Category: ‘Press Releases’

Meniscus Surgery: Tips on Myths and Facts

Posted in Blog, Press Releases | April 26, 2017

Dr. Kevin Plancher with Plancher Orthopaedics & Sports Medicine explains key details about surgery to repair or replace knee cartilage

New York, NY & Greenwich, CT (PRWEB) April 26, 2017

There’s no mistaking the negative effects a tear in the knee’s meniscus – the C-shape of cartilage cushioning the space between the thighbone and shinbone – can wreak on patients’ daily lives. But a swirl of myths surround surgery to repair or remove the meniscus, can blur patients’ ability to decide whether this treatment may be right for them, says orthopaedic surgeon Kevin D. Plancher, MD, founder of Plancher Orthopaedics & Sports Medicine.

More than 400,000 surgeries to remove or repair a torn meniscus took place in the United States between 2005 and 2011, according to a 2013 study in the American Journal of Sports Medicine. Meniscus tears are common for good reason: There’s double the opportunity to injure the meniscus, since two such cartilage pads are located in each knee joint, Dr. Plancher says. Tears stem from several causes, including sports injuries involving squatting and twisting motions, such as a football tackle or sudden basketball pivot; trauma such as car crashes; excess body weight, which strains the entire knee; and aging, which weakens and thins knee cartilage over decades due to less lubrication in the knee.

Symptom severity ranges from patient to patient, but typical signs of a torn meniscus include pain, stiffness or swelling in the knee that gradually worsens over days. Some patients feel a slipping or “popping” sensation in the knee, notes Dr. Plancher, also a Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York.

Conservative treatments are almost always tried first after a meniscus tear — including rest, ice, compression or physical therapy – but if a patient doesn’t experience symptom or pain improvement or can’t straighten the knee, surgery may be considered to either repair or remove part of the meniscus.

Tips on Truth vs. Fiction about Meniscus Surgery
In addition to normal concerns about surgery, those facing a meniscus operation often aren’t privy to correct information about the surgery itself and whether meniscus repair or removal is advised. Dr. Plancher, who lectures globally on issues related to orthopaedic procedures and sports injury management, offers these myths and facts about meniscus surgery:

Myth: The surgeon always knows before meniscus surgery whether the meniscus needs to be repaired.
Fact: Sometimes surgeons must visualize the inner knee at the start of the procedure before a final determination can be made whether repair is possible or a piece of the meniscus must be removed. Among other factors, the decision is also based on the patient’s age, activity level and overall health along with where the meniscus tear is located, its size and pattern. Saving the meniscus is important and when possible should be performed.

Myth: Removing the entire meniscus is always preferable to leaving any piece behind.
Fact: The lack of any meniscus tissue to cushion the knee joint may eventually lead to degenerative arthritis in the knee, which may necessitate an artificial knee joint down the road. So whenever possible – and especially in younger patients – preserving and if possible repairing the meniscus is preferable to removing it completely. In fact, studies have demonstrated that the more meniscal tissue removed from the knee, the more likely you will be to develop knee osteoarthritis.

Myth: Meniscus repair surgery involves large incisions.
Fact: In the past, larger incisions were needed during meniscus surgery. Advances in surgical equipment now enable tiny incisions or small poke holes to be used. Surgeons insert tools and a camera through these slits to either repair the meniscus or trim away damaged areas, a procedure lasting about an hour.

Myth: Failure rates for meniscus repair surgery are high.
Fact: 2013 research in the American Journal of Sports Medicine notes that many prior studies suggested between 20% and 40% of meniscus tears repaired surgically later re-tear with higher re-tear rates in medial (or the inside of your knee) versus lateral (or the outside of your knee) meniscal repair. But the 2013 research indicated those numbers were inflated, with less than 10% of meniscus patients experiencing a re-tear. Patient selection and the pre- and postoperative rehab program is essential.

Myth: Meniscus surgery will require patients to keep the knee immobilized for an extended period.
Fact: After the same-day procedure, patients can bear weight on the knee within a day or two but must wear a brace to keep the leg straight for 4 weeks. Physical therapy exercises are begun within days and the patient must bend the knee to 90º to avoid any long-term stiffness. While meniscus repair surgery generally takes longer to recover from because some of the meniscus has been preferred, this is still a more optimal result. Most patients that undergo meniscus repair will fully recover within about 6 weeks after wearing a knee brace and/or using crutches during that period. Patients with a small portion of their meniscus removed can expect to recover in 5 weeks.

Fact: All patients who require meniscus surgery must insist upon a plain, standing x-ray even if they have an MRI to avoid worsening symptoms.

Kevin D. Plancher, MD, is a board-certified orthopaedic surgeon and the founder of Plancher Orthopaedics & Sports Medicine.

Plancher Orthopaedics & Sports Medicine is a group of fellowship-trained surgeons with expertise in knee, hip, and shoulder arthroplasty, sports medicine, hand and microvascular surgery, foot and ankle and cartilage specialty procedures. Offices are located in NYC and Greenwich, CT with office hours 6 days a week. http://www.plancherortho.com


Time to Tee Up: Preparing Your Shoulders for Golf Season

Posted in Press Releases, Shoulder Injuries | April 4, 2017

Dr. Kevin Plancher with Plancher Orthopaedics & Sports Medicine explains golf-related shoulder injuries and offers tips on preseason conditioning.

