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Q & A with Dr. Rodney Brenneman

Q&A with Dr. Rodney Brenneman

November 01, 2019

Rodney E. Brenneman, M.D., serves as Chief of the Division of Orthopedics at Lancaster General Hospital. We asked Dr. Brenneman about his division’s current priorities, what he likes most about orthopedics, and his hobbies from singing to cycling. 

 

 









What is your background?
I grew up in Virginia on a cattle farm. Once I finished high school, I embarked on a nontraditional path to medical school, which included three years as a missionary in 12 European countries, followed by a job in construction. I studied religion, music and biology at Eastern Mennonite University. Then I had shoulder surgery and initially decided to go into physical therapy. However, I am a fixer at heart, and I decided eventually to be an orthopedic surgeon. I went to medical school at Penn State Hershey and completed my residency there as well. In 2014, I joined Orthopedic Associates of Lancaster, where I am primarily a joint replacement surgeon. 

I have served in a number of leadership positions in the past five years. I am currently Vice President of OAL. In the past I served as director of the LGH Geriatric Fracture Program; Chair of the Quality Committee for the LG Health Community Care Collaborative ACO; and on the Board of Directors for the Clinically Integrated Network. I became Chief of the Division of Orthopedics at LGH in fall 2018. I’m getting to know all of the people and the parts that make up LGH, going to a lot of meetings and still trying to figure things out. I am surrounded by a lot of hardworking and engaged individuals who all make my job an enjoyable challenge.

Why did you want to serve in a leadership role?
I have a natural desire to solve problems, and this has placed me into many leadership positions throughout the years. I enjoy refining established processes and developing novel solutions. The challenge I find is in balancing the time required by the extra commitments with my normal responsibilities and my family/recreational life. But it is very rewarding to be a part of something larger than my immediate circle of influence.

What are some current priorities or projects for the division? How about further down the road?
We are constantly refining protocols and procedures for the process of performing orthopedic surgery at LGH. We are currently developing pathways to facilitate the "outpatient" total joint surgery experience. I am overseeing some equipment upgrades to the Orthopedic Center ORs. I also try to facilitate and improve the interactions between members of the orthopedic community and those of other departments and divisions, hoping to enhance the quality of care across the LGH experience for our orthopedic patients.

What do you like most about your work?
As previously mentioned, I am a fixer and a problem solver. Some of my favorite patients are elderly farmers and laborers who have debilitating arthritis and are overjoyed after I replace their worn-out joints. That is perhaps the most satisfying part of my job: giving patients the function of their bodies back and returning them to the activities that give them purpose.


Dr. Brenneman with his family.

Tell us about singing.
When I was growing up, I played piano, guitar, bass guitar, mandolin and trumpet, and sang in numerous choirs. I had to put music on hold once I went to medical school. However, I picked up an instrument and sang for the first time in 10 years during residency graduation, when I performed my own spin on a country classic and created “Mamas, Don’t Let Your Babies Grow Up to do Ortho.” A couple of years ago, my physician assistant, Hope Weber, encouraged me to audition for singing the National Anthem for the Lancaster Barnstormers. I have done that a few times now. It’s a great experience and always a lot of fun. 

What else do you like to do when you’re not at work?
I like to spend time with my wife Michele and our three daughters, ages 11, 8 and 6, as well as our mini-labradoodle. I recently turned 40, and I celebrated by running two marathons and three half-marathons in 18 months. I also enjoy riding anything with wheels, including mountain and road bikes. I ride one of my motorcycles to work anytime I can. I also have several unicycles and a penny-farthing, which has a large front wheel and a smaller rear wheel. And yes, I do get some funny looks when I ride one of those around the neighborhood.


10 Tips for How To Use Crutches

10 Tips for How To Use Crutches

How to get around better on crutches

When you break your leg or injure your knee, you can end up coming home with a pair of crutches. If you’ve never used crutches before, you need to know some key tricks to using them correctly. Unfortunately, many of us don’t get the right instruction before we attempt to use them.

Using crutches requires good upper body strength and flexibility. Using crutches also requires the injury to be isolated to a single leg; patients with an injured arm or two injured legs will usually require another type of support. Read these tips to properly use your crutches.

Here’s How to Use Crutches

1. Size the Crutches
The crutches should be properly sized so they are used appropriately and do not cause problems.  You shouldn’t assume the crutches you have at home are the right ones for you, they may need adjusting or getting ones of the right size. Crutches should:
 • Be about one to two inches below the armpit when you are standing straight;

2. Have handles at hip height, so that your elbows are slightly bent when grasping 

3. Check the Padding and Grips
Check the crutches to ensure they have ample cushion on the armpit, grips, and especially on the base that    contacts the floor. These parts of crutches can be replaced by a medical supply store if they become worn. You will soon feel the pain if they don’t have enough padding.

4.Getting Up from a Chair
Place both crutches in the hand on the affected side (i.e., if you injured your right leg, grasp both crutches by the handle with your right hand). Grasp the handrest of your chair with one hand, and the
crutch handles in your other hand. Place your weight on your uninjured leg and push up with your arms.

