Avoiding arm casts this winter

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Many cases of injury originate from attempts to have fun. In winter, many people seek to take full advantage of the holidays and the snow, and engage in activities that sometimes leave them with several broken bones. If wearing an arm cast is not your idea of celebrating the Yuletide season, try these tips.


Warm up

Cold temperatures can leave the muscles in a state that is more prone to injury. It is best to take a few warm-up exercises especially if you are engaging in strenuous activities. For instance, you can take a few warm-up runs before skiing in new terrains.

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Know the terrain

Keep track of rocks, roots, fences, ridges, and others. Knowing where obstacles are can help you avoid them and the possibility of being injured because of them. Moreover, navigating through snowy ground poses certain difficulties; it is best for you to stay in marked trails. Ice is slippery, so staying in areas such as steep slopes and inclines is the beginning of injury.


Be properly equipped

Make sure to wear the proper equipment or attire. When walking in snowy or icy ground, use shoes with lots of tread as these offer more grip and minimizes the risk of slips. Wear several layers of loose garments. This can protect you from the cold and offers you the convenience of removing or adding layers depending on the need.

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You gain nothing from being overly complacent in winter—except scratches and broken bones. Doctors can treat fractures, but no one can return the winter holidays you lost because of broken limbs.

Norman K. Poppen, MD, is a recognized expert in the surgical treatment of musculoskeletal problems. Visit this Facebook page to learn more about him.

Obama's Thanksgiving message

"Fight the overwhelming urge to take a nap...at least until AFTER dinner," and other pieces of Thanksgiving advice from President Obama. 

Soft but tough: Norman K. Poppen, MD, and the body's cartilage

The cartilage is not as tough as the bone, but it is no softie either. Orthopedist Norman K. Poppen, MD, is familiar with the cartilage and how it allows the entire skeletal system to perform some of its most important functions.

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The cartilage is a connective tissue found in many areas in the human body, particularly in joints, in the rib cage, the ears, nose, ankle, knees, bronchial tubes, and in the intervertebral discs. It is quite common among other animals, particularly in cartilaginous fishes like sharks, rays, and sawfishes. It is naturally flexible, but is stiffer than muscles, and is not as rigid as bones.

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The primary function of the cartilage is to provide support to various organs of the body without being as hard as bones. Experts like Norman K. Poppen, MD, note that the relative softness of the cartilage makes it an excellent cushion for bone joints. This means that the tissue plays a vital role in the smooth movement of the human body.

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Among connective tissues, the cartilage is the slowest to grow and be repaired. Needless to say, damage or complications can lead to serious problems. The gradual thinning of the cartilage can cause joint pains when moving, and is the underlying cause of arthritis. In the case of chondrodystrophies, the cartilage in the joints is ossified and is transformed into bone, causing symptoms roughly similar to those in arthritis.

Every component of a bodily system performs a specific function vital to the whole. The same is true for the cartilage. It may not be as tough as bones, but without it, the skeletal system would never be the same.

More information about Norman K. Poppen, MD, is available in this Facebook page.

Yoga and stretching can help relieve bad backs

Here's an interesting article by Sora Song from Time Health & Family about how yoga can help relieve back pain. This article echoes the message of a previous Norman K. Poppen, MD, blog post that discussed asanas for back pains.

Chanting “om” might help ease your aching back, but only if it comes at the end of yoga practice. A new study finds that the physical act of doing yoga — but not its meditative aspect — may help reduce symptoms of chronic back pain.

Based on smaller previous studies, researchers thought it was some combination of yoga’s stretching and mental elements — deep breathing and relaxation — that improved back sufferers’ function. But the current study found that yoga worked no better than intensive stretching alone, suggesting that it’s the physical exercise, not the mindfulness component, that matters.

Whether doing yoga or stretching, however, it takes effort: participants in the study attended weekly 75-minute yoga or stretching classes for 12 weeks, and did additional 20-minute at-home practices with the help of instructional CDs or DVDs at least three days a week.

The trial, published on Monday in the Archives of Internal Medicine, is the largest to date on yoga and chronic back pain, a condition that affects millions of adults and often doesn’t have an easy solution. People spend billions of dollars a year seeking relief from pills, doctors, physical therapists and chiropractors. Although there’s no shortage of available treatments for low back pain, including exercise, it’s not entirely clear how they stack up against one another in terms of effectiveness.

For the new study, researchers recruited 228 adults in the Seattle area, all of whom had moderate chronic back pain but were fairly active despite their conditions. The participants were randomly assigned to do either yoga or intensive stretching or, as the control group, to use “self care.”

