Know Your Knee

I am an orthopedic surgeon specializing in sports medicine. I see about 30 patients everyday with knee problems and do over 200 knee surgeries every year. Most people with knee pain do not need surgery. If your knee is hurting and not getting better, you need to see a knee specialist.
What are the signs of a knee problem? The most common sign is pain. If you are young and twisted your knee with pain on the sides of the knee, a likely diagnosis is a tear of the meniscus cartilage. This is best diagnosed on physical exam by an orthopedic specialist and can be confirmed with an MRI. If there is a small tear in the meniscus it can heal, but a large tear will require arthroscopic surgery. Those of us who do a lot of these surgeries can typically do it in less than 15 minutes and you can walk immediately after the surgery. It is a quick and easy surgery, but if you can avoid the surgery avoid it.
If you twisted your knee and heard a “pop,” it is likely that you tore your anterior cruciate ligament (ACL). This is a very important stabilizer of the knee and if you play any pivoting sports you will need it reconstructed. Unlike a meniscus surgery, ACL surgery means recovery of at least 6 months before you can return to sports.
Swelling of your knee can be caused from either an acute injury or due to a chronic problem. Living in Westchester, if your knee swells without a direct injury test for Lyme disease. If diagnosed early, treatment with antibiotics will prevent long-term complications of Lyme disease which can include arthritis and brain/nerve issues.
If your knee swells and it is red, hot and painful make sure it is not an infection. This is an emergency. If you suspect an infection, go immediately to your orthopedist’s office or go to the emergency room. You cannot wait and ignore this. The consequences of not dealing with an infection early can be life altering.
Knee pain from arthritis usually presents as chronic pain that is getting worse over weeks to months. Pain is usually in the front of the knee and worse going up and down stairs or after sitting for too long. Also, arthritis usually feels worse in the morning when you first get out of bed and at the end of the day when your leg has fatigued.
If your knee hurts or swells, ice and Motrin may be helpful. However, if your symptoms persist or you worry about an infection get it evaluated and diagnosed by a medical doctor who will help get you back to normal activities.
By Dr. Rick Weinstein, MD, MBA
Director of Orthopedic Surgery
Westchester Sport & Spine of White Plains Hospital

Should I Take a Probiotic?

 

Our body contains over 100 trillion bacteria, which is more than all of cells in our body combined! Gut health of the microbiome has been shown to be related to many health conditions today, including obesity, diabetes and depression. The quality of the microorganisms are responsible for preventing or encouraging the onset of diseases. There is a combination of “good” and “bad” bacteria in the gut, and when the ratio of the bacteria becomes off balance, this can lead to health issues. Our gut bacteria can easily change due to changes in our food, environment, and lifestyle. This is where probiotics can help correct imbalances and improve our health.

Probiotics are live bacteria and yeasts that are helpful and benefit the digestive system. There is a great deal of research on the benefits of probiotics and how they improve health conditions. They have been shown to boost cognitive function and improve memory, anxiety, depression, autism symptoms, stress, and OCD. Probiotics improve gut health and decrease GI issues such as IBS, and they aid in the digestion and absorption of nutrients, such as B12, calcium, zinc and phosphorus. Intake of probiotics has also been shown to help promote weight loss, to improve HDL levels, and to improve insulin sensitivity and blood sugar control. Lastly, probiotic help reduce inflammation and improve immune health.

There are many different strains of probiotics, and some studies show that different strains are beneficial at healing certain ailments. For example, some strains may improve immune function while others promote hormonal balance. When purchasing a probiotic, purchase a reputable brand, and try to pick one with multiple strains. SBOs (soil based organisms) are a new popular trend of probiotics. They are probiotic strains/microbes found in soil, which used to be a large part of our ancestral diet. Proponents state that they increase gut diversity and benefit gut health, especially those with Irritable Bowel Syndrome and SIBO (small intestinal bacterial overgrowth). Common SBO strains are bacillus subtilis, bacillus clausii, saccharomyces boulardii, lactobacillus plantarum, and bacillus coagulans.