Source: VeryWellHealth https://www.verywellhealth.com/how-to-use-crutches-2549326


4 Common Injuries That Can Be Treated at an Orthopedic Urgent Care

Patients who have orthopedic injuries that involve open fractures (fractures that break the skin) should go to the emergency room. Patients who have other injuries besides orthopedic ones should also go to the emergency room. For all other types of orthopedic and sports injuries, our centers can be your best option.  Below are some of the common injuries we treat:

Knee Injuries

The knee is commonly injured during walking and running activities. Most knee injuries occur because of a sudden change in direction (pivoting, shifting, jumping) or a sudden force (stepping down from a curb or high surface, landing during a jump or fall). Most knee injuries can be seen at an orthopedic urgent care clinic. A physical examination and medical imaging studies are used to diagnose knee injuries and then come up with an appropriate treatment plan. Common knee injuries include sprains, strains, and tears (cartilage and ligament).

Shoulder Injuries

Because the shoulder is one of the most mobile joints in the body, it undergoes a tremendous amount of force and rotation each day.  When the ligaments and muscles of the shoulder are overused or overstressed, painful injuries can occur.  Many of the common shoulder injuries we see are rotator cuff tears, shoulder fractures, shoulder dislocations and injuries to the soft tissue and muscles of the shoulder.

Ankle Injuries

Ankle injuries are very common. The most common type of ankle injury is an ankle sprain. When the ankle is over inverted (the soles of the feet point inward) or over everted (the soles of the feet point outward), the ligaments that connect the bones of the ankle joint can be sprained. Ankle sprains are graded on an increasing severity scale of grades one to three (G1-G3). When ankle sprains are seen at an orthopedic urgent care clinic, they are diagnosed and treated appropriately. Additionally, specialists at a clinic can check to make sure the ankle is not fractured. If it is, it can be treated accordingly.

Wrist Injuries

Wrist injuries commonly occur because of landing on an outstretched arm during a fall. A wrist strain can be painful and cause swelling, bruising, and possible numbness. A wrist fracture can also cause these symptoms. The most common type of wrist fracture is a distal radius fracture, a fracture of the large forearm bone on its end closest to the wrist. Both wrist sprains and fractures can be seen and treated at an orthopedic urgent care clinic. However, it should be again noted that patients with open fractures should go to the emergency room rather.

Source: Orthoinfo from the American Academy of Orthopaedic Surgeons 

When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.  

 

OAL Lancaster
170 North Pointe Blvd.
Lancaster, PA 17601(717) 299-4871

Monday through Friday
No Appointment Necessary
7:30 a.m. to 4:30 p.m.

OAL Lebanon
North Cornwall Health Center
1701 Cornwall Road, Suite 200
Lebanon, PA 17042
(717) 277-7005

Monday through Friday
No Appointment Necessary
8:30 a.m. to 4:30 p.m.


Preventing Baseball Injuries

Injuries in young athletes are on the rise, but elbow and shoulder injuries in children are on the verge of becoming an epidemic. Thousands of children are seen each year complaining of elbow or shoulder pain. Damage or tear to the ulnar collateral ligament (UCL) is the most common injury suffered and is often caused by pitchers throwing too much. This ligament is the main stabilizer of the elbow for the motions of pitching. When it becomes damaged, it can be difficult to repair and rehabilitate.

HOW IS AN ELBOW OR SHOULDER INJURY DIAGNOSED?
If a young athlete is throwing too hard, too much, too early, and without rest, a serious elbow or shoulder injury may be on the horizon. If the athlete complains of elbow or shoulder pain the day after throwing, or movement of the joint is painful or restricted compared to the opposite side, see a physician familiar with youth sports injuries immediately.

HOW CAN OVERUSE BASEBALL INJURIES BE PREVENTED?
Overuse injuries
— especially those related to the UCL and shoulder—are preventable. Some tips to keep you in the game throughout your life include:

  • Warm up properly by stretching, running, and easy, gradual throwing
  • Rotate playing other positions besides pitcher
  • Concentrate on age-appropriate pitching
  • Adhere to pitch count guidelines, such as those established by Little League Baseball (See tables)
  • Avoid pitching on multiple teams with overlapping seasons
  • Don't pitch with elbow or shoulder pain, if the pain persists, see a doctor
  • Don't pitch on consecutive days
  • Don't play year-round
  • Never use a radar gun
    Communicate regularly about how your arm is feeling and if there is pain
  • Develop skills that are age appropriate
  • Emphasize control, accuracy, and good mechanics
  • Master the fastball first and the change-up second, before considering breaking pitches
  • Speak with a sports medicine professional or athletic trainer if you have any concerns about baseball injuries or baseball injury prevention strategies

    HOW IS AN OVERUSE ELBOW OR SHOULDER INJURY TREATED?
    The most obvious treatment for overuse is rest, especially from the activity that created the injury. Ice is also used to reduce soreness and inflammation. Ibuprofen can be taken to help with any pain. If symptoms persist, it is critical that a physician be contacted, especially if there is a lack of full-joint motion. An examination and radiographs should be done. An MRI scan may also be helpful.

    Usually a simple "rest cure" approach will not be enough, because even though it allows symptoms to subside, it also creates loss of muscle bulk, tone, flexibility, and endurance. Once pain is gone and full motion is present, a throwing rehabilitation program can start.

    Under some circumstances, surgery may be necessary to correct a problem. Overuse and stress related problems can affect growing parts of bone, not just the soft tissue (muscles, tendons, and ligaments). If the condition is not treated, it could cause deformity of the limb and permanent disability. The athlete should return to play only when clearance is granted by a health care professional.

