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Rheumatoid Arthritis | Symptoms, Diagnosis, Treatment Options

Rheumatoid Arthritis | Symptoms, Diagnosis, Treatment Options

There are hundreds of different types of arthritis, which is a broad term used to describe joint inflammation. Rheumatoid arthritis, one of the most common arthritic conditions (along with osteoarthritis and gout), is a type of autoimmune disorder affecting over 1.3 million Americans and an estimated 1% of the global population according to research. Dr. Steven Ferrer and Dr. Kevin McElroy of Progressive Spine & Sports Medicine are leading physicians in the Northern New Jersey area offering comprehensive, customized, and compassionate care for people with RA, using a combination of orthopedic, rehabilitative, and non-surgical pain management techniques.

Causes, Signs & Symptoms of Rheumatoid Arthritis (RA)

Autoimmune diseases occur when the body launches an abnormal immune system response to its own tissue. Other examples of autoimmune disorders include lupus, multiple sclerosis, psoriasis, and Chron’s disease.

In the case of rheumatoid arthritis (RA), a person’s immune system triggers an antibody attack against its own joint tissue, specifically the synovial fluid that acts as a natural lubricant in certain joints. Hallmark symptoms of RA include chronic inflammation, swelling, stiffness, pain, and deformities of the joints within the wrist, hands, and feet. These symptoms typically affect multiple joints on both the left and right sides of the body. As the disease progresses into its later stages, additional clinical signs and symptoms may include depression, fatigue, low-grade fevers, loss of appetite, weight loss, and general malaise.

Who Gets RA?

People of all ages and ethnicities can get RA (in children, it’s known as juvenile rheumatoid arthritis). However, it most commonly affects women (at a rate of 3:1 compared to men) with average age of onset between 30 and 60. It’s diagnosed via a combination of a physical examination, family and personal history assessment, blood tests, and diagnostic imaging that can identify bone density issues and the degree of joint inflammation.

Risk factors for the autoimmune disease include genetics, hormones, environment (e.g., exposure to pollution, chemicals, secondhand smoke, or joint trauma), and lifestyle (specifically, a positive smoking history, which may increase a person’s risk for RA by as much as 2.4%).

How Our Ramsey Pain Management Team Helps People Living with RA

At Progressive Spine & Sports Medicine, our Ramsey pain management team has worked with hundreds of men and women struggling to carry on a typical, pain-free life with RA and other autoimmune and/or chronic health conditions.

Early and routine treatment will generally make the biggest positive impact for the RA sufferer. Here are a few of the services we offer that can help:

  • Physical therapy, to maximize joint range of motion and function, muscle strength, and overall physical activity levels
  • Acupuncture, to reduce pain and promote increased circulation and healing growth factors
  • Lifestyle and nutritional advice to help promote anti-inflammation, smoking cessation, and other healthy habits

Are you or someone you know living with RA? Don’t let your pain hold you back from living the life you want full of the activities you love! Contact Progressive Spine & Sports Medicine in Ramsey, New Jersey at (201) 962-9199 to schedule your initial consultation today.

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Patellofemoral Pain Syndrome Diagnosis & Treatment in Ramsey NJ

Patellofemoral Pain Syndrome Diagnosis & Treatment in Ramsey NJ

Alternatively known as “runner’s knee,” “jumper’s knee,” or “patellar overload syndrome,” patellofemoral pain syndrome is a condition we see a lot of around here at our Ramsey NJ comprehensive pain management practice. While it can be painful and debilitating, this condition is treatable and typically responds well to conservative management.

What is Patellofemoral Pain Syndrome? How Will I Know I Have It?

Patellofemoral pain syndrome (knee and kneecap pain) is often caused by vigorous exercise, such as during sports training or physically-demanding work activities. These activities may lead to repeated stress on the knee and knee cap, resulting in pain and inflammation. Other causes and risk factors may include patella malalignment (often due to hip, knee, and/or ankle alignment problems) and abnormal tightness and/or weakness of the quadriceps and other hip and leg muscles.

Symptoms  include:

  • Anterior knee pain while squatting, climbing stairs, running, and jumping
  • Knee pain after prolonged sitting
  • Knee pain that comes on or worsens after a recent change in activity level
  • Audible popping or crackling noises in your knee joint during movement

Who Gets Patellofemoral Pain Syndrome?

