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Archive: February, 2013

POSTED: Thursday, February 28, 2013, 6:00 AM

Why are some cartilage injuries of the knee easily repairable while others are not? In order to answer that question, we have to start by understanding what type of cartilage lives in the knee. There are actually two different cartilage structures in the knee. The first is articular cartilage (the joint surface) and the second is the meniscus (the cushion between the bone.)  

Articular cartilage is the slippery structure that covers the ends of bones in all the joints in the body, allowing them to move smoothly. And it’s good at what it does… in fact, articular cartilage is 100 times more slippery than ice sliding over ice!

The meniscus on the other hand is a C-shaped structure in the knee, which acts as a shock absorber. There are actually two menisci in each knee, one on the inner side of the knee and the other on the outer side. The meniscus is not attached to bone like articular cartilage, but rather it sits in the knee between the thigh bone and the shin bone. Whether walking, running, or jumping, the meniscus absorbs and evenly distributes forces throughout knee.

POSTED: Wednesday, February 27, 2013, 6:00 AM
Filed Under: Julie Coté | Working Out

Chances are, you have spent some time checking yourself out in the mirror. It’s okay—we’ve all done it. After months of activity and exercise, it’s very satisfying to see definition in your muscles, or that goal weight on your scale. But toned arms and a smaller waistline aren’t the only contributing factors for a fabulous figure. You can’t ignore the frame your kickin’ bod is built on: your bones.

After age 30, we slowly start to lose bone mass. In fact, one in two women—that’s 50 percent, people—will be diagnosed with osteoporosis and be at high risk for fracture in their lifetime. But it’s not just fracture you have to worry about. Thinning of the bones leads to the slouched posture that sometimes comes with age.

But the good news is there are many things we can do to preserve our bone health for the future to ensure we have a sturdy frame to carry us through life and keep us active well into our golden years.

  • Get going. Weight bearing aerobic exercise will help you maintain bone density throughout your lifetime. Certain exercises, such as walking, running, aerobic exercise classes or stair climbing will stimulate more bone growth than other types of exercises, such as biking or swimming.
  • Get your pump on. Weight lifting causes muscles to pull on our bones, which also stimulates bone density. Some of the most important muscles to strengthen are buttocks and thigh muscles to support the hips, and back and shoulder muscles to support the spine and promote good posture. Strengthening exercises in weight-bearing positions are best—think squats, lunges and push-ups. And ladies, remember—weight lifting isn’t just for men.
  • Ensure good posture. Now, I’m not saying this is easy—we fight the weight of gravity all day, pushing our head and shoulders forward. Try this: take a look in the mirror at your side profile. Your ear, shoulder and the side of your hip should all line up. Try to keep yourself in this alignment most of the day—and if you have a desk job, be sure to get up every 30 minutes or so to stretch.
  • Be flexible. You might not think about flexibility as important to maintaining bone health, but think again! Flexibility in the front of the chest and spine helps you keep your posture upright—and I think I’ve drilled home how important that is.
  • Drink your milk! Maintaining a healthy diet of foods rich in calcium and vitamin D will help keep your frame strong. Talk to your doctor about calcium and vitamin D supplements if you feel your diet is insufficient.
  • Kick butts… and soda. As if you needed another reason to kick your nicotine habit, smoking has been shown to lead to bone loss. The other bad news? So do caffeinated beverages. Try to cut back on the coffee and soda to keep your frame solid.
POSTED: Monday, February 25, 2013, 10:01 AM
Filed Under: In The News | Joel H. Fish

The Oscar Pistorius story is the latest example of an elite athlete’s alleged behavior dominating both the news and the sports sections of the media. To fans, it’s yet another example of being forced to confront the fact that sports heroes are real people.

In my work as a sport psychologist with elite athletes over the years, I have come to understand that there are unique pressures that come along with being in the spotlight on a daily basis. This is by no means to excuse an athlete’s behavior, but it is an attempt to understand it.

In sport psychology, we talk about behavior being a combination of personality and the environment.  The environment in which our elite athletes are raised is often radically different from the average environment where most people are raised. If someone is treated as special from a very young age, he/she may not have to live by the same rules of cause and effect that other people must live by. If there are not consequences to one’s behavior, this can impact on a person’s ability to learn to make good decisions. 

POSTED: Wednesday, February 20, 2013, 11:58 AM
Filed Under: Robert Cabry | Running | Working Out

As the nice weather approaches, we all make plans to restart our exercise programs like walking, running and biking. Our bodies are capable of adapting to increasing load, but if we push hard too quickly, this can cause injury. If we typically train for 12 weeks to prepare for a half marathon and we try to do it in eight weeks, this may overload the body’s ability to adapt, leading to overuse injury.

A common overuse injury for runners is leg pain. In this case, leg pain refers to pain in the leg somewhere between the knee and ankle.  Often, that pain is called “shin splints.” This is a lay term for many types of exercise-induced leg pain, but doesn’t really identify the cause. The pain could be something as simple as a strain or as serious as a stress fracture. It’s important to know the warning signs of serious injury.  

