HealthConnection - Hospital for Special Surgerytendon. • Sever’s disease: This common cause of...

ConnectionDecember 2014 • Volume 21, No. 2 Hospital for Special Surgery’s Good Health Newsletter

Health

ExerciseThrough theAges Issue

Contents1 Kids Will Be Kids: Deal-

ing with Sports Injuries

3 ACL Tears: When toTreat, How to Prevent

6 Eating Well at Every Age

8 Moving ThroughMenopause

10 It’s Never too Late toExercise!

Kids Will Be Kids: Dealing with Sports InjuriesJames J. Kinderknecht, MDAssistant Attending Physician, Hospital for Special SurgeryAssistant Professor of Family Medicine in Pediatrics, Weill Cornell Medical College

There are things you can do, however, to reduce therisk of certain sports-related injuries as children getolder. Here are some of the most common childhoodinjuries affecting the muscles and bones.

Growth-Plate InjuriesGrowth plates are areas of growing tissue locatedat each end of the long bones (arms and legs) in chil-dren and adolescents. When a child is finishedgrowing — typically two years after menstruation be-gins in girls, and between the ages of 14 and 18 inboys — the growth plates close and are replaced bysolid bone.

Since the growth plate is the weakest part of theskeleton in a child who is still growing, injuries to thegrowth plates are commonly seen in children involvedin sports. They’re twice as common in boys as girlsand can occur as a result of trauma (such as falling orgetting hit hard) or overuse. Gymnasts who practicelong hours on the uneven bars, long-distance run-ners, and baseball pitchers who are exceeding therecommended number of pitches are most at risk foroveruse injuries to the growth plates.

Let’s look at baseball pitching. The maximum rec-ommended number of baseball pitches is 105 pergame for a 17- to 18-year-old pitcher, but only 50 for7- and 8-year-olds. (To learn more about pitching lim-its, visit www.stopsportsinjuries.org). However, withthe growth in popularity of organized sports and travelteams, some kids play on more than one team at atime and exceed the recommended number of

Our EducationMissionEducation & AcademicAffairs at HSS is committedto being the source foroutstanding initiativesin education, training,research and informationfor local, national andinternational communitiesto prevent and treatmusculoskeletal conditions.

Children are active creatures, and bumps and bruises are par for the course. As doctors, we see brokenarms in kids trying to be superheroes, clad in capes and jumping off of tables. We treat fractured wristsfrom those who reach back to break a fall while roller skating. And we regularly care for active childrenbetween the ages of nine months and three years with a break in the shinbone (tibia) called a “toddler’sfracture.” It’s all a part of growing up.

continued on page 2

22 | HealthConnection

pitches in a day, resulting in Little LeagueElbow or Little League Shoulder — injurieswhich can actually pull the growth plateaway from the bones in those joints.

Growth plate injuries are typicallytreated with rest, and growth plate frac-tures, when not displaced out of position,may require casting or a splint to immobilizethe bone and let it heal. More severegrowth plate fractures that are dislodgedout of their normal position may requireclosed or open surgical manipulation to re-store proper alignment and growth.

So it’s important to treat growth plate in-juries early, and even better, to prevent themfrom happening by avoiding overuse of thejoints. For example, if your child plays onmore than one baseball team, he or sheshould play different positions to avoiddoing the same movements repeatedly. It’salso a good idea to play different sports tokeep one joint or part of the body from be-coming overstressed.

Other Childhood Musculoskeletal InjuriesIn addition to growth plate injuries and frac-tures, active children and teens who are stillgrowing are prone to other problems in theirmuscles and bones — some of which maybe related to sports, and others which canoccur with normal growth. These include:• Osgood-Schlatter’s disease: This con-

dition is one of the most commoncauses of knee pain in adolescents. Itis caused by increased tension wherethe kneecap (patellar) tendon attachesto the top of the shinbone and is mostcommon in boys aged 13 to 16 years.Treatment includes ice, rest, and flexi-bility exercises to relieve tension on thetendon.