Women, especially younger women, are far more likely to be affected by patellofemoral pain syndrome. It’s common in athletes who participate in high impact athletic activities. However, patellofemoral pain syndrome can also happen in men as well as non-athletes.

Treatment & Prevention for Patellofemoral Knee Pain

Our patients who come to our Northern New Jersey pain clinic for help with their knee pain appreciate our approach to care. We don’t believe in simply covering up pain with medications, nor trying to “fix” symptoms without addressing the underlying causes of the problem. That’s why our plan of care for patellofemoral pain syndrome, whether for you or your loved one, will be thorough and comprehensive.

First, we’ll need to confirm a diagnosis and rule out other potential problems including quadriceps and patellar tendonitis, Osgood-Schlatter disease, or a degenerative condition known as chondromalacia patella. We rely on our physical examination techniques, diagnostic testing, and patient history taking to help us pinpoint the exact cause of your dysfunction.

Next, our multidisciplinary team will implement a customized treatment plan—all available right here under one roof! Some of the most effective treatments we can use include:

  • Physical therapy, with emphasis on stretching and strengthening your quadriceps and other key leg, hip, and trunk muscles
  • Acupuncture and percutaneous electroneuro stimulation for drug-free pain relief
  • Osteopathic manipulations and other non-surgical orthopedics, to relieve pain and improve joint range of motion and alignment

Lastly, we’ll educate you on ways to prevent your knee pain from coming back. This may include extending and customizing your pre-activity warm up, maintaining a home exercise program, wearing appropriately supportive shoes, and maintaining a healthy body weight.

Is your knee pain keeping you back from the sports and activities you love? Call our advanced orthopedic and rehabilitation team today, led by Dr. Steven Ferrer and Dr. Kevin McElroy. We’re proud to be among Northern New Jersey’s leaders in innovative, non-surgical, and comprehensive pain management, and we’re confident that we can help you and your loved ones, as well. To schedule your initial consultation or to learn more about the services we offer at our state-of-the-art facility, call Progressive Spine & Sports Medicine now at (201) 962-9199.

sports injury doctor ramsey nj

Common Falls Sport Injuries Seen in Student Athletes

Fall season is in full swing, which means fall sports season is in full swing, too! If you have student athletes in your house, then you should be aware of the following common injuries that tend to occur this time of year.

Common Falls Sport Injuries Seen in Student Athletes

 

Whether your child plays field hockey, soccer, football, cross-country, or another fall season sport, he or she may be at risk for any of the following conditions:

Whiplash

Commonly seen in football and other full contact sports, whiplash is pain, strain, and tissue damage in the neck caused by a sudden and violent forward/backward movement of the head. Common symptoms include headaches, dizziness, neck and shoulder pain, and neck stiffness.

Concussions and post-concussive syndrome are related issues seen particularly by football players. These are actually mild forms of a brain injury, and can present with some whiplash-like symptoms, like dizziness and headaches, as well as other symptoms including mental fogginess, irritability, and insomnia.

ACL Sprain or Tear

Consistently reported as one of the most common injuries among fall athletes, an anterior cruciate ligament (ACL) tear or sprain is damage to an important stabilizing ligament within the knee. It often happens due to sudden pivoting, turning, and/or jumping. Symptoms include knee pain, swelling, decreased range of motion, and difficulty walking. A person with an ACL sprain or tear may even hear an audible “pop” in their knee during the acute injury. This can often occur with damage to the meniscus (which serve as supportive discs inside the knee joint).

In addition to ACL tears, ligamentous injuries at the ankle are also frequently reported during the fall season.

Shin Splints

Cross-country runners are particularly at risk for this type of injury. Shin splints cause pain and tenderness on the front of the lower leg due to micro-damage of the muscles, tendons, and other connective tissues in that area. It’s often caused by overuse, or a sudden increase in physical activity.

How Our Orthopedic and Non-Surgical Pain Team Can Help Treat & Prevent Fall Sports-Related Injuries

 

In addition to getting quality sleep, recovery, hydration, and nutrition, your child can also minimize his or her risk by seeking preventive care through pre-season sports physicals and skills-specific training.

Sometimes, however, no amount of preparation can prevent an injury. At Progressive Spine & Sports Medicine, we offer some of Northern New Jersey’s leading diagnostic and treatment services for acute orthopedic injuries using non-surgical and highly effective approaches. We’ve helped hundreds of student athletes recover quickly and completely from their injuries so they can get back to their sport at their fullest potential.