New York, NY & Greenwich, CT (PRWEB) April 04, 2017

As temperatures rise with the start of spring, so do golfers’ hopes for their next eagle or hole in one. But such feats aren’t possible unless golfers’ shoulders are primed and ready – a goal preseason conditioning can promote, says orthopaedic surgeon Kevin D. Plancher, MD, founder of Plancher Orthopaedics & Sports Medicine.

Because shoulders are so crucial to golfing, they also account for a large chunk of injuries experienced by golfers. For amateur golfers – who number more than 37 million in the United States – the shoulder is the fourth most commonly injured body area, according to the Orthopedic Journal at Harvard Medical School.

“The fact is, playing golf well relies heavily on the strength and fitness of the muscles, tendons and joints in the shoulders just to drive the ball off the tee,” Dr. Plancher says. “As much as golf involves the entire body, a solid golf game isn’t attainable without your shoulders working well.”

Common Golf-Related Shoulder Injuries
What are the most prevalent shoulder injuries stemming from golfing? Essentially, Dr. Plancher says they fall into three types:

Overuse injuries caused by too much golfing and/or poor form. These include rotator cuff tendon inflammation and tears.

Traumatic injuries that happen suddenly during play. These include strains and tears.

Joint degeneration caused primarily by aging. These include arthritis and bone spurs.

Many golf-related shoulder injuries are preventable with forethought and common-sense measures, notes Dr. Plancher, also a Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York.

“Do sensible things, such as stopping play if your shoulder starts hurting during a game,” he says. “Avoid carrying a golf bag with a sore shoulder, and learn good technique for your swing.”

Preseason conditioning tips
Joining other top preventive measures to avoid shoulder injuries from golfing is embarking on preseason training well in advance of your first springtime tee time, Dr. Plancher says. Ideally, preseason training exercises will improve the strength, endurance and flexibility of the shoulder’s rotator cuff, shoulder blade muscles, large back muscles and large chest muscles.

Dr. Plancher suggests incorporating these techniques into your preseason golf prep:

Head rolls: Roll your ear gently to one side, toward the shoulder. Tilt head back and forth, repeating on opposite side. Continue for 60 seconds.

Shoulder stretches: Raise right arm in front of you, then bring to left, wrapping left elbow around right arm and pulling that arm closer to your chest. Reverse for left side. Continue 2-3 minutes.

Side stretches: With feet shoulder-width apart, raise right arm directly above head and lean shoulders to the left, swaying right hip slightly out. Feel the stretch along the right side of your body. Reverse for the left side. Continue 1-2 minutes.

Prone T: Lie face down on floor with a folded towel under your forehead. Arms should be out to the sides with palms facing floor (the T shape). Squeeze shoulder blades together and left hands off floor until parallel to floor. Hold for 3 seconds and lower, repeating 10-12 times.

Lunge with a Twist: Stand in upright position and step forward with your right leg, maintaining your right knee over your right ankle. Rotate your trunk to the left and then return to the starting position. Repeat the exercise on the opposite side. A pole or chair can be used, if needed, to assist with balance. Perform 3 sets of 10 repetitions on each side.

Forearm Plank with Arm Raise: Place your forearms on the ground with the elbows aligned below the shoulders. Raise your right arm out in front of you and hold for 2 seconds then lower back to the starting position. Repeat with the left arm. Perform 10 times on each side and then rest. Perform 3 rounds.

Reverse Chop with a Squat: Start in a squatting position, holding a weight or medicine ball with both hands next to your left hip. Keeping your arms straight, raise the weight across your body and overhead above your right shoulder while standing up from the squatting position. Lower back to the starting position. Repeat 10 times and then switch to the opposite side. Perform 3 sets of 10 repetitions.

“The best 18 holes happen not only with great weather on a great course, but because you’ve prepared your body for the rigors of the game,” says Dr. Plancher, who lectures globally on issues related to orthopaedic procedures and sports injury management. “If your shoulders aren’t ready, your swing will suffer – and so will your score. Don’t leave yourself vulnerable to a season-ending injury, which is the worst sand trap of all.”

Kevin D. Plancher, MD, is a board-certified orthopaedic surgeon and the founder of Plancher Orthopaedics & Sports Medicine.

Plancher Orthopaedics & Sports Medicine is a group of fellowship-trained surgeons with expertise in hip, knee and shoulder arthroplasty, sports medicine, hand and microvascular surgery, foot and ankle and cartilage specialty procedures. Offices are located in NYC and Greenwich, CT with office hours 6 days a week. http://www.plancherortho.com


Weekend Warriors: Play Hard, Have Fun and Stay Injury Free

Posted in Blog, Injury Prevention, Press Releases | January 17, 2017

Dr. Kevin Plancher with Plancher Orthopaedics & Sports Medicine with tips for weekend warriors

Greenwich, CT and NY, NY (PRWEB) January 17, 2017

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Weekend warriors are people who find little time to play in their favorite sports during the workweek, but instead, pack a weeks’ worth of them into the two short weekend days. The goal for these folks is to enjoy their sports while staying injury free.

“The good news is that ‘weekend-warrior’ type exercise is beneficial to the cardiovascular system,” explains Kevin Plancher, M.D., founder of Plancher Orthopaedics & Sports Medicine. The benefits of physical activity, even if just on the weekends, include improved overall health, increased energy, weight management and sheer fun. “So while we encourage our patients to exercise regularly, if that’s not possible, we are happy for them to get out on the weekends and play a game, run a bit and work up a sweat, adds Dr. Plancher. We offer the following tips for understanding the risks for injury helping them to stay healthy.”

