The first place to begin is to make sure you are getting enough fluids on a daily basis. Clear fluids act as a natural detox, while flushing any toxins out, especially after excessive ingestion of salt, sugar, and alcohol. Start every day with a tall glass of water or cup of tea, while trying to consume between 64 to 100 fluid ounces throughout the rest of the day. Your body is a machine and one of the best things for it is keeping up with hydration. Think of fluids as the coolant – you need them to assist all the working parts within your machine.

The next key factor is making sure that meal timing is consistent. Detox diets are all about getting your body back to neutral, so that you can begin introducing different types of food back into your diet without too much of a digestive reaction. A strong recommendation for a detox diet involves scheduling three meals a day, making sure that lunch is four hours after breakfast, and dinner between 6 and 7 in the evening. An afternoon snack is fine around 4, but make sure that it is light and “green,” preferably containing something like sea vegetables, probiotics, grasses, or enzymes, all known to aid with digestion, as well as setting your body up for successful digestion overnight.

Many experts recommend taking a multivitamin every day, while considering adding an omega-3 supplement with every meal, which can help reduce inflammation from ingesting something heavy and hard on your system. Try to avoid huge amounts of carbs, and stick to a strict schedule, filling up with protein and non-starchy vegetables. Maybe set a “cheat day,” where you are able to indulge in a small amount of something you wouldn’t otherwise eat during the detox. The key to consistently healthy eating is making sure that you never overdo it, even when you are technically “cheating.” Remember to enjoy the holidays, and indulge in moderation. New Year’s resolutions will be much easier to stick to if you start now. Your body will thank you for it!

The post 911: The Detox this Holiday Season appeared first on Premier Orthopaedics.

In simplest form, when an injury occurs, the body’s own platelets release co-factors that stimulate recruitment of mesenchymal stem cells (MSCs) to the site of injury. Some of the known components of PRP included platelet-derived growth factors, insulin-like growth factor, transforming growth factor-beta, fibroblast growth factor-2. Each of these have differing functions in the healing and reparative process.

Published studies of PRP use in adults and in animal models have shown promise for a number of orthopedic conditions. This is especially the case for tendon and soft tissue injuries and a recent article in the American Journal of Sports Medicine looked at the use of Platelet Rich Plasma (PRP) injections for osteoarthritis of the knee both from a safety and efficacy standpoint. In this study, 30 patients who received an intra-articular PRP injection in the knee consecutively for 3 weeks. Specifically, 3 to 8 mL of PRP was injected. Patients in the control group received 3 intra-articular injections of saline. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was used to assess outcome. One week after the first injection, and at every post-injection visit during the 12-month follow-up period, patients who received the PRP injections had better WOMAC scores than did patients who received placebos. One year after treatment, PRP improved WOMAC scores 78% compared to baseline. The scores of patients who received placebo injections only improved 7%. There were no complications or adverse reactions from PRP injections.

To date, many patients have been treated with PRP injections. Success rates that appear in the published literature and across the web vary considerably. Some are reported at greater than 90%. Caution must be exercised in interpreting these results as outcome measures vary. Again it is very difficult to compare studies or even one individual versus another due to the many different systems and variables used. However, the most recent literature promotes leukocytepoor (minimal white blood cells) PRP for treatment of osteoarthritis and leukocyte-rich (higher white blood cell content) for treatment of tendons and ligaments.

If you are considering this treatment, consider asking your healthcare professional about the optimal formulation for you and also remember to avoid ice for 24-48 hours after the procedure and Non-Steroidal Anti-Inflammatories (NSAIDS) for 1-2 weeks prior and 4 weeks after the treatment, as they inhibit platelet activation.

If you are interested in learning more about this treatment, contact us at 610-789-7767

The post What is PRP? appeared first on Premier Orthopaedics.