Specific techniques we use to help athletes heal include:

  • Regenerative medicine
  • Neurological and sports rehabilitation
  • Physical therapy
  • Diagnostic imaging

Planning on a Healthy Fall Sports Season? Let Our Ramsey Pain Management Doctors Help

Do you have a student athlete at home who’s struggling with an acute injury? Or, are you simply looking for someone who can help your young athlete avoid a sidelining injury altogether? Our  Ramsey pain management doctors, Dr. Steven Ferrer and Dr. Kevin McElroy, love working with athletes of all ages and abilities. To schedule an initial consultation today, call Progressive Spine & Sports Medicine today at 201-962-9199.

hip pain treatment ramsey nj

Everything You Need to Know about Hip Flexor Strains

Hip Flexor Strain

 

Hip flexor strains are a common injury among athletes. At Progressive Spine & Sports Medicine, our Northern New Jersey pain management team, led by Dr. Steven Ferrer and Dr. Kevin McElroy, offers a variety of diagnostic and therapeutic tools to help people suffering from this muscle injury recover as quickly and as completely as possible.

 

What are your hip flexors, and how might you injure them?

 

Your hip flexors are a group of muscle that, as the name implies, flexes the hip (brings the thigh closer to the trunk). They include the iliacus muscle and psoas muscle (often known collectively as the iliopsoas), the rectus femoris (a part of your quads), the sartorius muscle (the longest muscle in your body!) and a few other muscles located near your upper leg. These muscles have attachments on your lower spine, your pelvis, and your femur.

An injury to the hip flexor may occur due to poor technique in sport or an acute event such as a slip, trip, or fall. A common method of injury may also be forcefully kicking (such as kicking a ball), overextending the leg, or pivoting.

A person may be more at risk for injuring their hip flexor if he or she has tightness in these muscles, which is common among our industrialized, chair-sitting society.

Muscle strains, including those of the hip flexors, can range in severity, from small microscopic tears and inflammation in the muscle fibers to significant tears.

How can I tell if I have a hip flexor strain?

 

The exact nature and location of your pain will depend on which hip flexor muscle and which part of the muscle was injured. However, some of the most common symptoms include:

  • Sudden pain at the front of the hip
  • Pain that worsens when the thigh is raised against resistance
  • Pain that worsens when the hip flexors are stretched
  • Tenderness, bruising, and/or swelling at the front of the hip

A person with a hip flexor injury may also have back pain and difficulty walking.

What treatment is available for my hip flexor strain injury?

 

People who see us for help with a hip flexor injury will be thoroughly evaluated by our team. We’ll look for underlying factors that may have contributed to your injury, including your posture, your body mechanics, and your foot alignment/footwear.

Based on our findings, we’ll devise a customized treatment plan to facilitate your healing. Techniques may include:

Additionally, we may recommend that you rest and ice your leg within the first few days to control inflammation and assist with healing.

Are you experiencing hip pain? Call Progressive Spine & Sports Medicine today to schedule an appointment at our state-of-the-art facility. We offer a complete range of non-surgical orthopedic and therapeutic services to help you recover from a hip flexor strain or other injury. To schedule an appointment, call (201) 962-9199 today.

ACL & MCL Treatment NJ

Diagnosing & Treating ACL & MCL Tears

ACL & MCL Tears

 

You may have heard of ACL & MCL tears being a “career-ruining injury” back in the day for football players, soccer players, basketball players, and other athletes. Fortunately, recent advances in both diagnostic and therapeutic techniques have allowed many people suffering from ACL & MCL tears to enjoy full or near-full recoveries and a return to the sport they love.

At Progressive Spine & Sports Medicine, our Northern New Jersey pain management team works with hundreds people every year suffering from ACL and MCL tears. Lead by Ramsey pain doctors Dr. Steven Ferrer and Dr. Kevin McElroy, we’ve helped everyone from young student athletes to older adults find customized and comprehensive care for their knee ligament damage.

 

The Function of Your ACL and MCL

 

Your knee is a mobile, yet very stable, hinge joint. It gleans its stability largely from two major ligaments, your ACL (anterior cruciate ligament) and MCL (medial collateral ligament). These ligaments connect your femur to your tibia, which form the upper and lower articular surfaces of your knee.