• Sever’s disease: This common causeof heel pain is typically seen in childrenages 7 to 12. It is caused by stresswhere the Achilles tendon meets thetissue on the growth plate of the heelbone. Treatment includes ice, rest,and flexibility exercises to relieve ten-

Kids Will Be Kids, cont. from page 1

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continued on page 5

Since the growth plate is

the weakest part of the

skeleton in a child who is

still growing, injuries to

the growth plates are

commonly seen in children

involved in sports.


Thousands of people around the world ex-perience this injury each year. While doctorshave some clues about how and why theyhappen, there are more questions than an-swers, and plenty of research remains to bedone. Here’s what we know about the ACL:

1. The ACL supports the front of theknee. The ACL is one of four ligamentsconnecting the thigh bone (femur) tothe shin bone (tibia). It prevents theshin bone from sliding out in front ofthe thigh bone. Together, the four liga-ments provide stability to the knee.

2. ACL tears are commonly a result of a

noncontact injury. The ACL most oftentears when someone quickly stopsmoving and changes direction whilerunning, landing from a jump, or turn-ing. A hard hit to the side of the knee,such as a football tackle, can also in-jure the ligament. ACL tears are re-lated to personal biomechanics, but it’shard to predict who will experiencethem and who won’t.

3. ACL tears are more common with cer-

tain sports. Basketball, football, soc-cer, volleyball, and skiing are commonsports linked to ACL tears. A recentstudy (Beynnon et al. Am J SportsMed. August 2014) showed that the in-cidence of a first-time ACL injury washighest in soccer and rugby playersamong a group of high school and col-lege athletes. These sports are morecommonly associated with suddenstarting and turning or landing move-ments that can stress the knee.

4. ACL injuries are more common in

women. According to the AmericanAcademy of Orthopaedic Surgeons,

female athletes who participate injumping and pivoting sports are two toten times more likely to sustain a kneeligament injury, such as an ACL injury,than male athletes participating in thesame sports. This may be due to the

different alignment formed by the posi-tioning of their wider hips over theirknees, which can increase the torqueon the knee joint. It may also be due tohormonal differences, but the answeris not yet clear.

5. An injury to the ACL can increase therisk of osteoarthritis later in life. Ac-cording to the Arthritis Foundation, a

It starts with a “pop.” Then pain. And then the swelling comes. That’s what happenswhen the anterior cruciate ligament (ACL) of the knee tears. Some people are moresusceptible than others. And surgery isn’t always needed.

ACL Tears: When to Treat, How to PreventThomas L. Wickiewicz, MDAttending Orthopedic Surgeon, Hospital for Special SurgeryProfessor of Clinical Orthopedic Surgery, Weill Cornell Medical College

continued on page 4


ACL Tears, cont. from page 3torn ACL leads to osteoarthritis inmore than half of affected knees five to15 years after the injury. The risk ishighest among people who also suffera tear in the meniscus (shock-absorb-ing cartilage in the knee).

When to Treat, When to WatchDoctors typically perform surgery to repaira torn ACL in:

• Children who are very active, whose ac-tivities would be limited by a torn ACL,and who may be at risk for another in-jury if the knee remains unstable.

• Adults who are physically active.• Adults who are experiencing instability

or other symptoms from the tear.• Older adults who wish to remain active.

Older age is not a barrier to surgery.• Anyone who also has an injury to the

meniscus. Repairing the ACL andmeniscus may somewhat reduce therisk of later arthritis related to the injury.

Adults who experience a torn ACL, arenot very active, and don’t have a meniscustear may be able to forego surgery and justbe monitored by their doctors. For thosewho do need surgery, the repair is not ur-gent, but should be done before further in-jury occurs.