    REFERENCES AND ADDITIONAL RESOURCES
    Prevention and Emergency Management of Youth Baseball and Softball Injuries. American Orthopaedic Society for Sports Medicine. 2005.
    Little League Baseball. www.littleleague.org/Assets/old_assets/media/pitchcount_faq_08.pdf
    American Sports Medicine Institute. www.asmi.org
    Professional Baseball Athletic Trainers Society. www.pbats.com

    When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

    Monday through Friday
    No Appointment Necessary
    7:30 a.m. to 4:30 p.m.

    OAL Lancaster
    170 North Pointe Blvd.
    Lancaster, PA 17601
    (717) 299-4871




  • Hip Exercises to Ease Arthritis Pain

    Hip Exercises to Ease Arthritis Pain: How Exercise Helps Your Hips, and 7 Daily Exercises to Try

    Let’s get this important misconception out of the way: Done correctly, working out is not going to exacerbate your hip pain or make your arthritis worse. But not exercising can make your arthritis worse, which is why doctors recommend exercises as an important part of your arthritis treatment plan, whether you have osteoarthritis or an autoimmune, inflammatory form such as rheumatoid or psoriatic arthritis.

    Here’s what’s happening in your hip when you have arthritis, and why exercising and moving more helps relieve pain and stiffness.

    How Arthritis Affects Your Hips

    The hip is a ball-and-socket joint — the “ball” is the top of your thigh bone, and it sits in a “socket” that’s formed by part of your pelvic bone. Slippery tissue called cartilage covers the bone surface and helps cushion the joint. “Cartilage creates a low-friction environment so you can move easily and without pain,” explains Wayne Johnson, MD, orthopedic surgeon and assistant clinical professor at the University of Oklahoma.

    In osteoarthritis (OA), the cartilage in the hip joint gradually wears down, which over time leads to pain, stiffness, swelling, and lack of mobility, says Dr. Johnson, who is a fellow of the American Academy of Orthopaedic Surgeons. Everyday tasks — like bending over to tie a shoe, getting up from a chair, or going for a walk — become more challenging and painful. The lifetime risk of developing osteoarthritis of the hip is 25 percent.

    With rheumatoid and other forms of inflammatory arthritis, the immune system mistakenly attacks a protective lining in your joint called the synovium, and destroys cartilage. Though RA tends to affect smaller joints first (such as those in your hands and feet), symptoms can spread to both your hips as the disease progresses.

    How Exercise Helps Hip Arthritis

    Think of your hip joint like a bicycle, says Dr. Johnson. The muscles around the hip are the strong, supporting frame of the bike. The joint — especially one with arthritis — is like the weaker, flimsier chain. A strong frame takes some of the stress off a weaker chain.

    The same is true in your hip. “We lose muscle strength as we age,” explains Dr. Johnson. “And any excess weight puts even more stress on a joint that’s becoming weaker due to arthritis.”

    Exercise, then, helps strengthen the muscles that support your hip, which takes some of the load off on the worn-out, weaker joint. “That shift can translate to a decrease in pain and stiffness, easier motion and improved flexibility,” he says.

    Exercise also help enhance balance, boost energy, improve sleep, and control weight. And in people with mild to moderate hip OA, a study published in Annals of the Rheumatic Diseases found those who exercised for one hour at least twice a week for 12 weeks were 44 percent less likely to need hip replacement surgery six years later, compared with those who did not exercise.

    The types of exercise that can help ease arthritis pain may include:

    • Range-of-motion and stretching exercises (to help maintain and improve flexibility)
    • Strengthening exercises (to work your muscles a little harder)
    • Aerobic exercise, like swimming or biking (to improve cardiovascular health and control your weight)
    • Other activities like yoga and tai chi or even gardening and walking the dog.

    Precautions to Keep in Mind Before Exercising with Hip Arthritis

    If you’re new to exercise, it’s always smart to first talk to your doctor. “It’s important to consider the current limits of your joints, and work within those limits,” explains Lauren Shroyer, MS, director of product development at the American Council on Exercise. Your doctor or physical therapist can make sure the exercises are safe for you and help you gain strength, without exacerbating inflammation or aggravating joint pain, she says. Likewise, if you’ve had surgery on your hip, get guidance from your doctor or physical therapist on what hip exercises are safe for you.

    More tips to help protect your joints:

    Start slowly. Ease your joints into exercise if you haven’t been active for a while, say experts. Push too hard too fast, and you can overwork your muscles and worsen joint pain. Go easy at first, then increase the length and intensity of your work out as you progress.

    Move gently. Warm up your muscles with five to 10 minutes of stretching at the start of every exercise activity, says Dr. Johnson; and do it again at the end. Don’t force any stretches; keep your movements slow and easy. With strength training, begin with fewer reps or lower weight, and build up gradually.

    Stop if your hip (or anything else) hurts. “Listen to the pain,” says Shroyer. Take a break when your joints start to ache; or you feel any new joint pain, it’s time to stop. Talk to your doctor about what pain is normal and when it’s a sign of something more serious.

    Stretch every day. If you have a flare of RA or an increase in OA pain, you should still stay active, says Dr. Johnson. Some simple stretching may diminish some of the pain.