The yoga group did viniyoga, a style of hatha yoga that focuses on postures that stretch and strengthen back and leg muscles, and include breathing exercises and guided deep relaxation. The intensive stretching class was similarly devoted to exercises that stretch and strengthen trunk and leg muscles, except without the guided breathing and relaxation. And finally, the self-care group was given a book to read, The Back Pain Helpbook, which offers advice on exercise and lifestyle changes for back pain.

Over time, all study participants saw improvements in function, but those doing yoga and stretching did significantly better than the self-care group. By the end of their three-month classes, more than half of those in each exercise group reported at least 50% improvement in measures of day-to-day disability, compared with less than a quarter of the controls.

At each follow-up interview — conducted at 6, 12 and 26 weeks after the start of the interventions — yoga and stretch class participants were also significantly more likely to rate their back pain as better, much better or completely gone, compared with the self-care group. “More participants in the yoga and stretching groups were very satisfied with their overall care for back pain,” the authors wrote.

Yoga and stretching also helped people get off their pain medications. After 12 weeks, twice as many people in the yoga and stretching classes (40%) reported decreasing their medication use, compared with the self-care group (20%). That benefit lasted for another 3½ months after the classes ended.

Neither yoga nor stretching was more effective than the other, however. “We expected back pain to ease more with yoga than with stretching, so our findings surprised us,” said Karen Sherman, lead author of the study and a senior investigator at the Group Health Research Institute in Seattle, in a statement.

The findings may be attributed in part to the fact that the exercise classes ended up being so similar to each other. The stretching classes were more intensive than most such classes, with participants holding each stretch for a relatively long time. “People may have actually begun to relax more in the stretching classes than they would in a typical exercise class,” Sherman said. “In retrospect, we realized that these stretching classes were a bit more like yoga than a more typical exercise program would be.”

In an accompanying commentary, Dr. Timothy Carey of the University of North Carolina said doctors should feel comfortable prescribing either yoga or stretching for patients with back pain. “Are the results from this trial actionable for practice?” he wrote. “Yes.”

But Sherman cautioned that not any yoga or stretching class will do. The classes in the study were designed specifically for people with back problems and with no previous yoga or stretching experience. “It’s important for the classes to be therapeutically oriented, geared for beginners and taught by instructors who can modify postures for participants’ individual physical limitations,” she said.


Sora Song is the editor of TIME Healthland. Find her on Twitter at @sora_song. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.

Norman K. Poppen, MD: First aid for broken bones

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Orthopedic surgeons, such as Norman K. Poppen, M.D., always emphasize that bone fracture is a serious matter that requires immediate medical attention. In cases when you are with someone suffering from a broken bone caused by a major trauma or injury, Mayo Clinic suggests taking the following steps:

• Call 911.

• If the victim is not perspiring or if he has no heartbeat, begin performing cardiopulmonary resuscitation (CPR).

• Apply pressure on the wound using a sterile bandage or a clean cloth to stop the bleeding.

• Do not realign or push the bone that’s sticking out back in. If you are trained in how to splint, apply a splint to the area above and below the affected sites.

• Norman K. Poppen, M.D., and other orthopedic experts highly recommend applying ice packs to the fracture to reduce swelling and relieve pain. Keep doing this until the emergency personnel arrive. Be sure to wrap the ice in a towel or some other material and don’t apply it directly to the skin. A little water in the ice pack will help it conform to the shape of the injury.

• Have the victim lay down flat on his back and elevate his feet if he feels faint or is breathing in short, rapid breaths.

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The most important thing to remember when attending to a victim of broken bones is helping them remain calm and keeping the affected area still to prevent further tissue damage. By learning these first aid basics, you can help save a life.

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Norman K. Poppen, M.D., is affiliated with Sutter General Hospital and HealthSouth Alhambra Surgery Center. Follow this Twitter page for more.

Funny Bone: Norman K. Poppen, M.D., explains that Humerus sensation

You’ve felt it before: the inexplicable tingling sensation that accompanies the dull pain from accidentally bumping an elbow. Orthopedic surgeon Norman K. Poppen, M.D., explains to surprised patients that this phenomenon, known commonly as hitting the “funny bone,” actually isn’t caused by any bone at all.


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There is a nerve known as the “ulnar nerve” which runs alongside the ulna bone— one of the two slim bones that connect the elbow to the wrist. Studies of the human anatomy have found that the ulnar nerve is the longest nerve in the entire human body that is naturally unprotected by either muscle or bone. As such, the body tends to feel impact or injury on this nerve more often and more intensely than on any other.


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To help curious patients understand further, Norman K. Poppen, M.D., demonstrates that the ulnar nerve is directly connected from the elbow to the pinky, or little finger, and even connects to the ring finger. This explains why, although only the elbow has been struck, the tickling sensation we feel seems to run up our arms and all the way to our fingertips.