Can ACL Tears Be Prevented?While there is no sure-fire way to prevent anACL tear, doctors do know there are someways to reduce the chance of experiencing

an injury:Jump and land carefully. Avoid landing

on a straight leg, allowing your knees tobend and do their job. Special warm-upsand landing exercises have been devel-oped by the Fédération Internationale deFootball Association (FIFA) to reduce therisk of ACL tears. (See f-marc.com/11plus

for more information.)Learn how to fall. This is especially true

for skiers, who tend to twist their kneeswhile struggling to stay upright in a precar-ious situation. Sometimes it’s better to fall,get back up, and resume skiing with stabil-ity and control. Also be sure your bindingsare adjusted appropriately so that they willrelease during a hard fall, to avoid puttingcontinued on page 5

The ACL most often tears

when someone quickly stops

moving and changes direction

while running, landing from

a jump, or turning.

ACL tears are related to

personal biomechanics, but

it’s hard to predict who will

experience them and who won’t.

your ski at an odd angle against the snowthat would result in a twist to your knee.

Build strength around the knees.Strength-ening the muscles that support the knees in abalanced way, particularly the quadriceps(muscles in front of the thigh) and hamstrings(muscles behind the thigh), can reduce theload on your knees.

Stretch your hips. There is some indica-tion that the risk of an ACL tear is greater inpeople with less hip rotation, because thestress is taken up in the knees. Hip openingexercises, such as those in yoga, may help.However, hip rotation may also be limited bythe shape of the skeleton a person is bornwith, so only so much can be changedthrough stretching.

Be smart about the sports you play. Noteveryone can play every sport. Choose thesports that are best suited for your bodyand abilities, and learn how to play themsafely and skillfully.

There has been an increase in ACLtears among children and teens which isdue to the rise in popularity of organizedsports. Children often play on multiplesports teams and at all times of the year.But not every child can play every sport,and not everyone is a great athlete. Be hon-est about your children’s physical abilitiesand don’t push them to do a sport theydon’t enjoy and are not well-suited to do.Their knees may thank you for it. �


ACL Tears, cont. from page 4

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sion on the growth plates. Some chil-dren benefit from heel cups or othershoe inserts.

• Snapping hip: This condition is mostoften seen in female adolescentdancers and causes a sometimespainful snapping sensation in the hip.It is usually caused by a tight or in-flamed tendon that “snaps” over thefront of the hip bone. Treatment mayinclude rest, ice, anti-inflammatorymedications, flexibility exercises, andphysical therapy.

• Anterior cruciate ligament (ACL)

tears: We are witnessing an increasein the incidence of these knee injurieswith the rise in youth sports. See thearticle on page 3 to learn more.

When to Take Your Child to a DoctorWhile occasional muscle pain and strainare normal in active children, any pain thatdoes not seem to be getting better — or

even gets worse — should be evaluated byyour primary care physician or an orthope-dic surgeon. It is particularly important ifyour child is limping, or if he or she is ex-periencing pain at night. While the cause ofthe pain is most likely due to a sports injury,overuse, or even “growing pains,” occa-sionally the cause is something more seri-ous, like a bone tumor.

Let’s promote youth participation insports for the multiple benefits it pro-vides to kids. Most importantly, don’tpush your child to do more than he orshe wants to do. Winning a game oftenseems to be the priority for parents andcoaches, but for kids, they are drawn toparticipate because they just want tohave fun. Focusing on the enjoyment ofplaying a sport and the camaraderie theyhave with their friends on the team, aswell as not overdoing it to avoid overuseinjuries, can make the experience betterfor everyone. �

Kids Will Be Kids, cont. from page 2

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Your food needs change as you get older.Here are some simple guidelines for how toadopt and follow a healthy diet at any age— one that will fuel and support your bodyas you learn to maintain a physically activelifestyle.