    Exercises to Help Relieve Hip Arthritis Pain

    The following hip exercises were recommended by Shroyer at ACE and Dr. Johnson from the AAOS:

    Hip Exercise: Clock Tap

    Improves balance and stability, and strengthens muscles in your hips and legs

    • Stand next to a wall or door frame for support.
    • Balance on right foot; hold on to wall or door frame to stay steady, if needed. Keep your knee straight over your ankle, with a slight bend.
    • Tap your left foot around your right foot, as if your right foot is the centerpiece on a clock, and your left is touching numbers on a clockface. Start at 12 o’clock, then tap at 11, 10, and 9.
    • Retrace the numbers back to 12; then tap 1 and 2, and retrace back to 12.
    • Repeat the sequence four times; then complete with the opposite foot.

    Tip: Stay within a comfortable and stable range of motion when tapping “around the clock,” says Shroyer. If your knee starts to shift over as you tap for the 9 spot, you may be past your range. As you get stronger, you may be able to reach further on each side.

    Hip Exercise: Standing Iliotibial Band Stretch

    Stretches the outside of your hip

    • Stand next to a wall for support.
    • Cross the leg that is closest to the wall behind your other leg.
    • Lean your hip toward the wall until you feel a stretch at the outside of your hip. Hold the stretch for 30 seconds.
    • Cross the leg that is further from the wall behind your other leg.
    • Repeat on the opposite side; then repeat the entire sequence four times.

    Tip: Don’t lean forward or twist at the waist.

    Hip Exercise: Knee to Chest

    Stretches your buttocks

    • Lie on your back on the floor with your legs extended straight out.
    • Bend one knee and grasp your shinbone with your hands.
    • Gently pull your knee toward your chest as far as you’re comfortable.
    • Hold the stretch for 30 seconds and then relax for 30 seconds.
    • Repeat on the other side, then pull both legs in together. Repeat the entire sequence four times.

    Tip: Keep your lower back pressed into the floor.

    Hip Exercise: Hamstring Stretch

    Stretches the back of your thigh and behind your knee

    • Lie on the floor with both knees bent.
    • Lift one leg off of the floor and bring the knee toward your chest. Clasp your hands behind your thigh below your knee.
    • Straighten your leg and then pull it gently toward your head until you feel a stretch. (If you can’t clasp your hands behind your leg, loop a towel around your thigh. Grasp the ends of the towel and pull your leg toward you.)
    • Hold for 30 seconds and then relax for 30 seconds.
    • Repeat on the other side; then repeat the entire sequence four times.

    Tip: Don’t pull at your knee joint.

    Hip Exercise: Hip Extension

    Strengthens your buttocks

    • Lie on your stomach on a firm, flat surface with a pillow under your hips. Keep your head, neck, and upper body relaxed.
    • Bend one knee 90°.
    • Lift your leg straight up.
    • Slowly lower your leg down to the floor, counting to 5.
    • Do 8 reps; then complete the exercise on the other side.

    Tip: Begin with 8 reps, using only your body weight; and progress to 12, recommends Dr. Johnson. When that becomes easier, add ankle weights in one-pound increments. Each time you increase the weight, start again at 8 reps, working back up to 12.

    Hip Exercise: Sit-and-Stand

    Increases mobility and strengthens leg, core, and back muscles

    • Stand in front of sturdy chair that won’t move, feet planted on the floor about hip-distance apart.
    • Press your hips back and bend your knees a little to lower yourself into a seated position.
    • Then tip forward from the hips, push through your feet and up with your legs to a standing position.
    • Repeat the sequence 3 times.

    Tip: Gradually build up to 5 or 10 reps, says Shroyer: “Sitting and standing is essential movement pattern you want to stay strong in.”

    Hip Exercise: Bodyweight Squat

    Progression from the sit-and stand to help strengthen thighs and buttocks

    • Stand with your feet shoulder-distance apart, or a little wider. If needed, hold on to something stable, like the back of sturdy chair or kitchen sink.
    • Keep your chest lifted and shift your weight back into your heels while slowly pushing your hips back, as is you were sitting down into a chair.
    • Keep your feet flat and lower yourself as far as you’re comfortable (such as a quarter or halfway down to where a chair would be).
    • Push through your heels and bring your body back up to standing.
    • Repeat the sequence 3 times; gradually build up to more reps.

    Tip: Keeping your feet a little wider than shoulder-distance apart is better for balance when you are struggling with hip pain, says Shroyer.

    Source: creakyjoints.org; Teresa Dumanin

    When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

    Monday through Friday
    No Appointment Necessary
    7:30 a.m. to 4:30 p.m.

    OAL Lancaster
    170 North Pointe Blvd.
    Lancaster, PA 17601
    (717) 299-4871

     


    Cold Weather Exposure & Frostbite

     

    Cold Weather Exposure & Frostbite

     

    Frostbite is an injury to the body's tissues caused by exposure to very cold temperatures. The nose, cheeks, ears, fingers, and toes are the extremities most commonly affected. The condition results in a loss of feeling and color in the affected area and can cause permanent tissue damage. In severe cases, frostbite can lead to amputation of the extremity.

    During winter, it is always important to cover exposed skin when you are working outdoors, participating in winter sports, or running errands. Frostbite can happen in just minutes when you are outside in extreme cold—and can also occur in temperatures that are above freezing if there is strong wind.