Pain that persists for several minutes to several hours after exercise, throbbing pain at rest, or pain at night after going to bed all can be warning signs of something serious. And running through the pain is not the answer.

POSTED: Wednesday, February 20, 2013, 8:00 AM

As pediatric sports therapists, we have to wear many hats during an athlete’s rehabilitation. We play the part of clinician, coach, cheerleader, and counselor within every session, while maintaining the ability to shift into being a drill sergeant when necessary. If we slip too deeply into any of these roles, we risk losing either our credibility or the connection that we need to have with our patient to keep him or her motivated through a challenging time. We need our patient to follow the medical plan of care that we have developed, but really need them to “buy in” rather than just follow blindly.

One of the most important things I’ve learned as a physical therapist is not a treatment technique or evaluation skill. It is the simple realization that my patients really don’t want to see me. I don’t take this personally. When an athlete comes in to our clinic to see a physical therapist or athletic trainer, it really is the last place they want to be. They’ve recently been diagnosed with an injury of some sort, and in many cases, have been told they need to take a break from the sport that they love.

Therefore, in order to get them to follow the physical therapy plan that is necessary for them to recover; I’m digging myself out of a pretty deep hole right from the start.

POSTED: Monday, February 18, 2013, 5:00 AM
Filed Under: Robert Senior | Running

While you’re enjoying the Presidents’ Day holiday, the Philadelphia Parks and Recreation Department will be hard at work, conducting their first-ever Blue Cross Broad Street Run lottery.

The lottery was introduced this year as the fairest way to determine the 40,000 lucky athletes who will line up on Sunday, May 5 for a 10-mile run down Philadelphia’s main thoroughfare.

Jim Marino has been the race director since 1998. “The race has grown tremendously since we added Blue Cross as our title sponsor,” he says, “Our best advertisement is word of mouth from our runners.”

POSTED: Thursday, February 14, 2013, 8:00 AM
Filed Under: Julie Coté
Making time for heart health is crucial. (iStockphoto)

Ah, February—a month filled with paper hearts, candy hearts, heart jewelry, heart garlands… you get the idea.

So why all the hearts? Sure, there’s Valentine’s Day—but more importantly, February is Heart Health Awareness Month. As a physical therapist at Magee Rehabilitation Hospital, I have seen firsthand the importance of caring for your heart. Year after year, we treat a growing number of younger people with heart disease or stroke—and a large number of these patients are women.

You probably know that heart disease is the number one killer of women. But did you know that one woman dies every minute from this disease? But why is this? A huge part of heart disease’s disproportionate impact on women is that we are too busy caring for others to care for ourselves. Yes, taking time for exercise when you have children or aging parents to care for is not generally at the top of your to-do list. But making time is crucial.

POSTED: Tuesday, February 12, 2013, 9:20 AM

When we discuss athletes who have been concussed, much of the discussion often concerns when they will return to play. However, when we discuss student athletes who have been concussed, parents often ask ‘when can they return to school and academics?’ 

There has been much published this season concerning NFL players in that the first step in treatment of any concussed athlete is complete mental and physical rest. For a student-athlete, that usually includes keeping them home from school initially when they are severely symptomatic and not allowing them to begin academics again until there is a decrease in symptoms and improvement in neurocognitive testing.

How to best return a student-athlete to school has been a work in progress with many theories being put forth but no consensus among physicians.  While this is not a complete list of recommendations, these are often the most common accommodations suggested. 

About this blog

Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

Robert Senior Sports Doc blog Editor
Alfred Atanda, Jr., M.D. Nemours/Alfred I. duPont Hospital for Children.
Robert Cabry, M.D. Drexel Sports Medicine, Team physician - U.S. Figure Skating, Assoc. Team Physician - Drexel
Brian Cammarota, MEd, ATC, CSCS, CES Symetrix Sports Performance, athletic trainer at OAA Orthopaedics
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Rothman Institute, Head Team Physician for the Phillies & St. Joe's
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Rothman Institute, Head Team Physician - Eagles, Head Orthopedic Surgeon - Flyers
Joel H. Fish, Ph.D. Director - The Center For Sport Psychology, Sports Psychology Consultant - 76ers & Flyers
R. Robert Franks, D.O. Rothman Institute, Team Physician - USA Wrestling, Consultant - Philadelphia Phillies
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer at The Sporting Club at The Bellevue
Cassie Haynes, JD, MPH Co-Founder, Trap Door Athletics, CrossFit LI Certified
Eugene Hong, MD, CAQSM, FAAFP Team Physician - Drexel, Philadelphia University, Saint Joe’s, & U.S. National Women’s Lacrosse
Jim McCrossin, ATC Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales, Pa.
David Rubenstein, M.D. Main Line Health Lankenau Medical Center, Team Orthopedist - Philadelphia 76ers
Justin Shaginaw, MPT, ATC Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation
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