While they are 2 distinct ligaments, the ACL and MCL are close enough together and serve a similar function that they will often both become injured at the same time.

 

How ACL and MCL Injuries Occur

 

The mechanism of injury of an ACL or MCL tear is often some sort of sudden stop or change in direction. As you can imagine, this often happens during sports like basketball, soccer, or gymnastics, when a person jumps or pivots. Ligament damage can also occur if the knee is directly hit or if it is exposed to repetitive stress.

The severity of ligament damage depends on the injury itself as well as other factors like general ligament laxity, age, weight, and overall health. Minor ligamentous injuries are considered “sprains,” whereas severe injuries can lead to a full on tear in the ligament fibers.

Of course, you don’t have to be an athlete to suffer from an ACL/MCL tear. Any sort of trip or fall may lead to stress and strain on the knee and lead to ligament damage. Symptoms include:

  • Mild, moderate, or severe knee pain, especially along in the inside of the knee
  • Swelling and tenderness around the knee
  • The sensation of instability, as if the knee will lock, catch, or give way

 

Diagnosing & Treating ACL & MCL Tears at Progressive Spine & Sports

 

Our team at Progressive Spine & Sports Medicine can diagnose an ACL/MCL tear through a variety of techniques, including physical exam, symptom assessment, and musculoskeletal ultrasound imaging. Depending on the degree of your injury, we’ll implement an individualized treatment plan which may include:

  • Regenerative treatments, including platelet rich plasma injections and stem cell injections
  • Physical therapy
  • Interventional pain injections

Together, these services can heal your injured ligaments, reduce your pain, reduce excessive scarring, and increase stability and strength of your knee.

 

Is Your Knee Injury Keeping You From the Active Lifestyle You Love? Our Ramsey Pain Doctors Can Help

 

If you live near Ramsey, NJ and are looking for someone to help you or a loved one recover from an ACL & MCL tear, then call Progressive Spine & Sports Medicine. To schedule an appointment or speak with one of our Ramsey pain doctors, call us today at (201) 962-9199.

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Achilles Tendonitis: Common Causes, Factors, & Treatment Options

Your Achilles tendon is a thick, strong band of connective tissue that attaches your calf muscle to the heel bone (calcaneus). You can feel it when you run your fingers along the lowest part of your leg, just behind the ankle. This tendon is responsible for helping control the movement and stability of your ankle joint and is involved in many dynamic activities including jumping, running, and pivoting.

When it Might be Achilles Tendonitis

Any time you see a word ending in “-itis,” you can safely assume that something is inflamed and irritated. With Achilles tendonitis, inflammation of the tendon leads to symptoms including:

  • Pain in the tendon, heel, and lower leg that is worse with activity and first thing in the morning
  • Stiffness in the tendon and ankle joint
  • Swelling and thickening of the tendon

Keep in mind that if the tendon becomes thicker, this does not necessarily mean it is becoming stronger. This thickening often occurs as a result of scar tissue formation, which is notably less elastic and pliable compared to normal tendon tissue. As a result, your ankle can become even more stiff and weak over time, especially if the condition isn’t managed appropriately.

Common Causes & Risk Factors for Achilles Tendonitis

Unlike certain sports injuries that tend to be caused by a frank trauma or a specific precipitating event, Achilles tendonitis tends to develop over time as a result of repetitive stress and strain. The “too much, too soon” blunder that many of us fall prey to is often a major cause. Additional causes or risk factors for developing Achilles tendonitis may include:

  • Bone spurs (visible on digital X-rays), or spots of excess bone growth from the calcaneus that can rub against and irritate the tendon
  • Shortened calf muscles and/or inflexible ankles
  • Overweight and obesity
  • Poor, unsupportive footwear
  • Improper sports technique

Treatment Options for Achilles Tendonitis

In the early stages of Achilles tendonitis, the main goals are to reduce swelling, pain, and inflammation. It’s also important to prevent additional tissue damage. Our team of Ramsey pain management clinicians and therapists achieve these goals through services including regenerative medicine, electrical stimulation, cryotherapy, and acupuncture. We’ll also provide thorough screens of your posture and movement mechanics to help identify any issues that may be contributing to your injury.

During the sub-acute stages of a recovery, our goal shifts to maximizing joint range of motion and increase the strength and stability of your ankle. Physical therapy exercises and osteopathic manipulations are very useful for this, as are other services.