    Description

    When you are out in the cold, your body's first priority is to maintain its core (optimal) temperature. To do that, it shifts blood away from your extremities, such as your hands and feet, and toward the central organs of your body—the heart and lungs. This is your body's way of ensuring that blood flows to the organs that need it most. This redirection of blood, however, increases the risk of localized injury from cold to your fingers, toes, or other extremities.

    Body tissues actually freeze when they are frostbitten. Ice crystals form in the cells, causing physical damage and permanent changes in cell chemistry. When the ice thaws, additional changes occur that may result in cell death.

    There are two degrees of frostbite:

    • Superficial frostbite occurs if only the skin surface is affected.
    • Deep frostbite affects the underlying tissues, as well.

    Cause

    Frostbite is caused by exposure to very cold temperatures. The elderly and the young are particularly susceptible to frostbite. Other risk factors include:

    • Not dressing properly for the weather, staying out in the cold too long, or getting wet while you are exposed to the cold.
    • Having a medical condition that affects your circulation, such as diabetes and atherosclerosis.
    • Having had a previous injury that was caused by the cold.
    • Taking certain drugs, including alcohol and nicotine, or medications such as beta-blockers—which decrease the flow of blood to the skin.

    Symptoms

     

    It is important to recognize the signs of frostbite so that you can seek medical help, if needed. Symptoms include:

    • The affected area becomes numb.
    • The skin may feel frozen, but deeper tissues are soft (superficial frostbite) or the entire affected area feels solid, hard and frozen (deep frostbite).
    • The skin may appear waxy, white, or grayish.

    Treatment

    Seek medical care promptly if you suspect that you or someone you are with has frostbite. In some cases, frostbite can have very serious outcomes. The lack of blood flow and oxygen to the skin can cause the flesh to die, leading to permanent tissue damage. This may result in the need for amputation of the affected extremities. In some cases, an individual with frostbite will also develop hypothermia, another serious cold-weather condition that requires emergency medical assistance.

    If medical care is not immediately available, follow these "do's and don'ts" for treating frostbite:

    The "DO's"

    • DO bring the person indoors into a warm room as soon as possible.
    • DO call for medical assistance immediately. While you are waiting for assistance to arrive, you can serve the person broth, tea, or another warm drink.
    • DO rest the injured areas.
    • DO remove any wet or restrictive clothing.
    • DO gently rewarm the frostbitten area. To do this, immerse the affected area in warm (not hot) water for at least 30 to 45 minutes, or until the area feels warm and sensation returns. During warming, be aware that the individual may complain of severe pain and the injured area may swell and change color.
    • DO prevent infection by leaving any blisters intact. Cover them loosely with a sterile or clean cloth.

    The "DON'Ts"

    • DON'T do anything that will further injure the tissue.
    • DON'T rub or massage the frostbitten area with your hands, with snow, or with anything else.
    • DON'T walk on frostbitten feet. Have the patient sit still with feet elevated slightly.
    • DON'T warm the affected area if there is any chance that it will be exposed to the cold again. Skin that is warmed and then refrozen can suffer additional tissue damage.
    • DON'T use dry heat, such as from a heating pad, fire, blow dryer, or radiator, to warm the area. The skin may be numb and can burn easily.

    Prevention

    It is easier to prevent frostbite than it is to treat it. If you must go out in the bitter cold, be prepared.

    Observing the five commonsense precautions below will help ensure that your winter outings end safely:

    1. Dress appropriately.
      Light, loose, layered clothing provides both ventilation and insulation. Top off your outfit with a water-repellent (not waterproof) fabric.
    2. Protect your head, hands, and feet.
      Substantial heat loss occurs through the scalp, so a warm hat is vital. Mittens are warmer than gloves, and two pair of socks (wool over lightweight cotton) will help keep your feet warm.
    3. Do not drink alcohol or smoke before going out into the cold.
      Alcohol, caffeine, and nicotine leave the skin more prone to thermal injury.
    4. If you get wet, get inside!
      Remove wet clothing as quickly as possible.
    5. Check yourself every half hour or so for signs of frostbite.
      If your fingers, toes, nose, ears or any other body parts feel numb, go inside immediately.

      Source: Orthoinfo from the American Academy of Orthopaedic Surgeons 

      When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

      Monday through Friday
      No Appointment Necessary
      7:30 a.m. to 4:30 p.m.

      OAL Lancaster
      170 North Pointe Blvd.
      Lancaster, PA 17601
      (717) 299-4871


    Preventing Back Pain: Tips for New Moms

    Back pain is common during pregnancy. Usually, the pain diminishes within a few weeks after delivery. But back pain may return as you begin lifting and carrying your infant on a daily basis. As your baby grows, the weight load increases and back pain can result.

    Caring for an infant puts stress on your back. Lifting your baby can be especially hard on your spine. Initially, you may be lifting the 7- to 10-pound baby up to 50 times a day. By the time your child is a year old, you are lifting and carrying 17 pounds. Two years later, you will be lifting a 25- to 30-pound child.

    In addition, many new parents spend a lot of time bending over their babies and holding that position for long periods of time.

    Fortunately, there are many things you can do to prevent back problems, such as modifying your activities and exercising to strengthen your spine. 

