they were sitting in our St. Margaret office! Don’t you just love what technology can do for you? We do! Conditions, problems, and challenges we currently tele-consult about include: Arthritis Degenerative disk disease Spine disorders Herniated/ruptured discs Osteoporosis of spine Sciatica Scoliosis Spondylosis Stenosis Fracture Care If you’re experiencing neck or back pain and live near UPMC’s Northwest Hospital, get the care you […]
Lower Back Pain: What’s New, What to Do UPMC St. Margaret orthopedic surgeon Jeffrey A. Baum, MD, Three Rivers Orthopedic Associates UPMC, will discuss current treatments for arthritis and low back pain. Dr. Baum will also discuss current surgical treatment options for arthritis of the lower back. Saturday, October 3, 2015 9:00 a.m. to 2:00 p.m. Regional Learning Alliance 850 Cranberry Woods Drive Cranberry, Twp. 16066 Registration closed.
Starting September 2015, Three Rivers Orthopedic Spine Physicians, Dr. Baum, Dr. Silvaggio and Dr. Smith will begin to provide care at the New State-of-the-Art Spine Center located in Wexford, PA. The new UPMC Passavant Spine Center will be a one-stop location for treatment of back and neck pain, and care of any injury, disorder, or deformity of the spine and will offer everything patients require at an easily accessible site designed specifically with patient’s needs in mind. Call us today for an appointment at 412-782-3990. To learn more about the Spine Center, please download the TRO_Spine_Center_Announcement_8-5-15.pdf.
Managing Carpal and Cubital Tunnel Syndrome Symptoms of carpal tunnel syndrome include wrist pain, hand numbness, loss of grip strength, and tingling fingers. With cubital tunnel syndrome, the tingling sensation occurs only in the pinkie and ring finger. In both conditions, early detection and treatment can help avoid permanent nerve damage. If you want to learn more about carpal tunnel and cubital tunnel syndrome-including causes, symptoms, and treatments-attend a presentation by Franklin H. Chou, MD, of Three Rivers Orthopedic Associates-UPMC, a specialist in hand and upper extremity surgery. Wednesday, May 6, 2015 6 to 7:30 p.m. UPMC St. Margaret 815 Freeport Road Pittsburgh, PA 15215 Neil Y. Van Horn Pavilion (Hospital Entrance A) Parking will be validated and light refreshments will be served. Reservations are required, call 412-784-4022. Why Are My Fingers Tingling?
By Carl T. Hasselman, M.D. and Alex J. Kline, M.D. Over the years shoes have been used for protection, to make a fashion statement, to improve athletic or dramatic performance and as a social status symbol. Styles have changed since the Greek times of sandals to high heel shoes in the 16th Century to constrictive high heel shoes after World War II. Interestingly, in barefoot societies there are few bunions and foot problems; however, in modern societies with constrictive shoe wear, 1 in 6 people will develop problems with their feet. If these facts are known, then why do we continue to wear such shoes and what can we do to improve comfort in our feet? The most important lesson to remember is this: The mo$t expen$ive $hoe is not nece$$arily the be$t $hoe!!!! Many times you are paying for a name or the advertising of that shoe and not for high quality or what is in your foot’s best interest. First, we must discuss the anatomy of a shoe by its parts. The top of a shoe (covering the foot) is called the upper and the bottom (the part in contact with the ground) is called the sole. The […]
By Patrick N. Smith, M.D. Every year in the United States about 65 million people will be suffering from back pain. Roughly ninety percent of the U.S population will experience at least one debilitating back-pain event in their lives. It is also estimated that back pain will cost the U.S. approximately 50 billion dollars in lost wages annually. It is the second most common reason a person sees the doctor (only behind the common cold!). So, WHY SO MUCH BACK PAIN? GOOD QUESTION! Here are two commonly overlooked risk factors: SMOKING – One of the most unrecognized risk factors for back problems is smoking. Approximately 43 million Americans smoke, or about 19% of the population. Smoking has been linked to heart disease and several cancers, but here’s another reason to stop- smoking has been linked to degenerative disc disease, a progressive deteriorating condition of the lumbar spine. Research published in the American Journal of Medicine found a greater than 30% increased risk for low back in smokers compared to non-smokers. Due to the decrease blood flow caused by nicotine and the lowering of oxygen in the blood, it is felt that smoking disrupts the supply of vital nutrients and oxygen […]