Children (Up through Age 12)The goal of nutrition during childhood is toprovide a balanced diet containing the nutri-ents children need to grow and thrive. Thekey to getting children to eat healthy is varietyand participation. Introduce them to differenttypes, colors, and textures of foods from ayoung age, and involve them when you makemeals. Continue to offer them a new foodeven if they don’t eat it the first few times. Talkto them about how good they feel when theyeat healthy foods, like sweet fruits andcrunchy vegetables. And model these be-haviors yourself, so they see you following ahealthy diet and will want to do the same.

It’s best not to force children to finisheverything on their plate if they are no longerhungry; they need to learn how to recognizetheir “hunger cues” in order to maintain ahealthy weight. How many calories doesyour child need? That varies greatly ac-cording to age, height, and activity level. Askyour pediatrician for guidance.

Be sure your kids get enough calciumand vitamin D during these prime bone-building years. Dairy products like fat-freemilk, yogurt, and low-fat cheeses are excel-lent sources of these nutrients. Also displayhealthy snacks on the kitchen counter oryour dining room table within your child’s

reach, and away from less nutritious foodslike cookies and chips. Examples include abowl of apples and bananas, a plate of gra-nola bars, or individual packets of nuts. Chil-dren may need to be introduced to a newfood as many as 20 times before trying it, sokeep the variety coming!

TeenagersAs teens become more independent, you’llwant them to learn how to make healthyfood choices on their own, so they will be-come self-sufficient in meeting their nutri-tional needs. Talk with them to identifyhealthy foods that they enjoy, can makethemselves, and can grab when they’re onthe go. Tasty snack choices to have on handinclude individually packaged nuts, freshfruits, hard-boiled eggs, and yogurt. En-courage them to eat real, whole foods overprocessed foods. A healthy whole-wheatwrap containing lettuce, red pepper strips,turkey, and hummus can make the schoollunch period more interesting!

If your teen is playing sports, make surehe or she gets enough calories, fats, andwater (which is better than sports drinks).Fats are especially important to support ateen girl’s menstrual cycle. Healthy fats in-clude nuts, hummus, and avocado. Teenswill also need to continue getting adequatecalcium and vitamin D for bone health,which can reduce their risk of fractures.

Young Adults (20s-30s)While young adults may still have active me-

Eating Well at Every AgeJessica Cording, MS, RD, CDNClinical Nutritionist, Hospital for Special Surgery

When it comes to good nutrition, it’s all about balance and moderation. When youincorporate exercise into your daily routine, it’s especially important to make sureyou get foods from all food groups, and make sure that you don’t take in morecalories than you burn each day. You need carbohydrates for energy, protein formuscle mass, and even fat for hormone production and brain health. No food is taboo— even sweets are okay every now and then — but just be sure not to overdo it.

A Word of Caution forPeople of All AgesTry to avoid sports drinks and bars,which are highly processed andoften contain lots of sugar andextra calories. (An exception:Sometimes it's okay to consumethese products when engaging in alengthy period of exercise, such astraining for a marathon, hiking ahigh peak, or riding your bicycle forseveral hours.) Ditto for "vitaminwaters." For something like a typi-cal exercise session at the gym ora run in the park, choose regularwater for hydration and a bananato get muscle-fueling electrolyteslike potassium.

continued on page 7

Eating Well, cont. from page 6

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tabolisms compared with older people, theymay burn fewer calories each day if theystart working less physically active jobs. Ifyou’re in this age group, you’ll need to payattention to how many calories you’re takingin compared with how many you’re burning.Incorporate exercise into your routine to off-set the time you may be sitting on the job.During the workday, it’s helpful to get up andwalk around the office periodically, and totake the stairs instead of the elevator whengoing to meet with a colleague.

Make sure to eat a variety of foods, withlots of vegetables and fruits. Include

sources of calcium and vitamin D for bonehealth (such as low-fat cheeses, milk or al-mond milk, and yogurt); healthy fats (likethose in some vegetables, nuts, and fish) foryour brain, skin, and hormone function; andproteins like chicken or fish for muscle massand lasting energy.