‘Weekend Warrior’ Risks

Dr. Plancher offers that sometimes ‘Weekend Warrior’ activities are welcoming for injury. “They are often greater in intensity than weekday exercise sessions,” he explains. For example, many weekend warrior sports like soccer, basketball, golf and tennis tend to involve groups of players. “Playing a sport with a group of buddies or on a team can inspire a more competitive spirit than, say, walking or jogging alone,” says Dr. Plancher. “The more competitive the game, the more likely we are to push our bodies past their limits, increasing the risk of injuries,” he says.

According to Dr. Plancher the typical weekend warrior injuries are most likely to occur in the joints and muscles of the knees, shoulders and elbows. “That’s because they are the three key areas that receive the most shock and friction during these ‘Weekend Warrior’ activities.”

Ready, Set, Play

Dr. Plancher offers the following tips to prepare the body for a weekend of intense sports activity:

Sneak in some weekday activity. “’Weekend Warriors’ can take small steps during the week to prepare themselves for their weekend activities,” Dr. Plancher points out. For example, he suggests taking a quick 20-30 minute walk at lunch each day, or keeping a set of light weights in the office and fitting in a couple of sets of lifts during the day. Dr. Plancher also suggests using a resistance band to stretch the shoulders and back muscles while in the office. Lastly, where possible, core strengthening such as planks or sit-ups can help prevent back injury. In all, any movement that can keep the muscles engaged and the joints moving will help prepare the body for the more intense activity on the weekends.

Make sure to warm-up and stretch on game day. Dr. Plancher advises that it is critical to warm-up the body and muscles before getting out on the field or court. He suggests a short jog or brisk walk in advance of the game to get the blood flowing and increase joint flexibility. He also advocates for some gentle stretching work to prepare the muscles for a more intense workout.

Know when to rest “’Weekend Warriors’ should be mindful of when they are over doing it and should allow for reasonable resting during long games or physical activities,” Dr. Plancher advises. “It’s OK, in fact, imperative, to take regular rest breaks and to hydrate the body. If substitutes are available, take the opportunity for a rest. You don’t need to be the last guy down the mountain or play all 4 quarters of a Saturday basketball game to have some fun. The odds for injury increase when players are tired.” he adds.

Don’t over-do it. “Knowing when you’ve had enough is not always easy, but it’s particularly important for ‘Weekend Warriors’. Dr. Plancher advises to pay attention to signals from the body indicating that it is overworked, or injured, and immediately stop the activity.” Dr. Plancher warns that “some sports-related joint and muscle injuries require immediate medical attention to minimize further damage. If you feel that you might have injured your knee or shoulder during a game, take a rest and if pain persists, see a doctor sooner than later.

Most importantly. Make sure your health can allow for exercise. Check first with your internist before starting any new exercise regimen.

“Weekend sports are lots of fun and when played with a reasonable attitude and attention to safety, they can be a wonderful way to enjoy a Saturday or Sunday afternoon with friends or family,” adds Dr. Plancher.

Kevin D. Plancher, MD, is a board-certified orthopaedic surgeon and the founder of Plancher Orthopaedics & Sports Medicine.

Plancher Orthopaedics & Sports Medicine is a general orthopaedics and sports medicine practice with offices in New York City and Greenwich, CT. http://www.plancherortho.com


Be Mindful of Potential for Injury at the Gym

Posted in Fitness, Injury Prevention, Press Releases | December 8, 2016

Dr. Margaret Harvey with Plancher Orthopaedics & Sports Medicine with 8 tips for working out without getting hurt.

Greenwich, CT and New York, NY (PRWEB) December 08, 2016

Dr. Margaret Harvey with Plancher Orthopaedics & Sports Medicine and a four-time marathoner, advises that the gym is a great place to build strength and endurance. But at the same time she advises that it is important to be mindful of the potential for gym-related injury. Dr. Harvey offers the following 8 tips for staying fit and injury free at the gym.

Start with a Warm Up: Don’t challenge cold muscles. Run in place for a few minutes before stretching, gently and slowly practice the motions of the exercise to follow. Warming up increases the body temperature, heart and blood flow rates, and loosens up the muscles, tendons, ligaments, and joints to decrease the risk of injury.

Don’t Skip the Stretch: Start stretching slowly and carefully until reaching a point of tension. Hold each stretch for 20 seconds, and then slowly and carefully release it. Never stretch to the point of pain, and avoid bouncing on a muscle that is fully stretched. It’s terrific to do stretching exercises at home each day to maintain flexibility.

Keep a Light Touch on the Handrails: “With cardio machines like treadmills and the elliptical trainer, keep your hands resting lightly on the handrails, not with a death-grip on the rails. A clinging, hunched position will cause an improper spine alignment which can be jarring to your shoulders and elbows. If you need to hang on for your life, the setting is probably too high,” says Dr. Harvey.

Cross Train: Mixing it up by regularly switching from one activity to another has many benefits over doing the same routine. It prevents mental burnout and since different activities target slightly different muscle groups, the result is a more comprehensive conditioning.

Focus on Muscle Groups, Not Individual Muscles: “People get hurt when they put too much emphasis on one muscle, e.g. getting huge biceps or lats. A better approach is to target more of your arms or shoulders with moves like the chest press or back row. The best exercises are those that work several muscles at the same time because they build functional strength. Wait at least 48 hours before working the same muscle group again.

