How to Keep Your 2017 New Year’s Resolutions

by TOI Admin January 2, 2017

The 2017 resolutions have begun! Most resolutions will focus on better eating habits, losing weight and being a happier, more centered person. If you identify with these...keep reading! If you don't... keep reading! Here's some advice on how to stick to your resolutions, whatever they may be. 



Be realistic: Once the ball drops on New Year’s Eve, many of us feel a burst of excitement and inspiration about the year ahead – and that’s great! But don’t let all that enthusiasm lead to setting a New Year’s resolution that’s so extreme or beyond your reach! You’ll wind up feeling overwhelmed or disheartened when you inevitably fall off track. If you give yourself enough time and resources to accomplish your resolution, you’ll set yourself up to be successful.

Write your resolutions down: When you put pen to paper and write down your New Year's resolutions, you automatically turn your thoughts into something tangible. Post your goals in a place you'll be forced to look at them regularly, and as you re-read them again and again, the words will form a stronger impression in your mind. 

Measure Up: If you don’t set a goal that’s measureable in some way, how will you know when you’ve achieved it? Your New Year’s resolution should also include some smaller mini-goals to function as progress checkpoints along the way to the main goal. 

Get Others Involved: Having friends and family on board is such a huge motivator. Research has shown that people who have support are the most successful at diet and exercise programs. Plus, when you make a commitment to improve your lifestyle along with someone else — a close friend, your significant other, a child — you're more likely to stick with it.

Reward Yourself: Sometimes staying motivated requires a little incentive. Hey — there's nothing wrong with that! When you get through a really tough workout or follow your healthy-eating plan flawlessly for a week, give yourself a well-deserved pat on the back. Or go pamper yourself!




The Dangers of Hoverboards

by TOI Admin December 27, 2016

Courtesy of Stop Sports Injuries by Lance LeClere, MD, and Brian Gerstenlager, BS

One of the most popular gifts this year was a “self-balancing scooter,” more commonly known as a hoverboard. Just like any vehicle or toy, hoverboards can be fun and entertaining, but some safety concerns have arisen, including the toy catching fire and injuries such as concussions, fractures, cuts, bruises, and internal organ damage.

The American Association of Pediatrics (AAP) recently issued a statement on the use of safety equipment while hoverboarding, and advises against allowing children under the age of 16 to ride. 

The source of the fall risk from hoverboards may not as obvious as it seems. The mechanics of the self-balancing scooters themselves, and not necessarily rider error, may be a major contributing cause of the high rate of falls. Specifically, the devices may not accurately account for the weights of different riders, and therefore, the hoverboard can lurch forward or backward unexpectedly. This may not come as a surprise when considering that self-balancing scooters support weight ranges from 45 pounds to up to 300 pounds.

In addition, many hoverboards are capable of tackling steep inclines. Most  of the two-wheeled transportation devices claim to climb an incline of around 30 degrees. For reference, a parking garage ramp is normally about 4 degrees and the typical max incline for pedestrians is about 7 degrees. So riders can easily climb any ramp in an urban area. But this ability may also increase the risk  of falling because as the degree of incline or decline becomes larger, so too can the tilt.

Hoverboard top speeds are variable between different brands, ranging from about 6 mph up to 12 mph. Faster devices can lead to falls with more serious injuries, especially if the falls are from unexpected, sudden movements of the hoverboard coupled with a high degree of tilting.

With the potential hazards of hoverboarding, many experts recommend wearing a helmet, elbow and knee pads, and wrist guards, and avoid riding on excessive inclines and near roads.

References Chairman-Kayes-Statements/Statements/Statement-from-the- US-CPSC-Chairman-Elliot-F-Kaye-on-the-safety-of-hoverboards Chairman-Kayes-Statements/Statements/Statement-from-US- CPSC-Chairman-Elliot-F-Kaye-on-the-Safety-of-Hoverboards- and-the-Status-of-the-Investigation


Ankle Pain and Arthritis

by TOI Admin December 20, 2016

By: R. James Toussaint, M.D.

When the topic of arthritis comes to mind, people usually think of the hip and knee joints. Indeed, ankle arthritis is less common than hip and knee arthritis. However, it can be just as painful and debilitating. Arthritis of the ankle is different from the hip and knee. It is usually the result of a past traumatic event such as an ankle fracture or major ankle sprain. Eventually, the damage to the joint leads to cartilage loss and progressive discomfort within the joint. In addition to pain, ankle arthritis usually results in joint swelling and stiffness. The pain may radiate up into the shin or down into the foot. 

When you come for a consultation in my clinic, it is my responsibility to you as your orthopaedic surgeon to rule out other causes of your pain. During the course of your workup, we will also obtain weight-bearing ankle X-rays to correlate with the diagnosis. Depending on the extent of the arthritis,
the images may show bone-on-bone changes.