During these years, you may be going outto eat and drink more often with your friends.Watch out for the empty calories that youtake in when you’re drinking alcohol. Therecommended maximum alcohol intake is nomore than one drink per day for women andtwo for men. Also beware of large portion

sizes in restaurants. Consider sharing an en-trée with a friend or take half of it home toeat the next day, and choose grilled andsteamed foods over fried choices.

Middle Age (40s and 50s)As you enter your middle years, your metab-olism slows down and muscle mass beginsto decline. It’s a good idea to step up yourprotein intake during this time. Examples ofhealthy proteins include poultry, lean meats,eggs, low-fat cheeses, fat-free milk, nuts, andGreek yogurt. How much do you need? Oneway to learn is to divide your weight in poundsby two, and that’s how many grams of proteinyou should try to eat each day (example: 75gof protein for a 150-pound person). This is ageneral guideline — your protein needs maybe slightly higher or lower depending on youractivity level and/or any health conditions youmay have. Consider speaking with a nutri-tionist to examine your current diet and iden-tify ways you can improve it.

Find ways to incorporate more physicalactivity into your day, such as walking anextra block or two, getting off the bus or sub-way a stop sooner and walking the rest ofthe way, and taking the stairs whenever youcan. If you’re not doing so already, it wouldbe a great time to start lifting light weights tobuild strength and tone your muscles.

The Golden Years: 60+After age 60, muscle mass continues to de-cline even more. It’s very important to makesure you are continuing to get enough pro-tein in your diet. Have some source of pro-tein at every meal, again aiming for a dailyintake based on your body weight (see thesection for eating in middle age for guid-ance). Make sure you’re not taking in morecalories than you are expending. People intheir 60s typically need fewer calories thanyounger adults because they tend to be-come more sedentary.

Choosing “real,” natural foods at allstages of your life and maintaining a balanceof calories and nutrients will always serveyou well, no matter what your age! �



Here’s what’s happening during menopause:Your ovaries begin to make less estrogen asthey start to go into retirement. Fat cells alsomake estrogen. So during menopause, yourbody makes more fat cells to try to compen-sate for the decline in estrogen productionby your ovaries. In addition, changes in prog-

esterone production can cause you to retainmore water, making you feel bloated.

Even though you’re a woman, your bodyalso makes testosterone, though not as muchas men. Testosterone supports the develop-ment of lean muscle and boosts metabolism.During menopause, however, testosterone

levels also decline, making it more challeng-ing to build muscle and burn calories.

If you’re gaining weight during meno-pause, you’re not alone. Studies show thatbefore and during menopause, it’s not un-usual to put on an extra pound per year. Overthe entire period of time when your body isgearing up for menopause and then goingthrough it, you may end up carrying an extraten pounds. That’s why it’s so important toeat a healthy diet and to exercise during thistime. (For more about nutrition in middle age,see the article on page 6.)

It’s not unusual for women to gain weight during menopause. Hormonal fluctuations,an increase in appetite, a decline in metabolism, and a drop in calorie-burning musclemass all combine to create the “perfect storm” for gaining weight. But there arethings you can do to keep your weight in check and avoid (or at least minimize)developing a “menopot” — that bulge around the abdomen that many women beginto see during their middle years.

Moving through MenopausePolly de Mille, RN, MA, RCEP, CSCSExercise PhysiologistCoordinator of Performance Services, Hospital for Special Surgery

continued on page 9

If you’re gaining weight during

menopause, you’re not alone.

Studies show that before and

during menopause, it’s not

unusual to put on an extra

pound per year.