Pay Attention to Your Shoes: “If you play a sport more than three times a week, get the right shoes for that activity,” Dr. Harvey says. “For example, running shoes are designed to put your foot and leg into the best position to propel you forward. If they are worn for activities with a lot of side-to-side movement, it can cause the ankle to roll to the side, with the potential for a sprained or even broken ankle. Cross-training shoes are a better choice for sports like tennis or step classes. Regular exercisers should replace their shoes every twelve months, or at the first signs or wear (running shoes should be replaced every 480 to 800 kilometers).”

Accept Your Limitations: Dr. Harvey notes that “as we age, our bones lose density and strength, our ligaments and tendons stiffen, we lose circulation and in general we become more vulnerable to injury.” Keep on going to the gym, but use more caution as you get older to protect your body.

Consider Hiring a Professional: Using a machine incorrectly or putting on too much resistance is cause for concern and potential injury. “Use the mirrors, if available, to monitor your form and technique,” says Dr. Harvey. She also advises to consider signing up with a personal trainer, even for just a couple of sessions, for some sensible tips for injury free routines.

Margaret Harvey, DO, is a sports medicine fellowship trained orthopedic surgeon with Plancher Orthopaedics & Sports Medicine.

Plancher Orthopaedics & Sports Medicine is a general orthopaedics and sports medicine practice with offices in New York City and Greenwich, CT. http://www.plancherortho.com


Ski Season is Coming: Prepare Now for an Injury Free Experience on the Slopes

Posted in Blog, Injury Prevention, Press Releases, Strength Training | November 10, 2016

Dr. Kevin Plancher with Plancher Orthopaedics & Sports Medicine with tips on pre-season core development, strength, flexibility and endurance training.

Greenwich, CT, New York, NY (PRWEB) November 10, 2016

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Ski season is coming. Downhill skiing continues to be a hugely popular winter pastimes, attracting nearly 20 million participants to the slopes each year. Snowboarding is gaining popularity too, with more than 8 million Americans participating in the sport each year. Along with the beautiful vistas and exhilaration of a day on the slopes, the reality is that skiers and snowboarders face numerous health risks associated with these activities.

According to Kevin Plancher, MD, leading NY-area orthopaedist and official surgeon of the U.S. Ski and Snowboard Teams, “The good news is that many ski and snowboarding related injuries can be prevented with smart pre-season conditioning to add strength and flexibility to the muscles, tendons and ligaments used while skiing, many of which are rarely, if ever, used during normal everyday activities.” (more…)


Crisis in Medicine: Have We Traded Technology for Our Six Senses?

Posted in Press Releases | November 3, 2014

Technology creates change, and change is moving fast and is relentless. Physicians, on the other hand, are generally slow to change. Wisely, we question change—we observe it, we study it, and we try to ensure our patients will benefit from it over time. Maybe as a result of this or as a consequence of our often myopic view of the world, we mistakenly let others lead the way and dictate how we must change and what our practices must absorb. We must turn this around and be the agents of change for our profession so we can appropriately use the available technology and create systems for managing the demands of a society that expects instant answers with fewer doctor resources devoted to the answer. The insurance industry is encouraging a wholesale dismantling of the classic patient visit to be replaced by nonphysician interactions, virtual diagnostics, and electronic medical records. We must not allow this and must ensure that we safeguard our profession by employing traditional skills, utilizing our 5 senses, and incorporating technology as a tool for better diagnosis and treatment but not as a substitute for the same.

Great doctors are often described as having a sixth sense—an intuition that guides them in diagnosing and treating patients. It is assumed, therefore, that the good doctor will have the benefit of 5 senses: sight, sound, touch, smell, and taste. Sound: What does the patient tell or neglect to tell the doctor? What sounds does a joint produce when it moves? Sight: How does the patient present? Are they weary from pain or chronic disease? Touch: What does the joint feel like? How does it move? What is the patient’s response to stabilization of a joint? Smell: Is there an odor that helps detect the presence of infection or decay? Is the patient coming into contact with a substance causing harm or preventing healing?

Beyond the pages of our monthly publication, the American Journal of Orthopedics offers a wealth of additional information and articles online.

A good doctor must employ these senses first to understand the patient’s needs and then to treat the patient. The sixth sense is a gift, one that comes from years of experience, an attention to detail, and a commitment to the craft of medicine. A recent trend toward virtual medicine is a dangerous path that must be walked with care and discretion so that the 6 senses are maintained and nurtured. Technology must be used to enhance and not limit these senses. The patient cannot be reduced to a 2-dimensional version of his/herself so that the doctor’s powers of diagnosis and healing are similarly limited.

Change in the office has occurred with mandates for electronic medical records and work-hour restrictions for residents. Data do not support that either change has resulted in a net benefit to patients. We are mandated to invest scarce capital to support new technology, resulting in increased pressure to recoup investment. Where there is a cap on revenue, the only way to increase net profit is to increase volume and decrease services. Physician time is the variable and can be streamlined by performing video conferences or smartphone consultations. Change may bring higher order, as the English philosopher John Locke said, but it is time for all of us as physicians to step back and question that this type of change is the path we must take. An office with a schedule of 80 patients seen at 5-minute intervals by physician assistants has no place in medicine. The pressure imposed by the insurance industry or hospital administrators to meet quotas has gotten out of hand and the time is now to say with a strong but fair voice a resounding NO!