Has Your Lower Leg & Heel Been Sore Lately? It Could be Achilles Tendonitis! Call Our Ramsey Pain Management Doctors Today

If you’ve been diagnosed with Achilles tendonitis, our team here at Progressive Spine & Sports Medicine can help you get back on your feet. Our comprehensive selection of nonsurgical orthopedic and therapeutic solutions have helped thousands of people from Ramsey and surrounding Northern New Jersey communities recover from their injuries. To schedule an appointment with one of our Ramsey pain management doctors, Dr. Steven Ferrer or Dr. Kevin McElroy, or if you’d like to learn more about our nonsurgical pain management services, then call us today at (201) 962-9199.

Shoulder Pain Doctor Near Me

Shoulder Bursitis

Our Multidisciplinary Pain Management Team in Ramsey NJ Proudly Treats Shoulder Bursitis

 

Shoulder bursitis is a common pain condition diagnosed and treated by our Ramsey pain doctor team, Dr. Steven Ferrer and Dr. Kevin McElroy. If you have shoulder pain, keep reading to learn more about this condition and how our multidisciplinary pain management team may be able to help you.

What Is Shoulder Bursitis?

A bursa is a fluid-filled sac that helps reduce friction in areas where muscles and tendons slide over bones and other spaces around a joint. You have several of these in and around your shoulder joints.

Consider the following symptoms:

  • You have shoulder pain that came on gradually over the course of weeks or months.
  • You have shoulder pain that is felt on the outside of your joint or may even radiate down toward your elbow or wrist.
  • Your shoulder pain worsens when you perform overhead activities, like washing your hair, putting things away on a shelf, or screwing in a light bulb. It particularly hurts in what’s called a “painful arc,” or during the middle part of the motion of moving your arm out and up like a T.
  • Your shoulder hurts less when your arm is by your side.
  • Your shoulder hurts more when you lie on it.

If you are exhibiting any of these symptoms, you could be suffering from a case of shoulder bursitis.

As with any physical condition ending in “-itis,” shoulder bursitis is hallmarked by inflammation of one of the bursas near this joint (typically the subacromial bursa, which is located under the bone on the top of your shoulder).

Such inflammation can be caused by multiple factors, including repetitive motion and overuse, direct trauma, or a disruption in the normal alignment of the shoulder joint (called impingement). Other conditions, including rotator cuff strains and biceps tendonitis, may also lead to an irritation of your shoulder bursa.

How Is Shoulder Bursitis Diagnosed?

The only way to know for sure what’s causing your shoulder dysfunction is to consult with a healthcare professional. Drs. Ferrer and McElroy, along with their physical therapy staff, can determine if your shoulder pain is caused by bursitis based on a combination of diagnostic imaging studies (such as MRI or ultrasound), physical tests, and a patient history interview. We’ll ask you about your pain and evaluate how your shoulder responds to our special tests.

Once we have confirmed a diagnosis of shoulder bursitis, we’ll be able to work with you to determine the most appropriate course of treatment.

What Are My Treatment Options for Shoulder Bursitis?

Treating shoulder bursitis focuses on reducing inflammation, eliminating the factors that are contributing to such inflammation (including posture, muscle imbalances, and poor body mechanics), and healing the bursa and other injured tissues in the shoulder area. To do this, our staff utilizes comprehensive therapies including:

Wondering if Your Shoulder Pain Could be Caused by Bursitis? Call Our Ramsey Pain Doctors Today For The Right Diagnosis & Treatment

Progressive Spine & Sports Medicine is proud to be Northern New Jersey’s most advanced and comprehensive facility for pain management services. If you’re struggling with shoulder pain or any other type of acute or chronic condition, then call our Ramsey pain doctors, Dr. Ferrer and Dr. McElroy, to schedule a consultation. Our number is 201 962 9199 and our office hours are from 8:00 a.m. to 8:00 p.m. Mondays, Wednesdays, and Fridays, and 8:00 a.m. to 6:00 p.m. Tuesdays and Thursdays.

We look forward to serving you!

Treatment for Golfer's Elbow

Golfer’s Elbow & Tennis Elbow

Our Ramsey pain management doctors, Dr. Steven Ferrer and Dr. Kevin McElroy, have seen many of their patients affected by elbow pain. Epicondylitis, or inflammation of the muscles and tendons that attach to the elbow, is often the underlying cause. You may know this condition as 1 of its 2 varieties, golfer’s elbow or tennis elbow–both of which respond positively to the variety of services we offer at our facility.