We cannot wait to see what kinds of costumes turn up this year, but we also like to make sure that all costumes are properly fitted and are as safe as possible. Make sure that the costume isn’t too baggy while out and about for trick or treating to prevent any injuries. The last thing we want is for a trip and fall to ruin any part of the night. It’s already getting darker earlier, so try to make the costumes light in color or add reflective tape or stickers. Masks can obstruct vision and shift with movement while making the trek from house to house, so we highly recommend non-toxic face paint as a safer alternative.

Children under 12 really should be trick or treating with a parent or guardian. But no matter your age, stick to well-lit areas. This might be a good opportunity to review emergency numbers and what to do in case of an injury. While out and about, we recommend putting electronic devices away and staying alert! Always walk on sidewalks when available and cross streets using crosswalks, only after looking both ways. If a crosswalk isn’t available, go to the nearest corner and wait until the cars are finished passing. Watch for cars turning or backing up and never dart out onto streets or cross between parked cars, no matter how much of a candy jag you have going.

If you are out running errands, remember that dusk is the most difficult time for driving visibility. Trick or treating traditionally starts between the hours of 5:30 and 9:30 so it might be a good idea to turn headlights on a bit earlier than usual. We’re sure you already know this, but make sure to keep distractions to a minimum – pull over if you need to return a text or make a phone call, and have a passenger tune the radio. Excited kids can move in an unpredictable way (especially when on a mission involving candy) and this sometimes includes darting out unexpectedly – always be prepared.

Although this might sound like a lot to remember, the important thing is to make sure you have fun. With these safety tips, there’s no reason you can’t collect the most candy, carve the best pumpkin, and bob for the most apples. Happy Halloween from the team at Premier!

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Why is it that weather can affect joint pain so drastically? The sky is blue, the air is crisp, not a cloud in sight, so why is your previously injured hip joint throbbing? Unfortunately, there is no definitive scientific answer, but there are quite a few theories. Scientists did a study in Boston, where temperatures reach a drastically low temperature during the middle of winter. Around two-thirds of the volunteered answers agreed: The weather absolutely affects their injuries. But why?

A leading theory is that the air pressure changes with impending weather fronts and this can cause swelling of the joints. Scientists have suggested that it is the shift in barometric pressure that might be the cause of discomfort. Barometric pressure is the weight of the atmosphere that surrounds us. When bad weather is on its way in, barometric pressure drops. The lower air pressure will push less against the body, sometimes enough that tissues will expand. If the tissues expand enough, during a particularly bad incoming storm, for instance, the tissues can press onto the joints, causing a dull, throbbing pain. Scientists also have found receptors in the joints, called baroreceptors that can sense changes in barometric pressure. In other words, your joints, can act like mini-barometers, sensing change in the weather.

The cause of the pain remains hypothetical, but it has been previously proven that higher altitudes cause our bodies to swell, particularly our extremities, such as hands or feet. Many experience these symptoms while flying, so they will remove rings or switch to roomier shoes for the duration of the flight. This confirms that the drop in air pressure can significantly affect the human body.

Bottom line, aches and pains with weather change is not all in your head. So if you experience discomfort with change in the weather, it is never a bad idea to get things properly checked out with an orthopedic surgeon or sports medicine specialist.

Here’s Premier Orthopedic Surgeon Nicholas DINubile, MD discussing the effect of weather on your body and joints with Al Roker on The Weather Channel: https://edit.weather.com/tv/shows/wake-up-with-al/video/feeling-the-weather-in-your-joints

The post Does weather affect joint pain? appeared first on Premier Orthopaedics.

First things first, make sure you’re covered. Safety is the number one priority. USA Today’s guide to school sports recommends, “all athletes should have a pre-participation exam to determine if their bodies are physically able to play.” For this reason, many school sports require medical authorization forms, as well as physical examination, in order to try out. Make sure to include their medical history, emergency contacts, as well as official permission to participate. This process is especially important if they were previously injured and are returning for the fall season.