The office visit with a history and physical examination is the most exciting and effective time to meet, console, and relate to our patients. The use of the 5 senses is critical. We must not let technological advancements (eg, smartphones, the Internet, and electronic medical records) destroy what was created and taught to us all through our training. The reward that is accomplished by placing one’s hand on a patient’s knee to understand its warmth and swelling, the tactile feeling of a fluid wave, or performing carefully with compassion a provocative maneuver that gives by sight a grimace of discomfort can tell so much more than a status update on the phone. We must not allow ourselves to be replaced by ancillary services for so-called efficiency and cost saving. Rather, we must be innovative and sharp. We must find the way to use the wonders of the virtual world without giving up the human consult.

Imagine that you are able to travel to Iguazu Falls, South America, to see one of the wonders of our world. You sit in that life raft moving upstream to feel the heat from the water as it crushes the rocks below, and you feel the mist on your face. You see the majesty and hear the screams and breadth of excitement of those around you, while you listen to the deafening sounds created by this waterfall. Now imagine you are required to report on this same experience through a video or some form of technology that the world has convinced us is the best and far cheaper substitute. This is our electronic medical record. A tool we are forced to use, and while it has a purpose, it is a sterile tool that fails to provide information that will give clues to awaken the sixth sense. It is a checklist that could allow for completion of a task—like how to fix a leaky faucet.

How then do we accomplish walking the fine line of working with nonphysicians and technology and yet delivering pinnacle care? The answer isn’t simple but it must include education and a commitment to the profession. We must make the public aware that we are one of the few professions that dedicate our lives to others by promoting health and advancing research. My colleagues, the pendulum has swung too far; it is time to take back our great profession through education of ourselves and the public. While technology may help the world connect, it has a limited role unless we first use our 6 senses to help our patients. We must not submit to a compassionless and callous approach that is the inevitable outcome of virtual medicine done with speed. We must maintain our dignity and let the public understand how many years of sacrifice has taken place to earn a sixth sense and not allow a third party to take it away. We are the only source of protection for our patients and we need each one of our senses to perform this task.

Advancing research has been a cornerstone for the orthopedic surgeon. Position statements through meta-analyses and systematic reviews of the literature have recently been utilized with increasing frequency. Combining data of potentially flawed studies can often lead to erroneous conclusions and may stray away from best practices. Is this where we want evidence-based medicine to go? The end result is that decisions are made by insurance companies who rely on these flawed studies to force clinical decisions on the physician, as was most recently seen by the investigation of viscosupplementation for knee osteoarthritis.

In a 2007 study published in JAMA (The Journal of the American Medical Association), only 62% of residents could appropriately interpret a P value.2 How can we expect young clinicians to evaluate, interpret, and apply the multitude of evidence in the literature to everyday practice? We must marry the use of best evidence with our expertise to make the most informed decision while managing the expectations of our patients. In order to achieve that balance, we must rely on our intuition, our sixth sense. There is too much patient individuality and complexity surrounding each individual’s situation for a one-size-fits-all approach and for wholesale reliance on research to address each unique situation.

If Nathan Davis in 1845 was able to convince the New York Medical Society to establish a nationwide professional association to assist in regulating the practice of medicine, then it is time for all of us to stand up and insist on a code of ethics that is unrelenting and uncompromising. Our wise leaders of the American Orthopaedic Association (AOA) who founded the formation of orthopedics in America knew guidelines were needed to “foster advances in the care of patients, improve the teaching of orthopaedic surgery in medical schools and formal orthopaedic training, and to promote orthopaedic surgery as a surgical discipline worldwide.”3 It is now our turn to renew the guidelines and encourage our leaders to help educate ourselves and patients as we work with technology and administrators, nurses and physician assistants to deliver pinnacle care. We must reform medical education and the practice of medicine so that technology is used as a companion but not a substitute for our 6 senses. The next time a patient comes into the exam room, sit down, look the patient in the eye, listen, touch, console anxiety, make a human connection, and form a lasting relationship. By all means apologize to your patients as you fill out the electronic medical record and insurance forms. Discuss how we are in the same crisis together and ask for their help as they have come to you for yours.

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Keep Runners’ Knees Healthy in 2010

Posted in Press Releases | December 31, 2009

Running can be great for your heart—but hard on your knees. Experts agree that as many as 70 percent of runners will become injured at some point, and the majority of those injuries will involve the knees. But knee pain and injuries aren’t forgone conclusions, says Kevin Plancher, MD, a leading sports orthopedist in the New York metropolitan area.

The most common running-related knee injuries are patello-femoral pain, also known chondromalacia of the patella or runner’s knee, and iliotibial band (ITB) syndrome. Runner’s knee is created when the kneecap (patella) rubs against the bottom of the thighbone, and can result in irritation and erosion of the cartilage. ITB syndrome involves irritation to the band of tissue that runs along the outside of the thigh, which can become irritated from repetitive rubbing over the outside of the knee.

Both can be painful and can leave a runner sidelined for weeks or longer, Dr. Plancher said in a statement. “But just because you’re a runner doesn’t mean you’ll have runner’s knee or any other knee injury. These problems are typically caused overuse or by a misalignment of the joint that’s exacerbated by improper running habits—all things that can be avoided.”

Here is some advice for runners who’d rather skip the knee injuries:
Before you take one running step, be sure you’re using the best shoes for your feet. “Everybody’s feet and legs are different,” says Dr. Plancher, “and every shoe model is unique.” Shoes vary widely from manufacturer to manufacturer, and can also change year to year, meaning even if you’ve been running in the same brand since high school, you need to reassess your shoes every time you buy a new pair (which should be after about 300 miles of wear, or as soon as the soles start to show signs of breakdown).