Golfer’s Elbow vs. Tennis Elbow: Similarities & Differences

Epicondylitis is a relatively common health condition, especially among working adults in their 40s and 50s. It’s typically caused by excessive physical load or overuse, including repetitive arm movements which are commonly seen during certain athletic and occupational activities. According to research published in the American Journal of Epidemiology, epicondylitis is more likely to occur in people who smoke and/or who are obese.

There are 2 specific types of epicondylitis, lateral and medial:

  • Tennis elbow (lateral epicondylitis): pain presents on the outer elbow and may radiate down the forearm; the main muscle and tendon involved is called the extensor carpi radialis brevis
  • Golfer’s elbow (medial epicondylitis): pain presents on the inner elbow and may also radiate down to the forearm or wrist; the main muscle and tendon involved is called the flexor carpi radialis

Of course, you don’t have to play tennis or golf in order to be afflicted with either of these injuries, however the nicknames are apt since these activities are often precipitating factors. In both cases, the elbow pain typically presents gradually. Both conditions may lead to weakness in grip strength and a decreased tolerance to perform certain upper extremity tasks such as holding a racquet or golf club, typing, turning a door knob, etc. Typically, a person’s dominant arm will be affected, although either or even both arms may be involved.

Elbow Pain Ramsey NJ

How Our Ramsey Pain Management Team Treats Golfer’s Elbow & Tennis Elbow

Since the majority of golfer’s elbow and tennis elbow are caused by some sort of overuse, one of our main tasks when treating this type of elbow pain is to identify the causative movements and figure out how to modify or avoid them in order to reduce further damage. This may include taking a break from your sport of choice or adjusting your occupational body mechanics and work tasks. We also need to initiate tissue healing as soon as possible. Not only will this help relieve your elbow pain and reduce inflammation, but it will also minimize the risk of recurring symptoms.

  • Our physical therapy team can help by providing therapeutic exercises to promote tissue healing and increased circulation, along with soft tissue mobilizations to relax painful muscles
  • Our Ramsey doctors can also prescribe various pain management modalities including acupuncture, electrical stimulation, and pain relief injections to provide fast and effective pain relief
  • Osteopathic manipulations that improve the alignment of your spine may also help reduce strain and tension on the nervous system which could be contributing to/exacerbating your symptoms

No matter what your unique presentation is, our team will work thoroughly to develop the most appropriate treatment plan to manage your elbow pain effectively. Is your elbow pain holding you back? Come experience the difference in care at Progressive Spine & Sports Medicine, serving Ramsey and surrounding New Jersey communities. To book an appointment, call (201) 962-9199 today.

 

Ulnar Nerve Treatment

Athlete Injuries: Jacob deGrom’s Ulnar Nerve

This post is part of our ongoing series to educate fans about the injuries to their favorite athletes and when they might expect them to return to play. If you have questions about your sports injury, call us at 201-962-9199 or learn more about our Sports Medicine or Sports Rehabilitation services in Bergen County, NJ.


 

Mets Pitcher Jacob deGrom’s Ulnar Nerve Injury

 

Jacob deGrom is just one of the Mets electric young pitchers to suffer a significant injury this year. The biggest concern a pitcher has when they experience elbow pain is damage to the ulnar collateral ligament, which would require Tommy John surgery. He avoided that fate, but Jacob deGrom does have an injury to his ulnar nerve, which will require surgery.

What is ulnar nerve entrapment?

Have you ever hit your “funny bone”? It’s obviously not very funny, but that does give you an example of what deGrom is experiencing. When you hit your funny bone, you actually are hitting your ulnar nerve. The nerve passes through a space known as the cubital tunnel along the middle part of the elbow.

Cubital Tunnel Syndrome

Ulnar nerve entrapment is simply compression of the ulnar nerve, usually within this cubital tunnel. Common causes of this compression is from keeping the elbow bent for long periods of time (e.g. during sleep), leaning on the elbow, and fluid or cysts within the cubital tunnel.

What are the symptoms of ulnar nerve entrapment?

  1. Numbness of the ringer finger and pinky
  2. Tingling of the same fingers
  3. Weakness of hand grip
  4. Wasting or reduction of the hand muscles

How is ulnar nerve entrapment treated?

