Partnering on Value-Based Care is Key to Reining In Health Care Costs

Partnering on Value-Based Care is Key to Reining In Health Care Costs

August 16, 2019

I came across an article recently in Managed Care about Dr. Stephen Zabinski, a surgeon at Shore Orthopaedic University Associates in Somers Point, New Jersey, who also happens to participate in the Episodes of Care program here at Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ).

Continue reading

Golf Injuries to the Foot and Ankle

Although golf does not involve running or jumping, injuries can occur to the foot and ankle. Golfers should be aware Heel Pain or Plantar Fasciitis can be exacerbated by excessive walking on the golf course. 

Heel Pain (Plantar Fasciitis)

Heel pain is most often caused by plantar fasciitis, a condition that is sometimes also called heel spur syndrome when a spur is present. Heel pain may also be due to other causes, such as a stress fracture, tendonitis, arthritis, nerve irritation or, rarely, a cyst.

Because there are several potential causes, it is important to have heel pain properly diagnosed. A foot and ankle surgeon is able to distinguish between all the possibilities and to determine the underlying source of your heel pain.


What Is Plantar Fasciitis?

Plantar fasciitis is an inflammation of the band of tissue (the plantar fascia) that extends from the heel to the toes. In this condition, the fascia first becomes irritated and then inflamed, resulting in heel pain.

Causes

The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.

Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly evident when one’s job requires long hours on the feet. Obesity and overuse may also contribute to plantar fasciitis.

 

Symptoms

Continue reading

Dr. Dalzell Explains Treatment and Prevention of the “Most Common Golf Injuries”

MOST COMMON GOLF INJURIES


Frederick G. Dalzell, MD
Board Certified Orthopaedic Surgeon

Fractured ribs, herniated discs, injured wrist and knees, we’re not talking the Eagles injury report, but rather some of the injuries suffered on the PGA tour! Hard to believe that what’s been described as “a good walk spoiled” and debated by others as not even being a sport could result in this litany of injuries.

So what are the most common problems suffered by the weekend golfer and how can you treat and prevent them?

BACK PAIN 
It’s been estimated that 80% of Americans will experience back pain at some time in their life. That number becomes even higher when you enjoy golf as an activity. With the average golfer generating torque and swing speeds of 80 to 90 miles an hour and pros well over 110 it is not surprising that the raid generation and sudden stop put significant stress on the lumbar spine. Pre and in-season stretching and core strengthening can be good preventatives. Rest, anti-inflammatories (like Motrin or Aleve) stretching, deep tissue massage and bracing all may be helpful early on. If not responding after a week you may need to see your health care professional.

ELBOW PAIN 
Tennis elbow (outside of the elbow) and golfer’s elbow (medial elbow) are also the bane of the duffer and pro golfer alike. Over use, hitting off mats, too stiff a shaft and improper grip size can lead to these problems.  Stretching, tennis elbow straps, ice, anti inflammatories and injections all have a place in treatment. Sometimes a switch to graphite or a more flexible shaft may be beneficial and could be a reason to consult a golf professional.

WRIST PAIN
Most wrist pain related to golf comes from tendonitis and over use. Taking time off (sorry fellow golfers), ice and anti-inflammatories will cure most cases. If the pain follows striking a root or another object, results in joint swelling or lasts more than a week after treatment than a more serious injury (fracture or ligament tear) is a possibility and a trip to the doctor is more advisable.

KNEE PAIN  
The stiff lead leg is exposed to high stress during weight shift, and while not as common as some of these other problems these injuries often involve ligaments  or meniscus and may need medical attention earlier. Those with arthritis also may see flares during golf season. Bracing and an evaluation of your swing by your golf pro may help. Continue reading

Better Golf through fitness: Shore Orthopaedic’s Physical Therapist LJ Georgetti, DPT

“Its all In The Hips” By Larry Justin “LJ” Georgetti, DPT

Any aging golfer can count on one of his/her friend’s bailing on an eight o-clock tee time due to “back pain”. Range of motion and strength of the whole body are essential when building a strong foundation to a healthy golf swing. I believe that the abnormalities in swing mechanics and mobility limitations in the hips/spine will cause restrictions in how one develops force in the golf swing.  These abnormalities over time will result in dysfunction and eventually pain.

The golf swing has many variables, as does the human body. However, one thing remains consistent throughout all golf swings: energy must be delivered to a stationary golf ball in order to move it a desired distance. In the most efficient swings, energy is generated by the lower extremities via the ground. How this energy is gained, stored and eventually transmitted are exactly where the variables begin to differentiate between professional and recreational golfers. A golfer utilizes his/her lower extremity to generate force through the ground and eventually to the ball at impact. It is worth noting that the musculature surrounding the hips, known as the “glutes”, are the strongest in the body. These are the ones responsible for getting us up out of a chair and keeping us erect when walking. Problems arise when we do not train and utilize these muscles appropriately. As my colleague, Chris Hanson, previously discussed, the hip and the lumbar spine are closely related in the golf swing. If dysfunction arises in one, the other will suffer.

Continue reading