Everyone’s gut microbiome is different, and different strains will react differently in our bodies. In my opinion, a probiotic can be beneficial for just about everyone. They are especially helping for those with persistent GI issues, allergies, asthma, frequent yeast infections, autoimmune conditions, anxiety, and skin conditions. They are also beneficial with those with a history of antibiotic use and when one is on a weight loss program or traveling. If probiotics cause your digestive symptoms to get worse, stop them immediately.

by Denise Groothuis MS RD CFMP

10 Success Strategies for Boosting Your Immune System

Many over the counter products, vitamins and supplements claim to help improve your health, but the best strategies for boosting your immune system involve a number of simple lifestyle strategies anyone can follow through with. Some of the best success strategies to boost and support your immune system are:

  1. Eating a healthy diet
  2. Losing weight if you are carrying extra pounds
  3. Exercising regularly
  4. Getting more quality sleep
  5. Decreasing stress levels
  6. Making time for yourself
  7. Socializing with friends and family
  8. Quitting smoking
  9. Avoiding or minimizing antibiotic use
  10. Cutting down on your alcohol consumption

Let’s look at each of these success strategies in turn.

We are what we eat, digest and absorb, so a healthy diet goes a long way in preserving our health. Eating plenty of fresh fruits and vegetables offers a range of nutrients, phytochemicals and antioxidants, powerful disease-fighting molecules found in certain foods such a berries, legumes and apples. Eating a rainbow every day will help you achieve a balanced diet, and the fiber and water in these foods will also help you feel full and satisfied for longer, which in turn can help with weight loss.

If you are carrying extra weight, turn to clean natural foods to help slim down. Don’t rely on supplements or packaged diet foods, but rather, fresh organic fruits and vegetables, healthy, properly-raised animal protein, wild fish and smaller portions.

Regular exercise can not only help you achieve your weight loss goals, but boost your immunity too. Exercise improves digestion, brain function and helps eliminate toxins from the body through sweating. It also stimulates circulation, including not only the blood but the lymphatic system, which helps the body fight and prevent illness.

Getting more sleep can help boost the immune system, especially high-quality, deep, restorative sleep. If you’re feeling stressed, it can be difficult to fall asleep and/or stay asleep. Stress reduction strategies such as meditation can help lower your stress levels and improve your quality of sleep.

You can also decrease your stress by making more time for yourself to do some of the things you enjoy. This can include hobbies, time at the gym getting more exercise, or going for long walks. It should also include nurturing the relationships that are important to you by spending quality time with friends and family. Loneliness and feelings of isolation can make you feel run down but surrounding yourself with positive people can help boost your immune system.

By now we all know about the negative effects of smoking on the body, especially the immune system. It scorches away the cilia, the little hairs that line the nostrils and nasal passages, for example, making it far easier for germs to get into your body. It also decreases circulation in the microscopic blood vessles leading to slowed healing.

Many people turn to a range of pills in an attempt to boost their health, and when used correctly, they may be beneficial. The flipside is that excessive use can cause harm. In particular, antibiotics can damage your immune system as they kill off both helpful and harmful bacteria. They do not help against viruses such as colds and flu, so do not ask for a prescription from your doctor in the hope you will get better faster.

If you do have to take an antibiotic, take it EXACTLY as prescribed. Once you have finished the full course of treatment, consider probiotics to help get your system back in balance.

Finally, if you consume a lot of alcohol, especially in an attempt to reduce stress, try cutting down. Alcohol has many negative effects on the body, including suppressing the immune system and increasing inflammation.

Adopt these simple, practical success strategies to boost your immune system and see what a difference they can make to your health.

by Dr. Robert Inesta, DC L.Ac CFMP CCSP

Viavitae Health

Confused About CBD Oil?

There has been a lot of buzz about CBD oil and many people are confused about what it is, how it differs from marijuana (cannabis) and how to use it. Cannabis is a drug that is approved for recreational/medicinal use in some states in the US. Cannabis contains a substance called THC (tetrahydrocannabinol), which is responsible for the psychoactive properties of the plant.  In additional to THC, cannabis contains many other biologically active compounds called phytocannabinoids. One of these compounds is called cannabidiol (CBD), and it has been shown to have significant anti-inflammatory and pain reducing properties without the psychoactive “high” effect of THC. Therefore, cannabis oil is not the same as CBD oil since cannabis oil contains CBD oil and THC while CBD oil does not.

Research has shown many benefits from CBD oil including pain relief, decreased anxiety and depression, a reduction in cancer-related symptoms such as nausea and vomiting, improvement of acne, neuroprotective properties, treatment of  symptoms related to Parkinson’s and epilepsy, and improvement of gut health and heart health. Further some research shows that CBD oil may help treat diabetes and substance abuse and prevent certain cancers and diabetes.

