Penn Orthopaedics

Penn Orthopaedics

Tuesday, February 2, 2016

Avoid the Winter Workout Rut

When the temperatures start to dip, working out can become a challenge even for the fittest of people. It’s just a little more difficult to convince yourself to put on multiple layers of clothes to trek outdoors for a run or to drive to the gym to get on the treadmill.

But, if you want to look and feel great once the snow and ice thaw at winter’s end, you need to put in the work now.

Here are five ways to stay motivated and keep active during the cold months.

Set goals 

If you’re struggling to keep yourself motivated this time of the year, heat things up by challenging yourself with a new goal you’d like to reach.

Since most big exercise events and races are in the spring and summer, the winter can be all about getting yourself ready for those events. It can be anything from upping your weight lifting weight, to losing a few pounds, to running a 5K. Or, for more experienced runners, running your first half marathon at the Love Run on April 10.

Be sure to choose a goal that you really want so that it pushes you beyond your comfort zone in order to reach it. Once you have a big goal in mind, break it down into smaller, achievable action steps so that you stay on the path to success.

Get a workout wingman (or wingwoman) 

Training with a buddy or significant other is a great way to increase accountability.

Committing to train with someone will often force you to increase your level of effort as you both push each other to achieve more. It will also help you to keep more of a set schedule since you won’t be doing it alone. It's important to find a partner who has similar reasons for working out. This will help to form a stronger bond between the two of you and encourage you both to keep cheering each other on as you progress.

Try something new 

Why not mix in some cross training into your workout routine?

Being limited to indoor workouts is a great opportunity to add in cross-training and/or core-strengthening, which will help prevent injury. Sign up for a new class at the gym, join an indoor sports league or simply change up your workout regimen this winter. Trying something new can reignite your motivation and give you a fresh perspective. Also, paying extra to participate is a good way to keep you from deciding to skip too many days.

And speaking of being indoors,  if you are spending a lot of time running on a treadmill due to the weather, be sure to build up to your outdoor runs slowly once the weather breaks. The mechanics and pace of a treadmill workout versus a run on the roads are not always the same, so it's best to get your body used to the change slowly. Similarly, if you are starting to run on a treadmill after only running outdoors, it's important to build up your workouts to help your body adjust.

Dress the part 

If you know you won’t be able to get past the distractions at home or work to make exercising indoors on possible, make exercising outside easier. You’ll need breathable, but fitted attire to keep warm and help reduce sweat. Because the body is mainly focused on warming your core, a hat, gloves, and warm socks are critical to feeling comfortable when the cold really hits.

If your workout includes a trip to the gym, you’ll be more motivated to stick to your plans if you dress comfortably and can easily change to your workout gear. Wear boots with zippers, comfy pants, or thick tights so getting your street clothes on and off isn't a battle.

Refresh your workout beats 

What can get you going? How about some new tunes? Bear in mind that the best exercise music has been found to be between 120 and 140 beats per minute, and try to work out to some material you’re not that familiar with for a change.

Wednesday, December 16, 2015

Penn Sports Medicine Teams Up With Philadelphia Love Run

It's almost that time of the year again! The “The Race That Loves You Back” is quickly approaching. This 13.1-mile race is scheduled for Sunday, April 10 and is expected to surpass last year’s number of runners.

Penn Sports Medicine
Rahul Kapur, MD
Members from Penn Sports Medicine were asked to serve as the Official Medical Team for the 2016 Love Run.

“We are proud to be part of the Philadelphia Love Run”, says Rahul Kapur, MD, head medical team physician for Penn Athletics and Penn Sports. “Although we hope nobody needs our services, our medical team is well equipped to assist those in need. We wish all the runners the best of luck and look forward to cheering everyone on in this great community event.”

Penn Sports Medicine physicians will supervise medical staff at mobile medical tents along the course and finish line. The Penn team will also provide training to the nurses, paramedics, EMTs and athletic training volunteers who will be staffing the half marathon on race day.

About the Philadelphia Love Run

Join thousands from the Philadelphia region and around the nation for an unforgettable weekend in Philadelphia. This half marathon offers runners a combination of competing in a world-class event with thousands of others and an opportunity to experience all the great sights and sounds of Philadelphia.

The course, which will take you through Center City, is also walker-friendly.

From free Phillies ticket, to vanity bibs, to team challenges, to incredible Philadelphia-themed finish food, this is one race that loves you back!