Menopause, cont. from page 8

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What Kinds of Exercise Are Best?The best kind of exercise is the one youenjoy the most. The more you like an activity,the more likely you are to do it and to stickwith it over the long run. Find something thatadds enjoyment to your life which you will doon a regular basis. Try to incorporate a vari-ety of exercises into your routine:• Aerobic activities — such as brisk walk-

ing, stair climbing, bike riding, swim-ming, and running — are good for yourheart and lungs, burn calories, improvemood, reduce hot flashes, and helpkeep your bowels regular.

• Strength training, such as lifting lightweights or even your own body weight,help build lean muscle mass, increasebone density by putting pressure on thebones, strengthen muscles around yourjoints, and improve the shape of yourbody. Strength training doesn’t have totake place in a gym. You can do push-ups, “downward dog” in yoga, squats,or stair climbing in your home or outsidein the park.

• Stretching keeps your muscles flexible,makes it easier to move throughout theday, and reduces your risk of injury.Stretching is best done after exercise,when your muscles are warm.

• Stress reduction activities provide a nicebalance to other kinds of exercise by en-gaging both the body and the mind. Sim-ple exercises like walking and bike ridingcan provide relaxation. Consider practic-ing yoga, t’ai chi, meditation, or Pilates.It’s exponentially more important to enter

this next phase of your life with strong bones,strong muscles, and the ability to get a goodnight’s sleep. Exercise can get you there. Ifyou haven’t exercised in a while, see yourdoctor to get clearance for activity. Considermeeting with a certified trainer who is famil-iar with activity for people in your age group,who can help you create a program that fitsinto your life. A small investment up front canhave a big payoff in the future in the form ofa healthier, happier you! �

The Benefits of ExerciseIn addition to helping you burn calories, exercising during menopause can also:

• Reduce the development of insulin resistance and type 2 diabetes by keeping your blood sugar low.

• Increase bone density, which is important as you enter the years when osteoporosis risk rises.

• Lower your risk of heart disease, which rises during menopause as yourbody makes less heart-protective estrogen.

• Control menopause symptoms, such as hot flashes, sleep problems, andmood swings. These are especially reduced by aerobic exercise, such asbrisk walking, stair climbing, bike riding, and running.

• Build muscle mass, which is so important since your hormone changes areworking to reduce your muscle mass.

MYTH VERSUS FACT

Myth: It’s pointless to start exercising. I’mtoo old to make a change.Fact: It’s never too late to start somethingnew! Lifestyle changes can be made at anyage. Or you can go back to doing somethingyou used to enjoy but haven’t done in awhile, like taking a walk each day. Take itslow — there’s no rush.

Myth: I hurt myself, so I can’t exercise any-more.Fact: This may be somewhat true if youhave an injury that prevents you from en-gaging in certain activities, like running.See a doctor or physical therapist and findout what you can do. Start slow and buildup to an activity you feel comfortable doingand that you enjoy.

Myth: I’m already in pain. Exercise will onlymake it worse.Fact: If your pain is from an injury or sur-gery, talk to your doctor or physical ther-apist about how much you should do.But if your pain is from arthritis, exercis-ing will actually help reduce the pain bywarming up your joints and getting themmoving, and by sending blood to yourmuscles. Start with simple exerciseswithin your range of motion, and then ex-pand your range of motion as you do theexercises regularly. A physical therapistcan guide you in learning what activitiesare best for you.

Myth: I don’t want to exercise because Imight fall.Fact: There is a risk of falling during exer-cise, but there is also a risk of falling when

you’re doing any movement. By buildingstrength, exercise will actually improve yourbalance and lower your chance of fallingand experiencing a fracture. There arethings you can do to reduce your risk offalling, such as holding onto a kitchencounter while you exercise. If you cannottolerate standing, you can do exercises in achair or lying in bed. T’ai chi is also a niceoption to help improve balance while pro-viding meditation and relaxation.

It’s Never Too Late to Exercise!Lauren P. Piljic, PT, DPTAdvanced ClinicianJoint Mobility Center, Hospital for Special Surgery

There’s the age-old image of a granny sitting in a rocking chair, biding her time to theclick of her knitting needles as she watches the hours of her golden years tick past.But it doesn’t always have to be that way, and it shouldn’t: You need to exercise at allstages of your life, no matter how old you are. And it’s never too late to begin.