    General Conditioning

    • Speak with your obstetrician about when you can start exercising again and what kinds of exercises are safe for you to do. Discuss what goals would be realistic in terms of returning to your pre-pregnancy weight and activity level. This will vary greatly depending on how easy or difficult your pregnancy and/or delivery were. If you had a Caesarian-section (C-section) delivery, it may take longer before you can begin exercising.
    • When you are "cleared" for exercise, begin trying to restore your hip and back flexibility with stretching exercises or light yoga. Your baby's nap time is often a good opportunity for exercise. Because the risk of back pain is high among young, overweight women, getting back to exercise is especially important after pregnancy.
    • If you are able to find a babysitter, participating in a group exercise class can be more interesting than exercising alone and can help ensure that your workout is safe and balanced.  Core muscles weaken during pregnancy and after a C-section delivery; taking a yoga or pilates class can help strengthen these muscles and may help prevent or reduce back pain.

    Lifting Your Baby

    • To pick up a child from the floor, bend at your knees — not at your waist. Squat down, tighten your stomach muscles and lift with your legs.
    • Do not stretch your arms out to pick up your baby. Bring your baby close to your chest before lifting. Avoid twisting your body while holding your baby. 

    Feeding Your Baby

    • To avoid upper back pain caused by breastfeeding, do not bend over your baby to breastfeed. Bring your baby to your breast. A pillow or two placed on your lap will help bring your baby up to you.
    • While you are nursing, sit in an upright chair rather than a soft couch.
    • Remove the high chair tray when you are trying to put the baby in or take the baby out of the high chair. 

    Carrying and Traveling With Your Baby

    • Consider using a "front pack" to carry your baby when you are walking.
    • Do not carry your child on your hip. This overloads the back muscles.
    • Do not stand outside the car and try to place your child in the car seat. Kneel on the back seat as you place your baby into the car seat. Because the safest place for a child's car seat is in the middle of the backseat, you can sit next to the car seat while you place the child into the seat. 
    • Infant car seats are heavy, and they get heavier as your infant grows. Rather than carrying your infant in the car seat, consider fastening the seat into place in the car first, then bring your baby outside separately and strap him or her into the seat. 

    Source: Orthoinfo from the American Academy of Orthopaedic Surgeons

     

    When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

    Monday through Friday
    No Appointment Necessary
    7:30 a.m. to 4:30 p.m.

    OAL Lancaster
    170 North Pointe Blvd.
    Lancaster, PA 17601
    (717) 299-4871


    Distracted Walking

    Distracted driving can cause crashes, injuries, and even death; it's a prevalent public issue that the American Academy of Orthopaedic Surgeons (AAOS) continues to champion. But what about distracted walking? What are the consequences of pedestrians talking on the phone, texting, listening to music, or engaging deeply in conversation with the person next to them?

    "Today, more and more people are falling down stairs, tripping over curbs and other streetscapes and, in many instances, stepping into traffic, causing cuts, bruises, sprains, and fractures," said Alan Hilibrand, MD, chair of the AAOS Communications Cabinet. "In fact, the number of injuries to pedestrians using their phones has more than doubled since 2004, and surveys have shown that 60% of pedestrians are distracted by other activities while walking."

    AAOS infographic with statistics on distracted walking

    In 2009, AAOS launched the "Decide to Drive" campaign to educate children, teens and adults about the dangers of distracted driving.

    More recently, AAOS expanded its injury-prevention efforts to include distracted walking. The "Digital Deadwalkers" radio and television public service announcements (PSAs) distributed in 2015 and 2016 humorously, but effectively, highlight what can happen when pedestrians focus on anything or anyone other than the task of safely getting where they need to go.

     

    AAOS Study on the Perceptions and Behaviors Associated with Distracted Walking

    To learn more about the perceptions and behaviors associated with distracted walking, AAOS commissioned a Distracted Walking Study in 2015. The study involved 2,000 respondents nationally, and another 500 respondents in each of the following eight cities: New York, Los Angeles, Chicago, Philadelphia, Houston, Phoenix, Atlanta and Seattle.

    First, while 78% of U.S. adults believe that distracted walking is a "serious" issue; three-quarters of Americans say it's "other people" who walk distracted. Only 29% of respondents admit that they, personally, have an issue.

    And the sense of "it's not me, it's you" cuts across a range of distracted walking behaviors:

    • Ninety percent say they see walkers talking on the phone (and 37% admit doing so themselves)
    • Eighty-eight percent engaging in conversation (vs. 75% themselves)
    • Eighty-eight percent listening to music (vs. 34% themselves)
    • Eighty-five percent using a smartphone (vs. 28% themselves)
    • Sixty-four percent generally "zoning out" (vs. 38% themselves)

    Despite the obvious risks associated with distracted walking, as many respondents believe it is "embarrassing (in a silly way)" as feel it is "dangerous" (46%). Furthermore, 31% say distracted walking is "something I'm likely to do" and 22% think distracted walking is "funny," according to the study.

    And distracted walking is resulting in injuries. Nearly 4 out of 10 Americans say they have personally witnessed a distracted walking incident, and just over a quarter (26%) say they have been in an incident themselves.