Event Details:
When: April 10, 2016, 8 am
Where: Philadelphia, Pennsylvania
Art Museum, Eakins Oval
Register Now

About Penn Sports Medicine

The specialists at Penn Sports Medicine treat everyone from the weekend warrior to the professional athlete--providing comprehensive care for athletes of all ages and abilities.
Sports medicine services are provided to those who receive injuries from sport, recreation and exercise activities. The goal is to develop individualized care plans to help patients return to normal activities as quickly as possible with the most appropriate diagnosis, treatment and rehabilitation for their particular sports injury.

Suffering from a specific condition, the experts at Penn Sports Medicine can help.

Friday, December 11, 2015

Should I See a Sports Medicine Doctor?

Penn Sports Medicine
Perhaps the only thing more frustrating than sustaining an injury is trying to figure out what type of doctor to see.

Should a college athlete that sustained an injury during a football game see the same type of physician as an active individual who was injured biking with their children?

The answer, which may come as a surprise to many, is yes. Both types of injuries, and patients, can be treated by sports medicine physicians.

What Exactly is Sports Medicine?

Sports medicine focuses on helping people improve their athletic performance (regardless of the level), recover from injury and help to prevent future injuries. Knee, leg, back, shoulder and hand injuries are a few of the common disorders treated.

Sports medicine physicians are experts in physical activity, with specialized training in musculoskeletal conditions and the medical concerns of active individuals. The goal of a sports medicine doctor is to help you get active or stay active, particularly when you’re sidelined by injury.

Penn Orthopaedics has a team of physicians that are specially trained in this specific field. The Penn Sports Medicine team works with patients to develop individualized care plans to help them return to normal activities as quickly as possible.

“We use the same technologies at Penn Sports Medicine to treat athletes as we do to take care of patients that are not playing baseball, soccer or football,” said Brian J. Sennett, MD. “The overall goal is to work with every patient to establish their diagnosis, explain what's wrong, how we are going to get them better and lead them through that process.”

When Should You See a Sports Medicine Physician?

Still a bit unsure as to when to seek a consultation with a Penn Sports Medicine physician? If any of the statements below apply to you, it may be time to do so.
  • Acute Injury: After sustaining a sudden injury, we can help you determine exactly what is injured and whether you will recover most effectively with – or without – surgery.
  • Chronic Injury: Long-lasting injuries and areas of discomfort will often improve or resolve with appropriate rehabilitation. We can identify and correct the training errors or biomechanical abnormalities that hinder your performance.
  • Injury Prevention: By helping you understand why you sustained an injury – and not just what was injured – we will help keep you injury-free for future races and events.
  • Performance Enhancement: Whether you are just starting a new fitness program or wishing to take your abilities to the next level, we can connect you to a team of professionals – physical therapists, registered dietitians, podiatrists, and more – to provide a comprehensive and well-rounded approach and maximize your athletic potential.

Friday, December 4, 2015

Labral Tear Surgery Gets this Ballerina Back on the Barre

Talin Kenar fell in love at 4 years old. It was the kind of love that put her into the zone while everything else faded to gray.

For most girls, it's a fantasy in the storybooks. For Talin, it kindled a lifelong commitment.

She'd discovered ballet.

"I loved everything about it"

labral tear
Photo Credit: Debra Bona
"I loved the physical expression combined with the artistry," says Talin, now in her 30s. "I loved the music, the precision of technique … it just spoke to me."

That love flourished into an international career. She headed to London at age 16 to attend ballet school. She has since lived a whirlwind life of dance. A year in Hong Kong, another year in Australia and roles at prestigious dance companies were among her many stops.

Pursuing a professional ballet career is definitely not easy. The most obvious challenge is the physical demand. Injuries are common, especially since so much of the choreography for women in classical ballet involves stabilizing on the left leg and gesturing with the right, Talin explains.

"You don’t want to give up …"

In October 2012, the resident choreographer at her dance company - American Repertory Ballet in New Jersey where she lives—selected her for an enviable opportunity: a principal role choreographed just for her.

The day before the premier at rehearsal, she poised for a move - and fell.

An unseen slick spot on the stage had caused her to slip, and the fall resulted in an ankle injury. Several days later, she noticed a vague twinge in her right hip. She ignored it.