Now that you are sure the athlete is ready to go, follow up to ensure a safe playing environment. Safety can make or break daily practices. Important factors, such as the school having an emergency action plan in place, specific to the athletic facilities, can provide peace of mind while your child is at practice. Make sure to inquire of the facility’s cleaning schedule – is it cleaned at least once a day? Locker rooms, gyms, and showers should be cleaned on a regular basis to prevent spreading of bacterial, viral, and fungal infections. Make sure to explain to your young athlete the dangers of sharing things like water bottles and hairbrushes. Gym clothing and equipment should be cleaned regularly and never shared.

Next, check to make sure the gym equipment is in working order. Game equipment, such as helmets and goals should be checked to make sure they are working properly. Schools should be equipped with external defibrillators, which should be checked monthly. Last, but not least, peace of mind comes with knowing who is taking care of your athlete. All coaches and referees should have the proper credentials, required by your state or league. Additionally, they should be thoroughly prepared for the chosen emergency action plan, as well as trained for CPR and the usage of an AED. And unfortunately, even with all the proper preseason planning and preventive measures, injuries can happen. The athlete’s short and long-term health are always the ultimate priority. A great rule of thumb is “when in doubt, keep the athlete out.” And if there is concern for an injury or other sports related ailment, it is essential to seek proper evaluation, and treatment when needed, by an orthopedic surgeon and/or sports medicine specialist.

These relatively simple tips can provide not only peace of mind, but the tools you need to have a fun and successful athletic fall season!

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A great workout includes all of the expected benefits, but requires a proper cool down afterwards. The human body requires maintenance – just like a piece of machinery or a winning race horse, without a cool down period, many of the benefits from working out can be undone in a matter of hours. In many cases, it can also cause wear-and-tear injuries (damage or deterioration resulting from ordinary use). Cool-down exercises are categorized as any light exercise, helping your body to smoothly transition from working hard with blood pumping and heightened breathing, to a period of resting.

The cool-down period is just as important as the actual exercise for many reasons, including reduced strain on the heart as it goes from exerting itself back to normal. The cool-down period can also help to decrease, if not prevent altogether, any post-workout dizziness or other common discomfort. Post-workout dizziness is caused by blood pooling in the lower extremities from veins increasing in size to accommodate the increased blood flow from the heart. The increased blood flow is one of the reasons why you sometimes feel weightless and euphoric after a workout, but if you are not used to it, it can turn into extreme dizziness or vertigo, which can lead to fainting. The key is to keep moving, but slow down gradually so that your heart rate is not dropping too suddenly.

Post-workout maintenance is key in preventing wear-and-tear injuries, or a more painful tear that could result in surgery and months of downtime. Stretching and slowing to a walk post-workout can help to return the muscles to their optimal length-tension relationship, while restoring the body’s physiological systems back to a comfortable baseline. Stretching while your muscles are still warm can also help to speed up and improve flexibility. Stretch each muscle group for at least 10-20 seconds after a workout. The stretching should not feel painful – this could be a warning sign of a potential tear or existing fatigue on the specific muscle.

The most important habit to get into is to listen to your body. There is no reason to over exert your muscles or circulatory system for a daily workout, especially when the risks include fainting or injury. If this is a new exercise regime, take it slow and bring a buddy or “spotter.” Workout buddies can provide support, both mentally and physically. And remember to have fun! The most successful exercise is one that doesn’t feel too much like homework. No one likes homework.

*Consult a physician or professional physical trainer for specific questions pertaining to your workout and physical capability.

The post The proper way to cool down after a hard workout appeared first on Premier Orthopaedics.

Children come in all shapes, sizes, and ages, so there is no cut and dry answer to how much water is needed per day. Factors such as outside temperature, humidity, weight, gender, the child’s activity level, their blood sugar levels, energy level, and overall standing health should all be taken into consideration during an extended amount of time spent outside. Because children are so active and constantly growing, the needed amount of water can adjust and can sometimes seem like the requirement is a huge amount. It should be noted that these recommended amounts of water include not only beverages, but also foods ingested throughout the day, and should be increased if it is an especially hot day.