During our appointment, my goal will be to educate you on non-operative treatment options for pain relief. The range of non-operative treatments includes activity modification (i.e., swimming instead of jogging), anti-inflammatory medications, and sturdy protective shoes. Some people may find that specific shoes, called rocker-bottom shoes, are useful because they help to propel you forward with less stress on the ankle. In many cases, an over-the-counter ankle brace is sufficient for relief. However, for severe arthritis cases, a custom brace may be needed for added stability and support. Additionally, a fluoroscopic ankle joint injection (where we use an X-ray machine to locate the joint and inject steroids directly into the joint) can be an excellent source of pain relief that can have a lasting effect. Although these non-operative options are preferred, they may not work for everyone. If your arthritis does not respond to these conservative non-surgical treatments, surgery may be an option for you. 

When is surgery the right option for you?

If you have daily pain that interferes with your quality of life and you’ve tried the above non-operative treatments, then we may consider surgery for your ankle. The type of surgery will vary depending on the extent of your arthritis. For example, early arthritis cases may be treated with a debridement, which is a type of “clean out” procedure that removes some of the inflamed tissue. End-stage arthritis will require a more extensive procedure such as an ankle fusion or a total ankle replacement. There are pros and cons to every surgery and I welcome the opportunity to discuss them in further detail with you and your family.

April’s Journey through Knee Surgery

by TOI Admin December 13, 2016

At 60 years old, April could not remember a time she was not active throughout her life. “I love to walk and have been power walking most of my life. I enjoy working out, walking our dog, hiking, and strength training.”

But then April began experiencing pain and difficulty after walking a short distance it began to negatively affect her quality of life. “The pain made me reserved and it slowed me down and it’s not my lifestyle to be slowed down. It finally got to the point where I wasn’t enjoying my life because I couldn’t do the things I loved to do.” It was time to see a doctor. April chose The Orthopaedic Institute’s Edward Jaffe, M.D. as her doctor and surgeon.

April needed a partial knee replacement. “One reason I chose Dr. Jaffe is because he performs the MAKOplasty knee surgery. There is no room for human error.”

“When Dr. Jaffe walked into the OR, he was smiling, happy, and confident. I knew everything was going to work out. I wanted to feel the best I can feel and Dr. Jaffe helped me achieve that. And I feel like TOI was there for me. I say TOI because I mean everyone at TOI made me feel like I belong, like I was a family member.”

At 7 weeks post-surgery, April resumed all her normal activities. “This may seem small, but since surgery I can easily go up and down stairs and step off curbs with confidence. I got my balance back! And more importantly, I got my life back.

April’s Advice on getting MAKOplasty knee surgery:

    • Do it! Get your life back. Don’t put it off!
    • Do your research
    • Choose the surgeon that is right for you and right for the job
    • It’s ok to get a second opinion  
  • Follow all post-operative instructions given to you by your doctor and medical staff
  • After surgery you have to push yourself and be determined to succeed
  • Go to physical therapy!

What is MAKOplasty?

MAKOplasty is used to enable surgeons to plan partial knee or total hip replacement procedures by using three-dimensional computer imaging based on a CT scan.[2] This allows them to determine optimal implant size, position, and alignment for each individual patient, and to map out accurately the areas of bone they want to remove. During surgery, the robotic arm system provides visual, auditory, and tactile control to help assure that surgeons cut away only the bone planned to be resected prior to surgery. The procedure is said to take the guesswork out of surgery, resulting in accurate and reproducible results.1

For partial-knee replacements, MAKOplasty allows surgeons to remove only the diseased portions of the joint, preserving healthy tissue and ligaments, resulting in a more natural feeling knee. The procedure can be performed on the medial compartment, the lateral compartment, the patello-femoral compartment or on a combination of the medial and the patello-femoral compartments of the knee. Patients with bicompartmental MAKOplasty have improved function over those with total knee replacement surgery, and demonstrate better post-operative range of motion and quadriceps strength compared to total knee arthroplasty.2

  1.  Doyle, Karen (March 2012). "MAKOplasty Improves Surgical Precision and Patient Outcomes at Quincy Medical Center". MD News. pp. 6–8.
  2.  Jump up^Conditt, Michael; Kreuzer, Stefan; Jones, Jennifer; Dalal, Sam (October 3–6, 2012). "Functional Recovery After Bicompartmental Arthroplasty, Navigated TKA and Traditional TKA". The Bone and Joint Journal.

Effects of Smartphones on our Fingers, Hands & Elbows

by TOI Admin December 6, 2016

By Rodger Powell, M.D.

Smartphones have become a lifestyle must have for most of us, from senior citizens to young children. These devices help us with learning, playing games, sharing stuff we like, liking stuff other people share, sending emails, watching videos and staying in touch with loved ones through video calls, voice calls and of course text. According to a recent study by Flurry, a digital analytics firm, the average person spends an about 2 hours and 57 minutes on their smartphone each day.

Although smartphones have made our lives easier, an increasing number of people have complained of finger, hand and elbow pain as a result of using their device. In non-medical terms, these conditions have been referred to as “text claw” and “cell phone elbow”.

