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Posted by on in Health News
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"Why does this have to happen now when I have so much to do?" You may be asking this question as you are raking the leaves, shoveling snow, cleaning the garage or even beginning your renewed exercise routine. Or "There goes that arm pain I have been having again-what a nuisance!" or maybe even, "That's probably just my indigestion kicking in..." These are commonly felt ideas and pains that one can experience as we age. Though sometimes we would like to push through pain and finish our work, these are warning signs of heart attacks or angina and are signs that you should see a physician immediately. Once any immediate danger has been ruled out by your physician, you may be asked to complete one of a series of tests. One of these tests is a cardiac stress test. Cardiac Stress Tests are beneficial for the diagnosis of coronary artery disease...
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Posted by on in Fitness
VO2 Max Uptake Norms by Scottsdale Sports Medicine
Maximal oxygen uptake norms for men (ml/kg/min)   Age (years)           rating 18-25 26-35 36-45 46-55 56-65 65+ excellent > 60 > 56 > 51 > 45 > 41 > 37 good 52-60 49-56 43-51 39-45 36-41 33-37 above average 47-51 43-48 39-42 36-38 32-35 29-32 average 42-46 40-42 35-38 32-35 30-31 26-28 below average 37-41 35-39 31-34 29-31 26-29 22-25 poor 30-36 30-34 26-30 25-28 22-25 20-21 very poor < 30 < 30 < 26 < 25 < 22 < 20 Maximal oxygen uptake norms for women (ml/kg/min)   Age (years)           rating 18-25 26-35 36-45 46-55 56-65 65+ excellent > 56 > 52 > 45 > 40 > 37 > 32 good 47-56 45-52 38-45 34-40 32-37 28-32 above average 42-46 39-44 34-37 31-33 28-31 25-27 average 38-41 35-38 31-33 28-30 25-27 22-24 below average 33-37 31-34 27-30 25-27 22-24 19-21...
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By Will Boggs MD   July 14, 2014   Information from Industry NEW YORK (Reuters Health) - Ultrasonography diagnoses hand bony fractures in pediatric patients with greater than 90% accuracy, researchers from Italy report.   "Ultrasonography is a useful addition to physical examination for the diagnosis of hand fracture," Dr. Ingrid Rabach from IRCCS "Burio Garofoldo," Trieste, Italy told Reuters Health. "It allows a rapid evaluation, using x-ray only with positive ultrasonography examination."   Ultrasonography offers high-resolution evaluation of the bone cortex without exposure to ionizing radiation, and several studies have shown that emergency department physicians with adequate training can rapidly diagnose fractures in children using ultrasonography.   Dr. Rabach and colleagues evaluated the diagnostic accuracy of ultrasonography performed by an expert radiologist in comparison to x-ray for the diagnosis of bony hand fractures (metacarpals and phalanges) in a cross-sectional study of 204 pediatric patients admitted for hand trauma.   Standard radiography (an...
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Tendonitis in the front of the knee Most people who have done any sort of sports, especially those that require a good amount of running, have experienced knee pain at some point.  One of the most common areas to experience pain is in the front of the knee around the kneecap (or patella). This is because the design of the knee uses the patella to increase leverage of the working muscles.  The downside is that repeated stress can accumulate around the patella and cause injury pain and swelling. Runners, people who constantly squat or lunge, and those who jump a lot (basketball, volleyball) are at risk of developing overuse injuries in their knees.  Often, people in the explosive, jumping sports will get knee pain starting either at the south pole of the patella or at the tibial tubercle, where the patellar tendon attaches to the lower leg.  The dynamics of jumping,...
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What is Shoulder Bursitis by Scottsdale Sports Medicine
A bursa is a fluid filled sac that lies between moving muscles/tendons and bony surfaces/other tendons and muscle. These sacs act as friction reducing pads that allow the moving parts to easily glide over each other. When there is too much friction for the pads to take, they can break down and get inflamed. Inflammation is the body's natural response to tissue damage and when a bursa gets inflamed, it's called bursitis. If it happens to a tendon, it's called tendonitis. Shoulder bursa The most commonly affected bursa in the shoulder is the subacromial bursa, which sits between the acromion and the supraspinatus tendon of the rotator cuff. This bursa often gets pinched between these two structures during overhead activities and can get irritated in the process (this is called shoulder impingement). When the bursa gets inflamed badly enough, motions such as crossing your arm in front of your chest and...
