Warming up: A sports medicine physician's Rx for easing back into winter sports.

Winter arrival invites athletes and outdoor enthusiasts to tackle different terrain. But going skiing, visiting a skating rink or even joining an indoor basketball game can take a toll on the joints and bring on mild to severe injuries.

Injuries from winter sports don’t limit themselves to a certain demographic, noted Dr. Dipan Patel of Garden State Pain & Orthopedics. Being out of practice and not warming up before taking part in an activity often are the common links among injury sufferers.

“Whether you're young, middle-aged or older, it's really just the luck of the draw based on how stable your knee is prior to you taking on those activities,” Dr. Patel said.

A board-certified anesthesiologist and interventional pain physician, Dr. Patel said that often you’ll see athletes turn their knees and it looks traumatic, yet they’ll pop back up and walk away. Other times, what seems to be a subtle twist can turn out to be a torn anterior cruciate ligament (ACL).

One way to diminish the risk of injury is to stretch before engaging in activities, advised Dr. Patel, who recommended doing some light jogging to get blood flowing after stretching.

“You want to make sure that your muscles are warmed up prior to taking on those activities,” Dr. Patel said. “That way you have more margin for error when it comes to the laxity of your muscles and your tendons and your ligaments.”

Whether you’re preparing for skiing, snowboarding, skating or just walking down the block, you want to know that your joints can stabilize themselves should you begin to fall. For those with knee issues, getting an evaluation can help prevent problems.

“We can prescribe a certain type of brace that will help stabilize the knee as well as some strengthening exercises to get them prepared for their winter activities,” Dr. Patel said.

When to See a Physician and What to Expect

People who experience discomfort may investigate a range of at-home remedies before seeking treatment. Pain sufferers often try resting and elevating the knee, ice and over-the-counter anti-inflammatories. If those don’t provide relief, it’s time to see a physician who can evaluate the injury.

“The patient’s story is the most important part of our clinical encounter when working up any type of orthopedic or musculoskeletal injury — especially the knee,” Dr. Patel noted. “Getting the history on what kind of feelings or sensations have been affecting them is very important in order for us to decide on a physical exam maneuver that we're going to be choosing to test out to see what are the limitations passively, and what the patient can do without my help. Then, when we try to put the knee under a little bit of stress, which would be similar to the motions that they would encounter during an athletic activity or just as part of daily life, we really get to understand what elicits this.”

Cutting-edge Care

With locations in Clifton, Edison, Hazlet and Jersey City, Garden State Pain & Orthopedics prides itself on providing compassionate and cutting-edge pain management. Many of the practice’s patients arrive as referrals from primary care physicians who lack the advanced imaging technology and treatments to handle such injuries.

The adage “a picture is worth a thousand words” applies when it come diagnosing an issue, said Dr. Patel, who utilizes X-rays and MRIs to pinpoint the source of the problem for patients. From there, he offers innovative treatment options, including gel injections that lubricate the joint and prevent further wear and tear.

“Those are called hyaluronic acid injections,” said Dr. Patel. “These provide extra cushion that the patient may not have because of over-utilization or gradual wear and tear, or athletic activity that has just eaten away at some of the cushioning within their knees.”

Platelet-rich plasma (PRP), a regenerative treatment, has surged in popularity.

“One of the beautiful things about that is you're using your body's own healing factors to be able to elicit a healing response within the knee itself, which is an area of the body that usually does not get much blood flow,” Dr. Patel said. “The reason why the knee breaks down a lot more than other parts of the body is because when you do have an injury, the blood flow to that area is scarce. And so what we do with platelet-rich plasma is we utilize the healing factors within a patient's own blood. And we actually spin this blood, using a specialized centrifuge machine, extract the healing factors, and then we inject them into the knee, and it can be done in the office setting, which is a beautiful thing.”

Patients enjoy the added advantage of avoiding unwanted side effects they may have experienced with previously popular steroid injections.

Listen to Your Body

Before starting any type of strenuous activity, individuals should scan their bodies for minor aches and pains, Dr. Patel said.

“The kind of things that they brush off like, ‘Oh, if I rest it will go away,’ those can be early indicators and warning signs of something that's underlying that you want to be conscious of before taking part in an activity that may exacerbate that and set it off becomes something more severe,” he said.

Dr. Patel added that he and his fellow physicians are always available to support patients and educate them in how to best avoid injuries.

— Liz Alterman