Avoidance of situations that compress the ulnar nerve is the most important part of treatment. At our Sports Medicine clinic in Ramsey, NJ this is usually accomplished with increased awareness and bracing. Your doctor should tell you to avoid the most common situations that result in compression of the ulnar nerve. For most people, that occurs while driving or using a computer. For people who drive a lot, they should be reminded to not rest the elbow on the door. For those patients who spend a lot of time on the computer, proper ergonomics should be encouraged. That includes keeping your elbows bent to 90 degrees and not resting your arms directly on your elbow.

Ulnar Nerve BraceBracing is usually recommended at night because you are not able to control the position of your arm while sleeping. The brace is simple and comfortable. The brace keeps your elbow fully extended to prevent bending it and causing compression of the ulnar nerve.

 

If these conservative treatments do not work, surgery is usually recommended. Typically there are two options. The first is a cubital tunnel release where the ligament that forms the “roof” of the tunnel is cut. The goal of this procedure is to relieve the pressure of the nerve while leaving it in is natural location. The other surgical treatment option is called an ulnar nerve transposition. This is when the ulnar nerve is moved from its normal anatomic position and placed in front of the cubital tunnel.

With Jacob deGrom, we’ve been told that the ulnar nerve compression is the result of scar tissue that has developed following his Tommy John surgery a number of years ago. Obviously this isn’t a common cause for nerve entrapment in the general population, but the issues are the same. Hopefully the procedure he requires will be less invasive that the ulnar nerve transposition, but any surgical procedure would end his season. Fortunately, the recovery time is significantly less than Tommy John surgery. This will allow him to rehabilitate and return to baseball during spring training.

At Progressive Spine and Sports Medicine, we specialize in physical therapy and nonsurgical pain management, and ulnar nerve entrapment is just one of the many injuries we diagnose and treat in our Ramsey, NJ medical center. For more information, please see our full list of our nonsurgical services, or to schedule a consultation, contact us today.

We look forward to being your #1 solution for nonsurgical pain treatment.`

NY Mets Pitcher Matt Harvey Thoracic Outlet Syndrome

Athlete Injuries: Matt Harvey’s Thoracic Outlet Syndrome

This post is part of our ongoing series to educate fans about the injuries to their favorite athletes and when they might expect them to return to play. If you have questions about your sports injury, call us at 201-962-9199 or learn more about our Sports Medicine or Sports Rehabilitation services.


 

Mets Pitcher Matt Harvey’s Thoracic Outlet Syndrome

 

When healthy, Matt Harvey has been one of the most electric pitchers in baseball. Unfortunately, he’s had a number of health issues. While most baseball fans are familiar with the Tommy John surgery he had, thoracic outlet syndrome (TOS) and its treatment is not nearly as common.

What is a thoracic outlet syndrome?

The thoracic outlet is the space in the lower neck/upper chest that the nerves (brachial plexus) and blood vessels pass through on their way down the arm. The nerves and vessels travel between the scalene muscles, collar bone and first rib.

Thoracic outlet syndrome describes a group of disorders that results in compression of either the nerves or blood vessels in the neck. This can be caused by a number of different conditions including enlarged muscles, an extra “cervical” rib, or an old fracture of the collar bone.

What are the symptoms of thoracic outlet syndrome?

  1. Neck, shoulder, or arm pain
  2. Numbness
  3. Tingling
  4. Weakness of the arm or hand

How is thoracic outlet syndrome treated?

For most patients, physical therapy is the mainstay of treatment for TOS. Therapy focuses on improving the range of motion for the muscles in the neck/shoulder and improving posture. For the majority of patients, conservative treatment with physical therapy results in improvement of the symptoms. Most patients, however, are not throwing 95 MPH fastballs.

There are specific situations when surgery is indicated. If the compression of the blood vessels is severe, surgery needs to be performed to maintain blood flow to the arm and prevent blood clots from forming. If the patient starts to notice worsening weakness or the loss of muscle bulk (atrophy) in the arm, surgery is necessary. Surgery typically involves removal of a rib to allow for more space for the nerves and blood vessels.