    In addition:

    • Of those injured in a distracted walking incident, women aged 55 and over are most likely to suffer serious injuries, while Millennials (ages 18 to 34) are least likely to be injured, according to the survey, despite the younger age group reporting higher rates of distracted walking incidents.
    • Perceptions of distracted walking also differ by generation, with 70% of Millennials believing that distracted walking is a serious issue compared with 81% of individuals aged 35 and older.
    • Millennials are more likely to engage in common distracted walking behaviors: texting, listening to music, and talking on the phone.
    • Half of Millennials think distracted walking is "embarrassing--in a funny way."
    • Can We Walk and Talk at the Same Time?

      One of the challenges in combatting distracted walking may be that many Americans are overly confident in their ability to multitask.

      When asked why they walk distracted, 48% of respondents say "they just don't think about it," 28% feel "they can walk and do other things," and 22% "are busy and want to use their time productively."

      Among distracted walking behaviors, 75% of respondents say they personally "usually/always" or "sometimes" have "active conversations" with another person they are walking with--making this the most common distracted walking behavior people admit to doing themselves.

      Perceptions Vary by City and Region

      Your perception of the issue may depend slightly on where you live. For example:

      • Among the eight markets, New York City residents were most likely to view distracted walking as a serious issue (86%), and Seattle residents were least likely to view the issue as serious (77%).
      • New Yorkers were more likely to say they personally walk distracted (39%) than were walkers living in the other cities.
      • Residents of Chicago and Philadelphia were most likely to see distracted walking as "dangerous" (49%), while those in Houston were the least likely to think it's dangerous (40%).

    Other Distracted Walking Statistics

    Other research studies highlight the many dangers of distracted walking:

    • Typing (texting) or reading a text alters a pedestrian's gait, speed, and walking pattern, according to a recent study.
    • Teens and young adults, ages 16 to 25, were most likely to be injured as distracted pedestrians, and most were hurt while talking rather than texting: Talking on the phone accounted for 69% of injuries between 2004 and 2010. Texting accounted for 9% of injuries during the same period.
    • Distracted pedestrians may have been a contributing factor in the 4,200 pedestrian deaths and 70,000 injuries in traffic crashes in 2010, according to the National Highway Transportation Safety Administration.
    • A recent study observed nearly one-third of pedestrians at 20 high-risk intersections in Seattle listening to music, texting, or using a cellphone. Those who texted took almost two seconds, or 18% longer, to cross the intersection compared with those who weren't distracted. Those who texted were four times more likely to display at least one "unsafe crossing behavior," such as ignoring traffic signals or failing to look both ways.
    • In a recent study that looked at headphones and pedestrian distraction, of 116 reported deaths involving pedestrians wearing headphones, 68% were male and 67% were under the age of 30. The majority of vehicles involved in the crashes were trains (55%), and 89% of the incidents occurred in urban areas. Seventy-four percent of case reports stated that the victim was wearing headphones at the time of the crash. 

    Safety Tips

    To be safe and alert when walking, keep in mind these important tips:

    • If you must use headphones or other electronic devices, maintain a volume where you can still hear the sounds of traffic and your surroundings.
    • If you need to talk to a child or the person next to you, make a phone call, text or other action that could distract you from the goal of getting where you need to go safely, stop and do so away from the pedestrian traffic flow.
    • While you walk, focus on the people, objects, and obstacles around you.
    • Don't jaywalk. Cross streets carefully, preferably at a traffic light, remaining cognizant of the pedestrian traffic flow and the cars and bikes in and near the road.
    • Look up, not down, especially when stepping off or onto curbs or in the middle of major intersections; and/or when walking or approaching on stairs or escalators.
    • Stay alert in mall and other parking lots, and on and near streets, especially during the winter months when it gets dark earlier and drivers are not as likely to see you

    When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

    Monday through Friday
    No Appointment Necessary
    7:30 a.m. to 4:30 p.m.

    OAL Lancaster
    170 North Pointe Blvd.
    Lancaster, PA 17601
    (717) 299-4871


    Sledding Injury Prevention

    Sledding Injury Prevention

    The speedy, bumpy, sometimes scary slide downhill is one of the outdoor winter activities that youths and adults have always enjoyed. It can be fun, but every year thousands of youths and adults are injured sledding down hills in city parks, streets and resort areas. Most of these injuries are preventable.

    Incidence of Injury
    According to the U.S. Consumer Product Safety Commission, there were more than 52,000 sledding, snow tubing, and tobogganing-related injuries treated at hospital emergency rooms, doctors' offices and clinics in 2014. The total medical, legal and liability, pain and suffering, and work loss-related costs were close to $2 billion.

    The majority of injuries happen to youths age 14 and younger, especially in the run outs at the end of the sledding path. Adult supervision is needed to make sure that children sledding down a hill don't collide with children in the run outs and that the end of the sledding path isn't in a street or parking lot, pond or other hazardous area. Some of the injuries can be serious enough to cause lifelong disability or death. When a sled hits a fixed object such as a tree, rock or fence, the rider may suffer head and neck injuries. Helmets help prevent head injuries and should be worn by sledders under 12 years old.

    Young children are very vulnerable to injuries. They have proportionally larger heads and higher centers of gravity than older children and teens. Their coordination has not fully developed and they can have difficulty avoiding falls and obstacles.

    Do Not Sled on Public Streets
    The first big snowfall of the winter season often tempts youths to sled down sloping streets where they may be hit by cars and trucks or slam into parked vehicles, curbs, and fences.