The “funny bone” reference is a pun based on the homophonic resemblance of the word “humorous” to the upper arm bone called the Humerus. It is the impact to the elbow joint connected to the Humerus bone that creates the prickly sensation most people would describe as unpleasant. Knowing this, perhaps the occurrence should be renamed, and be referred to bumping one’s “not-so-funny bone” instead.


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Read more about Norman K. Poppen, M.D., on this website.

Norman K. Poppen, M.D., on avoiding gymnastics injuries

The outstanding performance of the US gymnastics team in the 2012 Olympics is, undoubtedly, inspiring for many young gymnasts all over the country today. Orthopedic surgeons such as Norman K. Poppen, M.D., support the dreams of these young athletes by sharing advice whenever they can on how to continue engaging in the sport while avoiding unnecessary injuries.

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Gymnastics is a difficult sport and to be proficient at it, the athlete needs to dedicate many long hours to practice. The athlete’s body needs to get accustomed to performing the complex physical movements involved because all the weight-bearing routines and the various gymnastic moves place great strain on the body and put the gymnasts at risk for injury.

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Common injuries for this sport include tears of the tendons, elbow dislocations, wrist sprains in the upper body, and fractures, sprains, and strains that frequently occur in the lower body. Norman K. Poppen, M.D., advises young athletes and their guardians to create and follow strategies to prevent injuries. These strategies may range from vigilant spotting to ensuring that all pieces of equipment are properly maintained.

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The athletes are thus advised to ensure that their bodies are always in optimum shape. To do this, they only need to stick to a balanced fitness program which includes aerobic exercise, strength training, and flexibility. Apart from these, stretching before and after sessions and keeping oneself well-hydrated are also highly recommended.

Using proper equipment is also important. For instance, securing proper gymnastics shoes which are geared toward a specific event is necessary to avoid injury and to ensure maximum performance.

More orthopedic advice from Norman K. Poppen, M.D., can be found on this Facebook page.

Norman K. Poppen, MD: Bone health and calcium's role in overall health

Norman K. Poppen, MD, is an orthopedic surgeon. He specializes in treating bone defects caused by genetics, poor nutrition, and physical injury. Although he is highly qualified in treating such conditions and can perform even the most complicated procedures to restore broken or damaged bones back to their top form, he believes that prevention is still better than cure.

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Dr. Poppen is a strong advocate of bone health and always stresses the importance of calcium intake in maintaining healthy bones. Calcium is important for transmitting nerve impulses. Actions such as heartbeats and muscle contraction also require calcium. It is also essential for functions such as hormone and enzyme secretion. The body removes calcium from the bones, and when excessive amounts of calcium are extracted, bones become dense.

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Experts such as Norman K. Poppen, MD, recommend getting sufficient amounts of calcium, along with doing weight-bearing exercise to build strong bones, thus reducing the risk of developing osteoporosis. The body does not produce calcium, which is why it is important that the food one eats is rich in calcium. Dark, green leafy vegetables, nuts, and dairy products (cheese, milk, and yogurt), are excellent sources of calcium. Vitamin D supplements should also be taken, because it is necessary for the body to be able to absorb and use calcium.

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Find more tips on bone health on this Norman K. Poppen, MD, Facebook page.

Norman K. Poppen, MD: The importance of calcium and its role in preventing osteoporosis

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Norman K. Poppen, MD, is a leading orthopedic surgeon with years of experience dealing with various orthopedic issues. He is a Fellow of the American Academy of Orthopedic Surgeons, the New York Hospital of the Columbia Presbyterian Medical Center, the Visiting Scholar Surgery of the Shoulder and Elbow, and the Presbyterian Hospital. He is also a member of the American Society of Shoulder and Elbow Surgeons, American Society for Surgery of the Hand, and the Orthopedic Research Society.

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Calcium and osteoporosis 
Dr. Poppen highlights the importance of calcium in order to maintain bone health. Calcium is a naturally occurring mineral that is shed from the body in skin, nails, hair, sweat, urine, and feces. When a person suffers from an inadequate calcium supply, Norman K. Poppen, MD, says that the body breaks down bone to obtain the mineral, leading to osteoporosis.

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Osteoporosis refers to the thinning of the bones, more common among women than among men. Decreasing hormone levels, too little calcium in the diet early in life, and lack of exercise are the main causes of osteoporosis. In order to prevent osteoporosis later in life, women are advised to consume adequate amounts of calcium. Calcium-rich food include yogurt, milk and dairy products, almonds, broccoli, tofu, kidney beans, tapioca pudding, and kale, among many others.

Norman K. Poppen, MD, believes that osteoporosis can definitely be prevented with proper diet and exercise. More information about his medical expertise can be found on this Facebook page.