"You get so wrapped up in wanting to maintain yourself in a ballet company," Talin explains. "You don't want to give up roles. You don't want to give up your status. You don't want to give up the few short years we get in this profession."

She danced on that aching hip for the full season and for part of the season after that. Gradually, the pain escalated from a whining nag to a piercing scream.

"If you can’t walk, you can’t dance"

Photo Credit: Debra Bona
"Sometimes, it was really sharp if I moved a certain way," Talin recalls. "Sometimes, it radiated down my leg. I also was obviously compensating for my pain, so other parts of my body were starting to break down."

One morning in December, she was on her way to a ballet class. She had 10 more blocks to walk to the studio.

"I was in tears," she recalls. She stopped walking, surrendering to the pain. "If you can't walk, you can’t dance."

Instead of taking that class, Talin made plans for a trip home to San Diego. Her father picked her up from the airport and drove straight to the emergency room.

She was referred to an orthopaedist in California. But still hoping to salvage her dance career back on the East Coast, she searched for a surgeon near her home in New Jersey who could not only address her hip pain, but also get her back on stage.

She found John Kelly, IV, MD, Director of Sports Shoulder at Penn Orthopaedics.

"… Either that or stop dancing"

Dr. Kelly confirmed her diagnosis: mild arthritis and a labral tear in her right hip.

The labrum is a layer of cartilage that lines the hip socket to stabilize the joint. When it’s torn, certain movements - like raising your toes above your head - can feel like the joint is getting caught on something rather than gliding smoothly.

John Kelly, IV, MD
"Joint replacement was an option, but I'm really into joint preservation," says Dr. Kelly. "It was either that or stop dancing."

Dr. Kelly understood that for Talin, retirement was not on the table. They agreed that an arthroscopic procedure to repair the labrum and treat the arthritis would be best.

Arthroscopic surgery is a minimally-invasive procedure that involves inserting a small camera, called an arthroscope, into the hip joint to access and treat the damaged area.

"We just smoothed out her joint and took out some of the bone spurs that were causing the pain," Dr. Kelly explains.

"Zero pain"
Talin had the surgery in March 2014. "I know it's weird to say, but the moment I woke up, I felt I had been fixed," she says.

After several weeks of physical therapy, she was back at the barre. Soon, she was able to get through a full 90-minute ballet class. Shortly after that, she danced four performances in a full-scale role.

Talin now works as a freelance ballet dancer, opting to be selective about her roles rather than dive into the grind of dancing full-time for a company.

"Once you've been injured, it sets you up to be injured again," she reasons. "I want to protect my recovery."

Most importantly, she says, "I have zero pain—no pain whatsoever."

Interested in speaking with a specialist?

Tuesday, November 17, 2015

Advances in Throwing: Latest on Injury Treatment and Performance Optimization

Join us for a dynamic, one-day conference to learn about the latest tools and techniques for treating throwing athletes. Through a series of panels, presentations, and debates, we will discuss a wide range of topics designed to advance injury treatment and optimize performance for throwing athletes.

Event Details

Date: Saturday, March 19
Time: 8 am to 5 pm
Location: Biomedical Research Building Auditorium
                University of Pennsylvania
                421 Curie Boulevard
                Philadelphia, PA

Featured Lectures:

Keynote Address - W. Ben Kibler, MD, FACSM
Dr. Kibler (Lexington Clinic Orthopedics) is the medical director at the Lexington Clinic and a former vice president of the American College of Sports Medicine.

How to Keep Pitchers Pitching – Phillip Donley, PT, ATC, MS
Mr. Donley (Optimum Physical Therapy Associates, PC ) has practiced physical therapy in the Philadelphia region since 1957, authored numerous papers, and has been a consultant with the Phillies for 10 years.

Disabled throwing shoulder – cause, prevention and why slap tears fail. - Craig D. Morgan, MD
Dr. Morgan (Morgan Kalman Clinic) has cared for Major League Baseball pitchers, Olympic-level athletes and golfers on the LPGA.

Who should attend?
This program is intended for athletic trainers, coaches, physical therapists and physicians. Registration fee includes breakfast and lunch:
  • Athletic Trainers / Coaches: $100
  • Physical Therapists: $150
  • Physicians: $200
Attendees are eligible for:
  • Seven (7) CEU's for Athletic Trainers
  • Seven (7) Contact hours for Physical Therapists

Wednesday, November 11, 2015

Serving Wounding Warriors

In 1918, in the 11th hour of the 11th day of the 11th month, the armistice marked the end of World War I. This infamous day in history also marked the origin of Veteran’s Day.