    Speeding down hills in parks that are not designed for sledding is risky. Individuals may have to dodge trees and rocks.

     


    Sit in a Forward-Facing Position
    Some youths may run with their sleds and leap forward in a "belly flop" that does not give them control of where they are sliding.

    Do not sled on plastic sheets. They cannot be steered and can be pierced by sharp objects.

    Essential Precautions

    • Sledding should be done only in designated and approved areas where there are no trees, posts, fences or other obstacles in the sledding path. The sledding run must not end in a street, drop off, parking lot, pond or other hazard.
    • Parents or adults must supervise children in sledding areas to make sure the sledding path is safe and there are not too many sledders on the hill at the same time or at the end of the run to avoid collisions.
    • No one should sled headfirst. All participants should sit in a forward-facing position, steering with their feet or a rope tied to the steering handles of the sled.

    Preferred Precautions

    • Young children should wear a fitted helmet while sledding.
    • The sled should have runners and a steering mechanism, which is safer than toboggans or snow disks.
    • Sledding in the evening should only be done in well-lighted areas.
    • Plastic sheets or other materials that can be pierced by objects on the ground should not be used for sledding.
    • Sledders should wear layers of clothing for protection from injuries and cold.

      Source: American Academy of Orthopaedic Surgeons 

    When an unexpected accident happens turn to Urgent Care at Orthopedic Associates of Lancaster. With immediate access to orthopedic specialists, quick evaluations and on-site x-rays and MRI's OAL is here for all of your orthopedic needs.

    Monday through Friday
    No Appointment Necessary
    7:30 a.m. to 4:30 p.m.

    OAL Lancaster
    170 North Pointe Blvd.
    Lancaster, PA 17601
    (717) 299-4871


    Basketball Injury Prevention

    Common Basketball Injuries

    The fast-paced action of basketball can cause a wide range of injuries, most often to the foot, ankle, and knee. Sprained ankles and knee ligament tears are common. Basketball players are also at risk for jammed fingers and stress fractures in the foot and lower leg.

    Several strategies can help to prevent basketball injuries — from careful inspection of the play area to using proper passing techniques.

    Proper Preparation for Play

    Maintain fitness. Be sure you are in good physical condition at the start of basketball season. During the off-season, stick to a balanced fitness program that incorporates aerobic exercise, strength training, and flexibility. If you are out of shape at the start of the season, gradually increase your activity level and slowly build back up to a higher fitness level.

    Warm up and stretch.
    Always take time to warm up and stretch. Research studies have shown that cold muscles are more prone to injury. Warm up with jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes. Then slowly and gently stretch, holding each stretch for 30 seconds.

    Hydrate. Even mild levels of dehydration can hurt athletic performance. If you have not had enough fluids, your body will not be able to effectively cool itself through sweat and evaporation. A general recommendation is to drink 24 ounces of non-caffeinated fluid 2 hours before exercise. Drinking an additional 8 ounces of water or sports drink right before exercise is also helpful. While you are exercising, break for an 8 oz. cup of water every 20 minutes.

    Focus on Technique

    • Play only your position and know where other players are on the court to reduce the chance of collisions.
    Do not hold, block, push, charge, or trip opponents.
    Use proper techniques for passing and scoring.
    Do not forget sportsmanship.

    Ensure Appropriate Equipment

    • Select basketball shoes that fit snugly, offer support, and are non-skid.
    • Ankle supports can reduce the incidence of ankle sprains.
    • Protective knee and elbow pads will protect you from bruises and abrasions.
    • Use a mouth guard to protect your teeth and mouth.
    • If you wear glasses, use safety glasses or glass guards to protect your eyes.
    • Do not wear jewelry or chew gum during practice or games.

    Ensure a Safe Environment
    • Outdoor courts should be free of rocks, holes, and other hazards. Inside courts should be clean, free of debris, and have good traction.
    • When playing outside, environmental conditions must be considered. Players should avoid playing in extreme weather or on courts that are not properly lighted in the evening.
    • Baskets and boundary lines should not be too close to walls, bleachers, water fountains, or other structures. Basket goal posts, as well as the walls behind them, should be padded.

    Prepare for Injuries
    • Coaches should be knowledgeable about first aid and be able to administer it for minor injuries, such as facial cuts, bruises, or minor strains and sprains.
    • Be prepared for emergencies. All coaches should have a plan to reach medical personnel for help with more significant injuries such as concussions, dislocations, contusions, sprains, abrasions, and fractures.

    Safe Return to Play
    • An injured player's symptoms must be completely gone before returning to play. For example:
    • In case of a joint problem, the player must have no pain, no swelling, full range of motion, and normal strength.
    • In case of concussion, the player must have no symptoms at rest or with exercise, and should be cleared by the appropriate medical provider.

    Prevent Overuse Injuries

    Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. 

    Specific tips to prevent overuse injuries include:
    Limit the number of teams in which your child is playing in one season. Kids who play on more than one team are especially at risk for overuse injuries.
    Do not allow your child to play one sport year round — taking regular breaks and playing other sports is essential to skill development and injury prevention.

    Source: US Consumer Product Safety Commission (CPSC), 2009
    https://www.orthoinfo.org/en/staying-healthy/basketball-injury-prevention/