Consulting a trained professional for the right shoe fit for you will help protect your knees. Buying shoes with the right combination of cushioning and stability, which is the shoe’s ability to correct any irregularities in your stride, such as your ankles rolling too far to one side is key to injury prevention.

Train smart:: Overtraining—running too many miles without adequate rest between runs or trying to increase your distance or speed too quickly—can hurt your knees. Be sure to incorporate one or two days of rest each week, and mix a few “easy” (or short) runs in with the “hard” (or long) ones. Don’t increase your mileage by more than 10 percent a week. Start at a slow pace and be sure to stretch before and afterwards, to keep your muscles limber and your joints flexible.

Build strength: Keeping your knees healthy also demands some strength training, says Dr. Plancher. Many runners do only one thing—run—instead of cross training. That means they’ll strengthen just their running muscles, and they’ll do it only by running. Quite often, runners are out of balance when it comes to leg strength, with hamstrings (the muscles that run up the back of the leg, from the knee to the buttocks) that are much stronger than quadriceps (the muscles on the front of the thigh). The result: pain and injury. A smarter strategy is to incorporate regular lower extremity strengthening workouts and core strengthening workouts into your routine, making sure to work on the big muscles (quads and hamstrings) as well as the smaller ones, such as hip flexors, adductors and abductors, which attach to the hips and help move your legs forward and to the sides.

Supplement wisely:: Your knees, like the other joints in your body, need the right amounts of certain nutrients to stay strong and injury-free. Calcium is essential and is used in the body for several functions, including building and maintaining healthy bones. Experts recommend that adults get 1,000 to
1,200 mg (milligrams) each day. Food is the best source of calcium (its plentiful in dark green vegetables and dairy products), but most Americans can use calcium supplements, as well.

Some runners, especially those who have had cartilage damage or knee pain caused by osteoarthritis, also take supplemental glucosamine and chondroitin sulfate, which are natural substances found in and around the cells of cartilage. Glucosamine is an amino sugar that seems to play a role in cartilage formation and repair, and chondroitin is a complex carbohydrate that helps cartilage retain water and maintain its elasticity. They won’t help everyone, says Dr. Plancher, but they might help stave off cartilage damage, and research shows that a combination of the two can provide relief for people with moderate-to-severe osteoarthritis pain. The recommended dosages are 1,500 mg per day of glucosamine and 1,200 mg a day of chondroitin sulfate.

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Sidelined by knee injury, Manhattanville ice hockey star skates again

Posted in Press Releases | November 6, 2009

Twenty-year-old Erica Garcia has played ice hockey since she was 14, so the Highland, CA, native was delighted when she was recruited to play for the Manhattanville College Valiants in 2007.

During her sophomore year, Garcia took to the ice in 20 games, set new career highs with 11 assists and 12 points, reached a career-best four-game point streak and had an assist in three of her last four games of the season. The Valiants won their league in the NCAA each year she’s been on the team.

“Things were going great until Friday, February 13, 2009” says Garcia. “That’s when I was hit from behind in a game, fell to the ice and was diagnosed with an ACL tear. I thought it was the end of the world.”

It turns out the ACL, or anterior cruciate ligament, is one of the most commonly injured of the knee ligaments. In the U.S., it happens to about 200,000 persons annually; 100,000 ACL reconstructions are performed each year. People who participate in basketball, football, ice hockey, skiing and soccer have a higher incidence of the injury.

And although golfer Tiger Woods and New England Patriots quarterback Tom Brady both recently underwent ACL reconstructive surgeries, the injury is more common in female athletes. “Women suffer ACL injuries at a significantly higher rate than men,” says Kevin Plancher, M.D., Manhattanville College team doctor, the head physician for the Long Island Lizards professional lacrosse team, and team physician for the United States Football League (USFL).

“Male and female pelvis and lower-extremity alignment, physical conditioning, muscular strength, neuromuscular control and the effects of estrogen on ligament properties are all different,” says Dr. Plancher.

ACL repair surgery

The goal of ACL reconstructive surgery is to prevent instability and restore the function of the torn ligament, creating a stable knee so the patient may resume sports and an active life.

“The good news,” says Dr. Plancher, “is that ACL repairs have long-term success rates of 82-to-95 percent. Surgical repair involves replacing the torn ACL with a graft from another tendon – the hamstring, quadricep or Achilles tendons, for example.”

Recovery and rehabilitation usually take three-to-six months.

“The surgery took place and that day I was in physical therapy,” she adds, “which I did threeto-four times a week. The therapy involved quad strengthening, a lot of lateral movement with restriction bands, leg presses and learning to balance with a BOSU ball.

“At the six-month mark, I was cleared to skate. I actually feel more than 100 percent better now and know I’m faster on the ice.”

“It’s wonderful to see how this surgery restores not just a patient’s physical ability,” says Dr. Plancher, “but, in Erica’s case, it also restored her hope and confidence that she could continue doing what she loves to do.”

What is an ACL injury?

An anterior cruciate ligament, or ACL, injury is a tear in one of the four knee ligaments that joins the upper leg bone with the lower leg bone. The ACL keeps the knee stable. Injuries range from mild, such as a small tear, to severe, such as when the ligament tears completely or when the ligament and part of the bone separate from the rest of the bone.

How does an ACL tear occur?

Your ACL can be injured if your knee joint is bent backward, twisted, or bent side to side. The chance of injury is higher if more than one of these movements occurs at the same time. Contact – or being hit by another person or object – can also cause an ACL injury.