CBD oil is derived either from the cannabis plant or the hemp plant and then diluted with a carrier oil such as hemp seed oil or coconut oil. Hemp is a plant that comes from the same genus as the Cannabis plant, but only has trace amount of THC, usually less than .3%. The majority of CBD oil comes from industrial hemp. CBD oil can be extracted as a full spectrum oil or a crystalline isolate.

CBD oil products come as oils, tinctures, vapors, capsules, topical balms, teas, and sprays and they vary in concentrations. Higher concentrations have more CBD cannabinoid. It is difficult to suggest a dosage for CBD oil, because everyone is different, and weight, genetics, environment, diet, metabolism, and the product type all affect how it works. It is always important to start with the minimal suggested dose of the product then increase the dosage gradually. The dosage should be determined by your body weight, the reason you are taking CBD, and what kind of effect (mild, moderate, or high) you desire. There are varying recommendations for determining the correct CBD dosage. Some experts state that 5 mg is a good starting point, and it can be increased 7-10mg per use as necessary.  Desired effects are often found at 10 mg 1-2 times per day. Other guidelines state those under 130# should take a dosage ranging from 11-17mg, while those over 230 pounds should range from 23-45 mg. Websites on pain recommend higher doses, with as much as 1-6mg per every 10 pounds of body weight.

It is very important to buy high quality CBD oil, since it is not regulated by the FDA. High quality oil has been tested by accredited laboratories and is free of pesticides, residual solvents from the extraction process, heavy metals, bacteria and fungus. When purchasing CBD oil, you should determine the extraction method used to process the oil. You do not want to buy a product that uses toxic materials like propane or butane. Instead look for safer extraction methods, such as ethanol and carbon dioxide. You should also research if the hemp is organic and learn about the farm where it is grown so it is not contaminated with metals and unwanted minerals. Also consider whether the CBD oil was tested by a third-party to meet quality standards, and avoid oils that do not give information about their third party testing.

As with all supplements, consult a doctor before you take CBD oil to determine if it is right for you.

by Denise Groothuis MS RD CFMP

Getting in Shape 2019

It’s a new year and time to get in better shape. For many people that means losing weight. According to the National Health and Nutrition Examination Survey (NHANES) 47% of Latinos, 47% of black adults and 38% of white adults are obese. Overall 40% of American adults are obese and 19% of American youths. Obesity is slightly more common in women than men. This is a major health issue in our country. It cannot be called an epidemic because it is not contagious, but it is a growing issue with rates increasing for the past 20 years. Its ironic that we seem to have so many people dieting and joining gyms and so many diet foods in 2019, but we have more overweight people than ever before. What’s the problem?

Weight gain or loss is really just simple math. If you burn more calories than you consume you lose weight. Eat more than you burn you gain weight. There are so many diets including keto diets and low carb diets, nutri system and weight watchers and even the paleo diet and Zone diet. Some diets are dangerous and you should discuss options with your medical doctor or a certified nutritionist before making any drastic changes. All diets work by reducing your calorie intake…that’s it! There is no magic or secret to weight loss.

In terms of numbers to lose a pound you need to reduce your calories by 3,500. This done by decreasing how much you eat and also through burning more calories. This is very doable by combining eating less and working out more. To lose 1 pound a week, all you need to do is decrease calories by 250 each day and burn 250 more calories each day. In previous articles I discussed that interval training is much more effective in working out in a shorter amount of time. It would take about 20 minutes on an elliptical or treadmill to burn these calories but the intervals need to be hard getting your heart rate up to 80% of your max (220-age). Do hills or sprints for 2 minutes then go lighter for 2 minute intervals.

When it comes to working out try and do something every day. Do what you like. It should be hard but somewhat enjoyable. You will feel better after even those days you are feeling less motivated.

My simple rules to weight loss.

  1. Do not eat anything fried.
  2. Do not have dessert.
  3. Do not get so hungry that you will eat whatever is in front of you – that means having a snack in the late afternoon and perhaps in the morning to offset your hunger.

The bottom line is to get in shape this year, pick realistic goals. Eat healthier and work out every day.

 

Rick Weinstein, MD, MBA

Director of Orthopedic Surgery

Westchester Sport & Spine of White Plains Hospital

Choking

High level of emotions felt under pressure situations may undermine an athlete’s best skills leading to under-performing when it matters most. We can easily point out to the exact moment when choking occurs, but does missing a free-throw, penalty kick, or a 3-foot putt for birdie mean that the athlete choked?