The Importance of Exercise in Older AgeRegular physical activity has a number of benefits for:

Your Body Your Brain Your Stability

Reduces risk of Provides emotional Reduces your chanceheart disease and balance and lowers your of falling and experiencingtype 2 diabetes risk of depression a fracture

Lowers blood pressure Improves sleep Lowers your riskand heart rate of osteoporosis by

putting pressure on your bones

Controls weight Increases blood supply Supports jointsto the brain

Helps reduce Reduces sense of Builds muscle mass,menopause symptoms isolation when done which naturally declines

with others with age

continued on page 11

Programs and ResourcesHospital for Special Surgery offers a variety of wellness exercise classes designedto help you gain endurance, strength and flexibility. Meditation, relaxation andgeneral wellness programs are also offered.

Better Balance for Older Adults: Unique exercises selected for individuals who wouldlike to increase their balance control and decrease the risk of falls.

Therapeutic Yoga: The slow, controlled physical movement of yoga can provide pain relief, relax stiff muscles, ease sore joints and help build strength.

Pilates: A series of specific movements designed to strengthen the powerhouse muscles of the abdomen, back and waist.

Yogalates: A popular form of exercise that blends the best of yoga and Pilates.

T’ai Chi Chih®: Simple, rhythmic movements that provide benefits such as improved balance, strength, flexibility and maintenance of bone mass.

Dance for Fitness and Fun: Studies have shown that dance maintains cardiovascular fitness, enhances emotional well-being, strengthens weight-bearing bones and slows loss of bone mass.

For more information on the schedule, location and cost of these classes, visitwww.hss.edu/pped or call 212.606.1613. Additional programs and offerings can be found by visiting www.hss.edu/pped.

Integrative Care Center (ICC): The ICC, located in mid-Manhattan and affiliated with Hospitalfor Special Surgery, offers alternative care services including Pilates, acupuncture, massagetherapy, chiropractic medicine and pain management. Please visit www.hss.edu/icc for moreinformation or call 212.224.7900.

Other resources:• The SilverSneaker program: www.silversneakers.com• The North American Menopause Society: www.menopause.org• Choose My Plate: www.choosemyplate.gov• Let’s Move: www.letsmove.gov• U.S. Centers for Disease Control and Prevention:www.cdc.gov/physicalactivity/index.html

Online Webinars:Check out our free HSS webinars at www.hss.edu/pped-webinars. All webinars canalso be accessed as podcasts at www.hss.edu/podcasts. Topics include:

• 4th Annual Bone Health Education Seminar. Healthy Bones: Build Them for Life• Runner’s Health and Marathon Training Programs• Honoring Lupus Heroes• Lupus Care: The Past, the Present and the Future• Advances in Lupus Research: Spotlight on Treatment• Family Caregivers and Health Care Team: A Challenging Partnership• Osteoarthritis: Today’s Options for Osteoarthritis ManagementA short video excerpt on “Medita tion for Pain Management” is also available for patients via our YouTube playlist.

HealthConnection FastFacts This recurring publication is a convenient 1-page online health education newsletter designedto provide the public with fast, current, accurate musculoskeletal and general health information.Visit www.hss.edu/ppedfastfacts.

Never Too Late, cont. from page 10

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Myth: I’m too depressed to exercise. I can’tseem to get started.Fact: Many older adults experience depres-sion. Exercise can help reduce depressionby stimulating the release of natural mood-enhancing chemicals in the brain, such asdopamine and serotonin. Begin by taking awalk around the block. Start small, and workyour way up to a regular routine. Try to beactive to some extent every day.