John L. Esterhai Jr., MD
While Memorial Day honors those who died in active military service, Veteran’s Day honors all who have served in the U.S. Armed Forces, living and dead.

These men and women that have given so much for our country deserve access to top-notch health care that addresses issues with which they may struggle—physical or otherwise.

John L. Esterhai Jr., MD, a Penn Medicine orthopaedic surgeon and chief of orthopaedic surgery at the Philadelphia Veteran’s Affairs Medical Center (PVAMC), knows this all too well. Dr. Esterhai is a veteran, having served in the Air Force as a flight surgeon stationed in Okinawa, Japan during the Vietnam War.

For him, and other physicians who volunteer at PVAMC, care for veterans goes far beyond just Veterans Day.

How Penn Medicine and the PVAMC Help Veterans

Together, Penn Medicine and the PVAMC provide access to health care for nearly 90,000 veterans living in and around the Philadelphia area.

“We take care of a lot of people who come a fair distance because they need care specifically for service-related injuries or simply because we’re their preferred provider,” he explains.

Healing the Deepest Wounds

The orthopaedics team at the PVAMC provides services that range from total joint replacements for aging Vietnam veterans to fracture care and sports medicine care for veterans from more recent wars.

From a physical perspective, some injuries are more challenging to overcome than others.

“One of the most debilitating issues is when the folks who have already lost a limb need to have the amputation revised,” says Dr. Esterhai.

He explains that the need for revision may be because of infection, healing difficulty, chronic pain, or the inability to use prosthesis because of limb damage. This obstacle on the path to physical recovery after losing a limb can keep them from moving forward with their lives.

But Dr. Esterhai says that helping veterans return to civilian life transcends orthopaedic care.

Many patients have had closed-head injuries because of the blasts from improvised explosive devices. And many come back with post-traumatic stress disorder from the situations that they’ve been in overseas.

“We at Penn are available to help so many other damaging effects of being a war fighter,” says Dr. Esterhai.

The Power of Empathy

Dr. Esterhai says empathy and the ability to relate to veterans on a human level is a critical part of their care.

“It’s easy to become a surgical technician who can fix something but then really doesn’t relate well to the patient, and the veterans are very sensitive to that,” he says. “It takes extra time in the office to listen to what a veteran says and to have some empathy.”

But it’s worth it. The physicians who provide care for veterans know that those few extra moments can go a long way in healing the wounds of those who have sacrificed so much for the safety and well-being of others.

Friday, November 6, 2015

Advances in Throwing: Latest on Injury Treatment and Performance Optimization

Join us for a dynamic, one-day conference to learn about the latest tools and techniques for treating throwing athletes. Through a series of panels, presentations, and debates, we will discuss a wide range of topics designed to advance injury treatment and optimize performance for throwing athletes.

  • Proper biomechanical principles to evaluate the kinetic chain
  • Sound treatment for common injuries
  • Optimize training for peak performance
  • Updates on the latest surgical techniques – including Tommy John surgery

Event Details

Date: March 19, 2016
Time: 8 am to 5 pm
Location: Biomedical Research Building Auditorium
               University of Pennsylvania
               421 Curie Boulevard
               Philadelphia, PA

Keynote Speakers

W. Ben Kibler, MD, FACS - Lexington Clinic Orthopedics – Lexington, KY
Dr. Kibler is the medical director at the Lexington Clinic and a former vice president of the American College of Sports Medicine.

Phillip Donley, PT, ATC, MS, Optimum Physical Therapy Associates, PC – Swarthmore, PA
Mr. Donley has practiced physical therapy in the Philadelphia region since 1957, authored numerous papers, and has consulted with the Phillies and the Eagles.

Craig D. Morgan, MD, Morgan Kalman Clinic – Wilmington, DE
Dr. Morgan has cared for Major League Baseball pitchers, Olympic-level athletes and golfers on the LPGA.