Choking is more often than not the result of a process leading to under-performing than an isolated missed execution. Everybody misses free throws, penalty kicks, or short putts. And, emotions do not just show up all of the sudden. What we think prior to the game, our expectations, somebody else’s expectations, meaning of the game, and past experiences are all factors influencing performance. How we come mentally prepared to compete can greatly influence how we perform when the emotions of the game are at its highest level.

John McEnroe said it best: “When it comes to choking, the bottom line is that everyone does it. The question isn’t whether you choke or not, but how -when you choke- you are going to handle it. Choking is a big part of every sport, and part of being a champion is being able to cope with it better than everyone else.” (Goffi, 1984, pp 61-62).

As competition is about to start, the heart beat speeds up, muscles tense, and the breathing accelerates. What we think about the competition concurs with an immediate physiological reaction. Thoughts and body felt sense responses go hand-in-hand. It is a human response, not an individual response. Everyone’s bodies go through the same experience. Maybe for some individuals, the felt sense responses are less pronounced than for others. Regardless of your personal experience, negating, minimizing, or pretending that “I am fine” will only exacerbate the sensations. Unless these experiences are well managed, emotions will really come up when the game is on the line and, by then, it will be too late. The inability to better cope with normal competitive emotions will lead to loss of focus, increased muscle tension, under-performing, and later lamenting for not being able to show your true talents.

One of the ways to enhance your ability to manage emotions is by paying close attention to what you can vs. cannot manage. If emphasis is placed on meeting past successful results, then such expectations will only increase tension as past experiences do not dictate how you are performing right now. It may provide information to help you design your strategy, but it will not execute present tasks. For example, a tennis player who easily beat an opponent in their last match will be mistaken to overly rely on such an outcome to minimize his/her own preparation. If the opponent made significant improvements and you came in unprepared, when the game is on the line, pressure will tense your muscles and increase the chances of making mistakes.

Also, playing in a team sport may adds pressure as the thought of not wanting to let teammates down often enhances self-pressure. It is important that a team meeting takes place where a discussion about the pressure of wanting to do well and the fear of not wanting to let others down are verbally expressed. It is vital that teammates feel the support of one another to strengthen team spirit. Fear concerns are in everybody’s mind. We tend to believe that we are the only ones who have these concerns, but it is often a common concern that everybody has. Fearful thoughts and stressful feelings can easily remain hidden only to come up to the surface when the pressure is on and, by then, it is too late.

Another good mental preparation happens on the night before competition. Going to bed early, imagining all possible competitive scenarios and creating mental rehearsals on how to overcome those situations, including having success and experiencing a loss, practicing breathing relaxation, and remaining positive are all mental tools that foster readiness.

We only have control over our own thoughts, emotions, and behaviors. It is very easy to get distracted by what others are saying, bad weather conditions, unfair referee calls, and the opponent’s untimely good luck. Bring your attention to what you can control and embrace the process. If it was a successful experience, then celebrate it and remain focused. If it was an unsuccessful experience, then accept it as such without remaining overly emotionally attached and use a cue signal that fosters re- focusing.

To Parents: they can also serve as emotion regulators by reminding game strategies, focusing on variables that the athlete can control, such as positive talk, breathing relaxation, and mental rehearsal, and cheering for all his/her efforts. It builds internal trust and confidence. On the other hand, focusing on winning, saying that his/her child is the best, or yelling when an error is made will increase pressure. Learning comes from making constant adjustment. The more parents support the athlete’s ability to trust in their skills and learn from mistakes, the more likely the athlete will trust in his/her self-beliefs.

 

Alex Diaz, PhD

Sports Mental Edge

Low Impact Exercise May Help You Lose Weight

Are you more than 50 pounds overweight? Our staff is especially trained to help you safely get your health back with intense exercise. It doesn’t have to be complicated, you just have to be consistent.

Now, you may find some high intensity or quick workouts online but when you first start out it’s important to start slow and safe. You don’t want to rush into a program that will leave you so sore you can barely move or, worse, badly injured. The most effective way to burn a lot of calories in a short amount of time is circuit training, or HIIT workouts. However, there is a safe way to do this as a beginner.

Before beginning any type of exercise regimen, you should consult your doctor and be sure your body is ready for the new stress it will be under. Once given the green light, you should always start with stretching and fundamental movement patterns. Next, you will want to get some light cardio in to get your heart rate up and your body moving. Walking, riding a bicycle (either outdoors or stationary), or using the elliptical are all great low-impact options. You can work your way up to utilizing weights but it’s best to start with body-weight exercises, such as push-ups, squats, and planks. Once you master that, you can begin adding weights and other exercises to your routine. Circuit training is a great way to incorporate these different exercises while working your way up to a higher intensity workout. Often you will find circuits already set up in a designated area at your local gym, making it that much easier for you to complete!