Every child should drink at least the standard 6-8 cups of water per day, as well as the recommended servings of fruits and vegetables, no matter the weather. If your child or teen is active throughout the day, the goal is to drink between a half-cup to two cups of water every 15 to 20 minutes of activity. Exposure is a contributing factor to dehydration – taking precautions like regular reapplication of sunscreen and wearing protective gear, such as sun hats and lightweight protective clothing will help to prevent overexposure and heat exhaustion.

Attached below is an idea of the amount of water your kids should be hitting per day, depending on age and gender. Hot weather is no reason to miss out on anything this summer!

* Amounts of water ranges from child to child. ** Please consult your pediatrician with any questions or concerns regarding extensive amounts of time spent in the heat.

The post How much water should your kids drink during a hot day outside? appeared first on Premier Orthopaedics.

Gardening has been proven to directly reduce cortisol – the “stress hormone.” Studies show that gardening for an hour, in comparison to say, reading for an hour indoors, helps to increase mood and dramatically lower the brain’s level of cortisol. High cortisol levels can negatively impact mood, immune function, obesity, memory, heart disease, and various learning problems and mental illnesses. Studies have also concluded that when levels of cortisol increase, self-esteem begins to lower. The less cortisol, the better and happier you seem to be.

Exercising is used to help with strength, but what about the muscles that are not as obvious? Gardening is actually a great way to strengthen the muscles within the hands and arms, while supporting dexterity and brain health. Stroke and Alzheimer’s risk-patients have seen beneficial results for rebuilding strength and ability through gardening, using similar hand movements that physiologists recommend for stroke rehabilitation. Be careful not to push it too far or too often – if your body is already compromised, gardening can cause stress injuries from overuse, and in rare cases, carpal tunnel and tendonitis. Alternate using your right and left hand to keep everything in balance, while strengthening your brain function, sensory awareness, and dexterity.

A new kind of therapy is on the market – it’s called “horticultural therapy” and is being used to treat depression and anxiety. The benefits begin with endorphins from physical activity. Many gardeners swear by the buzz they get from tending to their harvests every morning. Endorphins are brought on by physical activity and sweat, so by gardening, you are producing the “happy hormone.” Another benefit, cognitive stimulation, can help with pretty much everything – by stimulating the senses, many report feeling “more alive.” For ideal cognitive stimulation, plant sweet-smelling and food-producing plants with bright flowers to stimulate a wide array of senses. By shocking your senses with pleasant smells and images, relaxation seems to come more easily later on, often lessening feelings of depression and anxiety over time.

The most obvious benefit of gardening is positive feelings and self-esteem brought on by satisfaction of work. Throughout various testing in history, humans have reacted well to a job well done – especially when it produces something delicious that you can ingest and offer to your family and friends. This supports the idea that gardening heightens self-esteem, while lowering depression and anxiety. The benefits of gardening are never-ending – is there anything that gardening doesn’t help?

The post Unexpected Health Benefits of Gardening appeared first on Premier Orthopaedics.

The only drawback to flip-flops? They aren’t always the best choice for your feet.

“It’s easy to see why more people opt for flip flops during the summer. They’re comfortable, they’re convenient, and very few people want to be wearing socks and sneakers in beautiful weather,” says Jason R. Miller, DPM, FACFAS, podiatric surgeon at Paoli Hospital. “Unfortunately, they can also put your feet at risk for injury and pain if you’re wearing them for an extended period of time.”

Although foot pain is the most common symptom of wearing flip-flops too often, it’s not the only one. Flip flops can also contribute to leg, hip, back pain, and shin splints. Next time you think about heading out to run a day of errands in flip-flops instead of something more sturdy, consider these risks.