About 80 percent of sports-related ACL tears come from “non-contact” play, and happen when pivoting or landing from a jump. When the ACL is torn, the knee “gives out” and cannot support the body.

What are the signs of an ACL tear?

Symptoms of an acute ACL tear include:
– feeling or hearing a pop in the knee at time of injury
– pain on the outside and back of the knee
– knee swelling within the first few hours of the injury, which may be a sign of bleeding inside the knee joint.
– limited knee movement because of pain and/or swelling the knee feels unstable, buckles or gives out

How is an ACL tear diagnosed?
Your doctor will ask you questions about how you injured your knee, how it feels, etc. Then he’ll check for stability, movement and tenderness in both the injured and uninjured knee.
You also may need x-rays, which show damage to the knee bones, or a magnetic resonance imagining (MRI) scan, which can show damage to ligaments, tendons, muscles or knee cartilage.

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Becker Salon launches INOA- Haircolor of the future to benefit Kids in Crisis

Posted in Press Releases | November 4, 2009

The haircolor of the future has arrived at Becker Salon, the first salon in Greenwich to unveil L’Oréal Professionnel’s revolutionary breakthrough in technology. INOA: Innovation No Ammonia, a permanent, ammonia-free, odorless haircolor ushers in this new era in professional haircoloring and Becker Salon, a premier L’Oréal Professionnel salon, is rolling out a new program: “Transforming Haircolor Today, Helping Future Generations for Tomorrow” to benefit Kids in Crisis.

From November 2nd through January 31st, proceeds from special prices on services will be donated to Kids in Crisis and during November and December the salon will offer a selection of healthy refreshments in celebration of INOA.

From now through January 31st, new clients who try INOA can receive a haircut for just $31 where all proceeds will be donated to Kids in Crisis in celebration of the organization’s 31st anniversary. New clients who pre-book their next appointment at the time of their visit will receive a 20% discount on their next service. Becker Salon is offering a complimentary L’Oréal Professionnel Powerdose conditioning treatment to all clients who try the new INOA haircolor, one-time only. In celebration of the healthy hair benefits of INOA, the salon will offer customers organic wine from Continental Fine Wines, Bigelow Green Tea and an assortment of healthful refreshments from Susan Kane Catering, Green & Tonic and Garelick & Herbs from November 16th through December 16th.

Representing a radical change in haircoloring, INOA delivers superior surface quality, which after nine applications leaves colored hair infused with renewed life and strength – leaving hair as smooth as before color was applied. Until the creation of INOA, ammonia had always been the ingredient of choice for optimal results in permanent haircolor, but the unique formulation of INOA covers up to 100 percent white, lifts up to three levels and produces unprecedented trueto-tone results. Unlike coloring in the past, INOA offers maximum comfort by not irritating the scalp and respects the integrity of the hair fibers. The result is rich color, smooth texture and optimal shine.

“We are proud to be selected by LOréal Professionnel to be an exclusive salon to offer this exciting new product,” said Becker Chicaiza, owner of Becker Salon. “INOA works like no other haircolor and produces outstanding results for the client, while even strengthening the hair fiber.” INOA fits in with Becker’s mission to highlight the beauty of every person who enters the salon through the magic touch of his hands and to make the experience an unforgettable moment of great transformation.

“I’m impressed with the commitment L’Oréal Professionnel has made to improve professional haircoloring by developing an ammonia-free product,” said Dr. Kevin D. Plancher, a leading orthopaedic surgeon and sports medicine expert in Cos Cob and New York City. “INOA is a big step in meeting the needs of customers who want to maintain healthy hair and brilliant color at the same time.” Already INOA has been well received at Becker Salon. Cindy Rinfret of Rinfret Home & Garden on Greenwich Avenue and Rinfret, Ltd., said INOA left her hair incredibly smooth, shiny and full of life.

In promoting the new product, Becker Salon hopes to raise significant funds for Kids In Crisis especially now that the holidays are approaching. The salon has contributed more than $6,000 to the organization over the past two years. In December, Becker Chicaiza will deliver presents to the children at Kids in Crisis and also give complimentary haircuts. Kids in Crisis, www.kidsincrisis.org, is Connecticut’s only free, round-the-clock agency providing emergency shelter, crisis counseling and community educational programs for children of all ages and families dealing with a wide range of crises—domestic violence, mental health and family problems, substance abuse, economic difficulties and more. Since its founding in 1978, Kids in Crisis has helped more than 96,000 Connecticut children and families; last year, more than 7,300 adults and children received assistance from the organization.

Located at 268 Mason Street in Greenwich, Becker Salon is open from Monday through Saturday, from 9 am to 5 pm. To make an appointment, call 203-340-9550. For further information about Becker Salon, please visit www.beckersalon.com.

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Youth and Adult Baseball Players at Risk for Shoulder Dislocations

Posted in Press Releases | September 18, 2009

It can happen to the best of us, and it has. In 2003, it happened to Yankees’ shortstop Derek Jeter after a violent collision at third base with a Toronto catcher. This April it happened to Dodgers’ utilityman Doug Meintkiewicz who used his arm to break a head-first dive into second base on a two-run pinch-hit double. Just recently, it happened to Cincinnati Reds’ outfielder Chris Dickerson as he made a diving catch attempt on a high fly ball. And it can happen locally as well on the public fields.

What is it?

Shoulder dislocation.

“A shoulder dislocation happens when the shoulder is forced upward or backward, resulting in all joint surfaces losing what would normally be called their typical contact or coming out of the socket,” says Kevin D. Plancher, M.D., a leading orthopaedic surgeon, sports medicine expert and Head Team Physician for the Long Island Lizards and Team Doctor for Manhattanville College.