Remember to eat right and exercise to begin your journey to weight loss.

by Gina Stallone

 

Stretching to Alleviate Back Pain

Stretching has many benefits including increased flexibility, improved posture, and a reduction in body aches, back pain, and stress. When your muscles are tight, your range of motion may be decreased, which increases the chance of straining your back muscles. Stretching can help loosen the tension in these muscles and decrease pain. Stretching can also hep prevent possible back issues because it reduces the risk of muscle strain and helps strengthen the back muscles.

Back issues can be agonizing, painful and debilitating. Our certified trainers can teach you great stretching techniques to alleviate your back pain and get you on the path to a pain free and more active lifestyle. Contact us today for your free evaluation –  info@thearena.fit

 

 

 

How to Lose Weight This New Year

It’s the New Year…a time for the usual weight loss and exercise resolutions. Lifestyle changes can be challenging and hard to maintain. How can you ensure that you will be successful in your exercise and diet goals this year?

First, diet is extremely important. Despite popular opinion, eating fat doesn’t make you fat. Instead high carbohydrate diets are really the enemy because of how they affect glucose and fat storage in the body. Every diet should be high in vegetables, which have important vitamins, minerals, fiber, and phytonutrients. Intermittent fasting is also a great tool to help with weight loss. The most popular method of intermittent fasting is to eat all your food in an 8 hour window and fast for the other 16 hours.  Research has shown many other benefits to intermittent fasting including improved blood sugar levels, improved heart health, a reduction of inflammation, and improvements in memory and cognitive function.

Exercise is also key in any weight loss program. It is important to incorporate resistance training and cardio training to get the desired result. Exercise programs should be tailored to your goals, fitness level, weight, time commitment, and limitations. At times, group exercise classes, while fun, can be dangerous because the instructor can’t individualize the routine or make sure your form is correct.

THE ARENA FITNESS can help with your diet and exercise goals. First, you can make a free consultation with our dietitian, Denise Groothuis, who will help you come up with a plan. Additionally, our personal trainers can put you on a routine to promote weight loss. Our trainers take more courses and are more credentialed than 95 % of the trainers in Westchester and Connecticut, even the trainers at the “elite” gyms. It’s time to shed those pounds. Come to THE ARENA and let us help you fulfill your resolutions!

 

by Denise Groothuis MS RD CFMP

How to Eat on Vacation

Most of us look forward to our vacations from life, work, responsibilities, etc. We spend months planning to find the perfect location, amazing hotel, and great restaurants. Many of us spend time dieting to get the perfect “beach body,” and we watch our intake for weeks. However, all that hard work often vanishes the second we arrive on our trip!

Vacations are meant to relaxing, fun, and decadent. You’ll often find huge buffet breakfasts, abundant lunches, and decadent dinners & desserts. And what is a vacation without a few drinks by the pool or beach?  After a day of eating and drinking, the hotel gym is nothing but a pipedream. Often, we end a vacation a few pounds heavier than we started.

So, how can we keep lean and healthy on vacation? First, pack healthy snacks for the plane and to keep in the hotel. These include nuts, seeds, energy bars, protein powder, and fruit. Second, plan ahead. Pick a few days to exercise in the morning and choose one big splurge meal instead of eating crazy every night.

For breakfast, stay away from the bread and muffins. Instead, choose fresh fruit and eggs. Drink plenty of water at each meal and throughout the day to stay hydrated, especially if you are drinking alcoholic beverages. For lunch, choose salads with dressing on the side or lean protein or fish with vegetables.  Try to avoid the bar food and French fries! At dinner, don’t order both an appetizer and entrée. Either get your own appetizer and split a main course with your partner or friend, or avoid the appetizer all together. Make sure foods are not fried or drenched in creamy, high caloric sauces. It is also important to avoid the bread basket! As far as dessert, pick two nights to splurge, and avoid sugar the rest of the trip. If there is a buffet, start with a plate full of salad first and then have protein and a vegetable.

It is possible to enjoy your food and keep your body trim. Just listen to your body and do not overeat, and remember to exercise and drink plenty of water. Eating healthy is a lifestyle, but that doesn’t mean you can’t indulge within reason on your trip. Happy Holidays!

 

by Denise Groothuis MS RD CFMP