The ideal exercise regimen includes a mix ofweight-bearing exercises, stretching, andaerobic activity at least three days a week.Examples include walking, swimming, bicy-cling, and yoga. Consider exercising with apartner or joining a wellness class designedfor older adults. The SilverSneakers program(www.silversneakers.com/) is a Medicare-supported national exercise program thatcan help you get started. Just remem-ber…it’s never too late to get moving! �

For more information, visitwww.hss.edu. To make an appointment, call our Physician Referral Service at 800.796.0486.

Public and Patient Education Department212.606.1057www.hss.edu/pped

Research Division212.774.7123www.hss.edu/researchwww.hss.edu/clinical-trials

The Education & Academic Affair’s Public and Patient Education Department provides information to the general public and patientsthrough a variety of health education programs. Professionals pro-vide practical information to help prevent or manage orthopedic andrheumatological conditions. Programs are held at the hospital as wellas in the community. The department is dedicated to providing education today, so that everyone can have a healthier tomorrow.

HealthConnection is published by Education & Academic Affairs atHospital for Special Surgery as a service to the general public andpatients. For further information regarding material contained in thisnewsletter or inquiries on how to obtain additional copies, contact:

Public and Patient Education DepartmentEducation & Academic Affairstel: 212.606.1057 | fax: [email protected]

Community Benefit ReportInvested in Our Community – 2013 Report

The HSS Community Benefit Report provides information about the Hospital’s contributionsto the community in the areas ofcommunity programs and services, research and health professionalseducation. Visit www.hss.edu/community for more informationand to download a copy of the2013 Community Benefit Reportand the 2014-16 HSS Community Service plan.

Hospital for Special Surgery is an affiliate of NewYork-Presbyterian HealthcareSystem and Weill Cornell Medical College.

Other LocationsHSS Stamford Outpatient Center (opening early 2015)Chelsea Piers1 Blachley RoadStamford, CT 06902

HSS Greenwich (until February 2015)143 Sound Beach AveOld Greenwich, CT 06870Tel: 203.409.3000

Integrative Care Center635 Madison Avenue, 5th FloorNew York, NY 10022Tel: 212.224.7900

HSS Long Island Outpatient Center333 Earle Ovington Boulevard, Suite 106Uniondale, NY 11553Tel: 516.222.8881

HSS Paramus Outpatient Center 140 East Ridgewood AvenueParamus, NJ 07652Tel: 201.599.8000

HSS Queens Outpatient Center176-60 Union Turnpike, Suite 190Fresh Meadows, NY 11360Tel: 718.591.7090

HSS Spine & Sport600 Heritage Drive, Suite 110Jupiter, FL 33458Tel: 561.253.8737

HSS Sports Rehabilitation at IMG Academy5500 34th Street WestBradenton, FL 34210Tel: 941.749.8760

Most major insurance plans are accepted.

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Find Hospital for SpecialSurgery on the web at www.hss.eduFollow us on:

Laura Robbins, DSWSenior Vice President Education & Academic AffairsAssociate Scientist, ResearchDivisionDesignated Institutional Officer,GME

Edward C. Jones, MD, MAAssistant Attending Orthopedic SurgeonMedical Editor

Contributing Writer:Rosie Foster, MA

Vilma Briones, MASenior Program Coordinator

Marcia EnnisDirector, Education Publicationsand Communications

Sandra Goldsmith, MA, MS, RDDirector, Public and Patient Education

Robyn Wiesel, CHESManager,Public and Patient Education

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All rights reserved. ©2014 Hospital for Special Surgery

2012 National Health Information Bronze Award

HealthConnection Newsletters2011 Osteoarthritis Prevention

and Management issues

2013 National Health Information Merit Award

HealthConnection NewsletterDecember 2012

Bone Health issue

2014 National Health Information Bronze AwardHealthConnection NewsletterWinter 2014 Aging Well issue

HealthConnection - Hospital for Special Surgerytendon. • Sever’s disease: This common cause of...

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