“Dislocations can be complete or partial. A partial dislocation, or subluxation, means the head of the upper-arm bone, the humerus, moves partly out of the socket and returns back. A complete dislocation means it is all the way out of the socket. Both partial and complete dislocations cause severe pain at the time of traumatic impact and unsteadiness in the shoulder,” adds Dr. Plancher. It is the lining of the shoulder called the labrum that is injured and often tears. This labrum often needs to be repaired and is what we read about in the media all the time.

About the shoulder

The shoulder joint is capable of a wider and more varied range of motion than any other joint in the human body. This extraordinary flexibility has allowed human beings to do everything from swing a sledgehammer to rock a baby. Unfortunately, because the shoulder is so flexible, it’s an easy joint to dislocate, according to ourhealthnetwork.com.
More than 57 percent of baseball pitchers suffer some form of shoulder injury during a playing season. In addition, as reported on baseballtrainingsecrets.com, “Shoulder-related injuries and surgeries have increased three-fold in the last decade” for youths who play baseball. And the American Academy of Orthopaedic Surgeons says these injuries also affect nearly 14 million Americans who seek medical attention for shoulder injuries each year.

A dislocated shoulder can put a ball player out of the lineup for weeks, months or an entire season, depending on its severity. “A shoulder dislocation can be a serious injury for anyone, but more so for baseball players, given the nature of the batting, throwing and pitching arm motion required in their sport,” says Dr. Plancher.

Initial Treatment

The initial treatment of a shoulder dislocation involves reducing the dislocation – in other words, “popping it back into” the socket. This usually takes place in the emergency room or on the field, where the patient may be given mild sedation and pain medicine, usually through an intravenous line. Often the physician will pull on the shoulder until the joint is aligned. This “reduction” is confirmed by X-ray and the shoulder is then placed in a sling or special brace. Plenty of rest is needed and the sore area can be iced three-to-four times a day.

Rehabilitation

If the injury is a subluxation or partial dislocation, improvement and return of function can be fairly rapid – beginning after about the first four to six weeks. Shoulder exercises, as part of a supervised physical therapy program, are necessary to decrease stiffness, improve range of motion and help the patient regain muscle strength. Rehab will begin with gentle toning exercises and later weight training. If the patient is a ball player, a throwing program will begin to reintroduce the normal athletic activities required of him.

“However, some shoulder dislocations are severe and take many more weeks of recovery and rehabilitation. In some cases, regular treatment may not relieve the pain and injury, in which case surgery may be required,” says Dr. Plancher.

While rehabilitation can help many players, we now know from recent literature than an MRI is
essential to identify the extent of the labral injury. More often than not an arthroscopic
procedure to repair the labrum will return the athlete to the field in a rapid fashion.

Preventing shoulder injuries

“There are precautions players can take to prevent or reduce the chances of initial or repeat shoulder injuries, including shoulder dislocations,” says Dr. Plancher. He recommends the following:

A thorough warm-up to get the blood flowing to muscles and joints before playing

Use of proper technique, as hitting, throwing or pitching a ball incorrectly can cause further stress on the shoulder and arm, and finally Shoulder-strengthening scapular stabilizing exercises under the direction of a fitness trainer or physical therapist to help keep muscles strong and more resistant to injury.

About Dr. Plancher:

Kevin D. Plancher, M.D., M.S., F.A.C.S., F.A.A.O.S., is one of the nation’s leading orthopaedic surgeons and sports medicine experts, specializing in the treatment of knee, shoulder, elbow and hand injuries. He is Associate Clinical Professor in Orthopaedics at Albert Einstein College of Medicine in New York City and the Head Team physician for the professional lacrosse team, the Long Island Lizards. Dr. Plancher is on the editorial review board of the Journal of the American Academy of Orthopaedic Surgeons. In 2007, 2008 and 2009, Castle Connolly Medical Ltd., a New York City research company, named Dr. Plancher America’s Top Doctor in Sports Medicine. Every year from 2001 to 2009 he has been included in Castle Connolly’s list of Top Doctors in the New York Metro area, as published in New York Magazine’s yearly “Best Doctors” issue.

Dr. Plancher received his M.D. degree (cum laude) and an M.S. degree in physiology from Georgetown University in Washington, DC. He completed his residency at Harvard University’s orthopaedic program and a fellowship at the Steadman-Hawkins Clinic in Vail, Colo., where he studied shoulder and knee reconstruction and served as consultant to the clinic for six years. He has been team physician for more than 15 high school, college and national championship teams.

An attending physician at Beth Israel Hospital in New York City and Stamford Hospital in Stamford, CT, he maintains offices in Manhattan and Greenwich, CT. Visit http://www.plancherortho.com for more information. Dr. Plancher lectures extensively in the U.S. and abroad on issues related to orthopaedic procedures and injury management. He also has been named to the sports medicine arthroscopy program subcommittee for the American Academy of Orthopaedic Surgeons. Dr. Plancher has been awarded the Order of Merit (magna cum laude) for distinguished philanthropy in the advancement of orthopaedic surgery by the Orthopaedic Research and Education Foundation. In 2001, he founded The Orthopaedic Foundation for
Active Lifestyles, a not-for-profit foundation focused on maintaining and enhancing the physical well-being of active individuals through the development and promotion of research and supporting technologies. See http://www.ofals.org for more information.

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