So are smartphones really having a negative impact on the health of our upper extremities?

To find out, we asked Dr. Roger Powell, a board certified orthopedic surgeon, specializing in hand and elbow surgery.

In the last 10 years, have you seen a rise in your patients complaining of pain or injuries from using their smartphones?

Yes I have, an increasing number of patients complain of pain or come in with injuries as a result of using their Smartphone

What are the common complaints?

The most common complaint is pain or numbness in the hand—especially in the ring and pinky fingers.

Can you provide a percent estimate of the increase in patients with these conditions?

According to a survey by 02 (a mobile provider), in the last 5 years, forty three percent of smartphone users have experienced thumb pain and from my own experience I have noticed that its occurrence corresponds with the rise in the use of computer workstations and cell phones.

Have you heard of text clawor &cell phone elbow?

Yes I have, they are the popular names for cubital tunnel syndrome and carpal tunnel syndrome.

What are these and what are the actual medical terms for these conditions?

"Text Claw" is a non-medical term that describes all of the finger cramping and aching muscles that come from constant gaming, scrolling and texting on smartphones, the medical term for it is cubital tunnel syndrome. It can also be called "Cell Phone Elbow", described numbness or tingling in the ring and pinky fingers that occurs after when the elbow is bent for long periods of time.

Have you coined any non-medical terms for these complaints?

"Text Claw" and "Cell Phone Elbow" are actually non-medical terms

As recognized conditions, what are some of the symptoms of cubital tunnel syndrome?

The symptoms are numbness or pain or tingling in the little finger and on half of the pinky facing side of the ring finger. Those are fingers that their sensation is supplied by the ulnar nerve. The median nerve supplies the other fingers.

What are some of the symptoms of carpal tunnel syndrome?

The symptoms are tingling and numbness in the index, thumb and middle finger

How is cubital tunnel syndrome different from carpal tunnel syndrome?

The cubital tunnel; the nerve gets pinched back behind the elbow and gives you numbness in the small and ring finger, whereas Carpal tunnel gives you tingling and numbness in the thumb, middle and index finger. They are similar because it is pressure on the nerve, but there is a little difference in the anatomy. The pain and tingling are the nerve telling you that it is uncomfortable.

Do you think cell phone usage is to blame for cubital tunnel syndrome, carpal tunnel syndrome or any other medical condition of the fingers, hand, or elbow?

It's not actually caused by anything. There are hundreds of millions of people who use smartphones who are never symptomatic. Some people are born with a narrower cubital tunnel or a little extra muscle that not everyone has. A person with a predisposition to this problem may become symptomatic when the elbow is flexed beyond 90 degrees. That can happen at night when we sleep or when performing a task like talking on the cell phone. Cubital tunnel syndrome may be on the rise due to heavy cell phone use.

Do people have a predisposition to these conditions?

Yes they do, someone who gets this often has a predisposition to have the problem

What are some other conditions smartphone usage can cause?

Different types of Repetitive Strain Injury

Repetitive Strain Injury?

Repetitive strain injury is a term used to refer to discrete conditions that are associated with repetitive tasks, and sustained awkward positions. Its cause is related to the overuse of muscles and tendons in the upper body

When should someone see a doctor if they think they are experiencing any of these conditions?

I advise you do some hand and wrist stretches at the initial occurrence of pain or discomfort, if the pain persists for longer than a week then it may be time to see a doctor.

How is it diagnosed? Answer for cubital tunnel syndrome and carpal tunnel syndrome

Cubital tunnel: by observing and inspecting the forearm and the elbow, checking the strength of some specific muscles and by checking their griping and pinching through an elbow flexion test.

Carpal tunnel: by examining the neck region, checking wrist and hand range of motion and performing a wrist flexion test and some sensory tests.

How is it treated? Answer for cubital tunnel syndrome and carpal tunnel syndrome

Mild cases of cubital tunnel syndrome can be treated by keeping pressure away from the elbow, protecting the funny bone by wearing an elbow pad or wearing a splint to sleep to avoid over-bending the elbow. Surgery is performed where the nerve compression is so severe as to release the pressure on the ulnar nerve.

For carpal tunnel, wrist splinting, non-steroid anti-inflammatory drugs or corticosteroids may be used to relieve the pain, endoscopic or open surgery might be the way to go if severe.

How is it prevented? Answer for cubital tunnel syndrome and carpal tunnel syndrome

  • You could use a hands-free device or an earphone.
  • Reduce usage time
  • Constant positional changes
  • Use headsets when speaking on a smartphone
  • Heat/cold packs
  • Stretches 


Welcome to TOI's Blog!

TOI's Blog is dedicated to patient education with topics addressing current issues in health and medicine. We will also blog about some of our other favorite things, like community events, our wonderful employees, helping the environment and whatever else comes to our minds! We hope the information contained in our blog is fun to read, assists you in making educated decisions regarding your health, and supports your decision to select TOI when you are in need of quality musculoskeletal care.


«  January 2017  »

View posts in large calendar