With Matt Harvey, we don’t have all of his medical information, but he has chosen to proceed with surgery. It’s unlikely that Matt had major compression of the blood vessels or his doctors wouldn’t have offered him conservative treatment with a nerve block. The more likely scenario is that he wasn’t responding to physical therapy and his symptoms were affecting his performance. If he delayed surgery a few months, his recovery would have likely extended in to spring training next year and could have negatively affected 2 seasons.

Whatever the reason is that Matt opted for surgery, the rehabilitation should be less intensive than a pitcher recovering from Tommy John surgery. Assuming there are no set backs, he should be ready for spring training in 2017. The long term picture for Matt Harvey is a little less clear. He’s only 27, but will have had 2 major procedures to his pitching arm in 3 years. It’s hard to predict how a power pitcher will respond to the surgeries.

At Progressive Spine and Sports Medicine, we specialize in physical therapy and nonsurgical pain management, and Thoracic Outlet Syndrome is just one of the many injuries we diagnose and treat in our Ramsey, NJ medical center. For more information, please see our full list of our nonsurgical services, or to schedule a consultation, contact us today.

We look forward to being your #1 solution for nonsurgical pain treatment.

Knee Pain Specialists Ramsey New Jersey

Athlete Injuries: Stephen Curry’s Knee Sprain

This post is part of our ongoing series to educate fans about the injuries to their favorite athletes and when they might expect them to return to play. If you have questions about your sports injury, call us at 201-962-9199 or learn more about our Sports Medicine or Sports Rehabilitation services.


 

NBA Point Guard Stephen Curry’s Knee Sprain Injury

 

Any time the reigning MVP (and likely 2016 MVP) suffers multiple injuries in the first round of the playoffs, there is going to be concern. How much should we worry about Steph Curry’s knee sprain?

What is a knee sprain?

Deciphering media reports is often the most difficult part of determining what actually happened to an athlete and when you can expect them to return. A “knee sprain” can mean a lot of different things and recovery time varies immensely. Simply put, a sprain is an injury to a ligament, which is a band of tissue that connects two bones together. This differs from a strain, which is an injury to a muscle or the part of the muscle that connects to a bone, the tendon.

Specifically in the knee, there are 4 ligaments that can be sprained, the anterior cruciate (ACL), the posterior cruciate (PCL), the medial collateral (MCL), and the lateral collateral ligaments (LCL). The ACL and PCL are ligaments deep within the knee that prevent the thigh bone and the lower leg bone from sliding forward and backward. The MCL is on the inside portion of the knee, while the LCL is on the outside.

Anterior view of knee joint anatomy; AMuscsk_20140311_v3_001 SOURCE: AMuscsk_20140311_v3_001_Layers.psd; AMuscsk_20130821_v1_012_Layers.psd MOD from print image

The MCL is the most commonly injured ligament of the knee and is usually damaged by a blow to the outer part of the knee causing the knee to move inward.

Aside from knowing which ligament is involved, the grade of the sprain is a critical piece of information. The media often doesn’t understand this and we rarely get all of the necessary information. If they presented an injury as a grade 2 sprain, you would be less concerned than if they said the athlete had a partial tear of his MCL, right? Well, it’s the same thing. Here is the grading system:

Grade 1 – The ligament is mildly damaged after being stretched more than it should be. There are no tears and the knee joint remains stable.
Grade 2 – The ligament is stretched further resulting in partial tearing of the tissue.
Grade 3 – This is a complete tear of the ligament. Obviously, the worst case scenario with instability of the knee.

Fortunately, for Steph, we’ve been told he has a grade 1 strain of his MCL and that he’ll be reevaluated in 2 weeks. Generally, that is a fair timetable for an elite athlete to return to play following a grade 1 MCL strain. The complicating factor in this situation is the status of his right ankle. Steph seemed to be moving well before his knee injury, so an additional 2 weeks of rest should allow his ankle to fully heal. If, however, he has any lingering ankle or knee pain when he returns, he is at higher risk for another soft tissue injury if he has to change the way he runs or jumps.

The bottom line is that assuming the Warriors can finish off the Rockets, Steph should return early in the next round of the playoffs.

At Progressive Spine and Sports Medicine, we specialize in Physical Therapy and nonsurgical pain management, and a sprained knee is just one of the many injuries we diagnose and treat in our Ramsey, NJ medical center. For more information, please see our full list of our nonsurgical services, or to schedule a consultation, contact us today.

We look forward to being your #1 solution for nonsurgical pain treatment.