Event Agenda

8:00am – 8:15am | Welcome and Opening Remarks

8:15am – 9:30am | Section 1 Throwers Shoulder: Science and Performance Optimization

     1) 8:15am | Pathomechanics
        Presenter: Steve Thomas, PhD, ATC

     2) 8:30am | My thoughts on ‘the Pathologic Cascade’
        Presenter: W. Ben Kibler, MD, FACSM

     3) 8:45am | Kinetic Chain: Importance and Evaluation
        Presenter: Brian Leggin, PT, DPT, OCS

     4) 9:00am | Throwing Mechanics: Optimizing the Kinetic Chain
        Presenter: James Davidson

     5) 9:15am | The Biceps and Scapula: lessons from the Lab
        Presenter: Louis J. Soslowsky, Ph.D.

9:30am – 10:10am | Debate/Case Presentation:  Scapula Dyskinesis – Does it exist?
     Yes:  Craig D. Morgan, MD No:  Martin Kelly, PT, DPT, OCS

10:10am – 10:30am | Break /Visit Exhibits

10.30am – 12:00am | Clinical Evaluation and Treatment

     1) 10:30am – 10:45am | How I do my shoulder evaluation?
       Presenter: Martin Kelly, PT, DPT, OCS

     2) 10:45am – 11:00am | Keys to Clinical Exam for rotator cuff and labral Injuries
       Presenter: Brian J. Sennett, MD

3) 11:00am – 11:15am | MRI diagnosis cuff and labral Injuries
       Presenter: Miltiadis H. Zgonis, MD

4) 11:15am – 11:30am | Diagnosis and Treatment of Cuff Injury in Throwers:
       Presenter: Andrew F. Kuntz, MD

5) 11:30am  – 11:45am | Biceps: Save or Kill?
       Presenter: David L. Glaser, MD

6) 11:45am | Slapaholics: Do we need to fix every labrum?
       Presenter: John D. Kelly, IV, MD

12:00am - 12:15am | Special Guest lecture:  How to Keep Pitchers Pitching – Phillip Donley, PT, ATC, MS

12:15 – 1pm Lunch

1:00 | Current Thoughts Regarding the Superior Labrum. – W. Ben Kibler, MD, FACSM: Keynote

1:45 -2:20pm – Elbow
     Tommy John Surgery: How to get it right (15mins). G. Russell Huffman, MD, MPH
     Debate: Tommy John Surgery is over performed (20mins)
     Yes: W. Ben Kibler, MD, FACSM No: G. Russell Huffman, MD, MPH

2:20 -2:45pm Return to Play
     Metrics to Assess Readiness to Play Marisa Pontillo, PT, DPT, SCS (15mins)
     Intangibles: Phillip Donley, PT, ATC, MS (10mins)

2:45 -3:15pm - Case Based  Approaches to Rotator Cuff and Labral Injuries: Surgery and Rehab
     Panel Discussion Moderated by:
     John D. Kelly, IV, MD. Penn Orthopaedics
     Panelists: Jess Turek ATC, Michele Monaco DsC, ATC, Martin Kelly, PT, DPT, OCS, W. Ben Kibler, MD, FACSM, Craig D. Morgan, MD, Miltiadis H. Zgonis, MD, Ryan Crotin, PhD, CSCS

3:15 p.m. - Elbow, Prevention and Treatment of UCL Injuries
     Panel Discussion Moderated by:
     John D. Kelly, IV, MD. Penn Orthopaedics
     Panelists: Craig D. Morgan, MD, G. Russell Huffman, MD, MPH, MPH, W. Ben Kibler, MD, FACSM, Brian Leggin, PT, DPT, OCS, Phillip Donley, PT, ATC, MS, Ray  Moyer

3:45 p.m. - Performance Optimization, a closer look at GIRD, Scapular Dyskinesia and Strengthening Techniques
     Panel Discussion Moderated by:
     John D. Kelly, IV, MD Penn Orthopaedics
     Panelists: Steve Thomas, PhD, ATC, James Davidson, Chris Kurtz, Nate Bump, W. Ben Kibler, MD, FACSM, Craig D. Morgan, MD, Ryan Crotin, PhD, CSCS, Brian Joslin MPT, MBA

4:10 p.m. – Feature Lecture: Disabled throwing shoulder – cause, prevention and why slap tears fail.
     Craig D. Morgan, MD

4:50 p.m. - Closing Remarks

Who Should Attend

This program is intended for athletic trainers, coaches, physical therapists and physicians. Attendees are eligible for eight (8) Continuing Education Units for athletic training.