No shock absorption

Shock absorption is one of the most important aspects of any good shoe, including flip flops. Shoes with adequate shock absorption help absorb the ‘shock’ or pounding that occurs when your feet jump, walk, run, or otherwise strike a hard surface. Flip flops, although they appear to provide a soft base, provide little to no shock absorption. So, whether you’re just using them for a walk or breaking out in an excited run toward the beach, your feet aren’t getting the protection
they need.

No support for your arch

If you have flat feet, shoes with arch support help keep your knees, hips, and back aligned and prevent the onset of pain. But with flip-flops, which provide no arch support, your joints are forced to compensate and work harder than they’re used to. Additionally, people tend to change their walking gait or cadence in order to just keep the flip flops on their feet and may ‘shuffle’ to do this. Although you might not experience any pain while you’re wearing flip flops, chances are you’ll experience pain later in the day, the next day, or even a few months or years later.

A greater risk for injury

Glass, bottle caps, loose screws, rusted nails…there is no shortage to the number of random objects scattered on sidewalks and driveways waiting to be stepped on. When you’re wearing a sneaker or a thick-soled shoe, most of these objects won’t make contact with your skin, but if you’re wearing a flip flop, your feet probably aren’t as safe.

“Most flip flops are only made with soft foam or plastic, which leaves your feet more susceptible to being punctured by something sharp,” explains Dr. Miller. “Not only are you at a higher risk for being injured but, depending on what the object is, this can also increase your risk of infection.”

This is an especially important factor to consider for patients with diabetes, who are more susceptible to infection and need to be more aware of the importance of proper footwear during the summer months.

A greater risk of deformities

Many people go to great lengths to keep their feet looking polished and pretty in flip flops during the summer months, but you might not be doing your feet many favors if you’re wearing these shoes every day.

The construction of a flip-flop, from its plastic middle to its missing back, make it difficult to walk comfortably, even if you’re used to wearing them. And although it might not feel unnatural to walk in flip flops, wearing them every day for an extended period of time is unnatural for your feet, and can aid in the development of foot deformities like bunions and hammertoes.

Although flip-flops aren’t the best choice for your feet this summer, remember you don’t have to ditch your favorite footwear altogether.

“Flip flops are fine to wear in moderation—to the beach, to the pool, around the house, but they are not a substitute for sneakers or other well-soled shoes,” says Dr. Miller.

The post Flip-Flops – Good or bad for feet? appeared first on Premier Orthopaedics.

Recently, a new kind of knee replacement has entered the Orthopaedic world – the quadriceps sparing knee replacement. Quad sparing knee replacements are a minimally invasive alternate surgical technique that allows for quicker recovery, as well as lower levels of post-operative pain. This occurs by avoiding the quadriceps entirely. The quadriceps muscle is one of the most important muscles in the leg. This presents an issue with the traditional knee replacement procedure because of the need to partially cut the quad tendon, which requires additional rehabilitation as well as the knee. This is what causes much more pain, as well as overall recovery time to increase. Although the outcome is relatively the same (most patients in both cases report having a huge decrease, if not complete disappearance, of arthritic and injury-related pain after full rehabilitation), the recovery time is accelerated.

Traditional knee replacements involve an intense amount of rehabilitation, combined with a large amount of time requiring ambulation using a walker or cane. Age and current health can be contributing factors for many surgeries’ expected recovery timeline, and replacement surgery is no exception.

Because recovery and healing can have so much to do with mindset, the quicker you get back to feeling like your old self, the better. Quad sparing knee replacement surgery might be the way to go if you want to be back on your feet as soon as possible!

*Quadriceps sparing knee replacements are subjective to individual patients and their individual health needs, and not everyone is a candidate. Premier joint replacement surgeons are trained in this newer technique. Please consult your Orthopaedic surgeon to learn more.

The post What’s the deal with quad sparing knee replacements? appeared first on Premier Orthopaedics.