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Posted by on in Health News
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Endurance athletes have long known that training at specific intensities and durations yields the quickest results for their efforts. Instead of running or biking at a random pace that just "feels good", you should think about setting up training zones that target specific training goals. For instance, aerobic exercise at a low intensity, commonly referred to as long, slow, distance (LSD), will burn mostly fat as a fuel source. This is fantastic if you're trying to lose fat or are training for a long distance event, however, the downside is that you're burning fewer calories per hour overall. This means that you need to make the "slow" workouts also "long" workouts so you burn an appreciable number of calories. On the other hand, there is an alternative. High intensity Interval training (HIIT) is excellent for extending your body's ability to handle faster and harder efforts while at the same time increasing...
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Loren M Describes how she deals with POTS and wants to run a marathon!
Meet SSMI patient, Loren M. She's a real inspiration and represents what it means to be determined. I'm so happy to have met her! "My successes with SSMI have been happening a lot longer than just the one month Metabolic Program. In early 2010, I was diagnosed with POTS [postural orthostatic tachycardia syndrome]. Some people are bed ridden from POTS, and at my worst I was only able to stand for 20 minutes at a time before fainting or extreme dizziness. I did some research and found that cardiovascular exercise can be very helpful. I prayed specifically for a Doc that could really understand I was in a bad place, but was a dynamic enough thinker to believe I didn't have to stay in that bad place. By the time I increased my running time from 4 minutes to 20 very hard minutes at a time, God brought me to Dr. Carfagno....
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SSMI Patient Story Scottsdale Sports Medicine Dr. Carafgno
Jen is just the latest to join our Top Tens list -- check out her numbers! I'm so impressed with what she achieved. Here's what she had to say: "I'm so happy that I took the first step and started Dr. Carfagno's weight loss and workout program. I'm very pleased with my results so far and will be keeping up with everything I've learned, that is keep active and watch what you put in your body. Thank you to Dr. C, and Dan for being very encouraging!  ...
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Originally from the Midwest, Don graduated from the University of Michigan and attended Cleveland State University for his Masters degree in Exercise Science.  At Michigan, he was a Student Athletic Trainer and worked full competitive seasons with the football team (1993) and women's gymnastics (1994). Because of his dedication to his work with the football team, he received a scholarship to work training camp for the NFL Detroit Lions in 1994 after graduation, allowing him the privilege to work with NFL legends Barry Sanders and Chris Spielman.  While attending graduate school, he was a Graduate Assistant at the Cleveland Clinic Foundation and eventually became a full staff Certified Athletic Trainer and Exercise Physiologist.  Don worked with athletes of all levels as the Coordinator for the Center for Athletic Performance at the Cleveland Clinic, designing sports-specific training programs and performing exercise testing for endurance athletes.  As a part of the Cleveland Clinic...
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Posted by on in Patient Success Stories
Scottsdale Sports Medicine 30 Day Metabolic Program Success Story Andy D
Congrats to Andy D!! He completed the 30 day Metabolic Program and totally crushed it, And he has awesome results! Here's what he has to say: "Just wanted to thank Dr. Carfagno and Dan and the whole staff for their encouragement and professionalism. I would encourage anyone who is thinking about changing their health to do this program. It is so simple to follow and the results in 4 weeks are amazing! I dropped 25lbs, my LDL cholesterol went from 126 to 78, and my total cholesterol from 232 down to 162. My LDL started at 126 and went down to 78. My DXA body composition went from 37.5 to 30.5. And my lean mass went from at 55,737 g to 58,265 g. My blood pressure wetn from 126/70 to 106/63. This truly will be a simple lifestyle change!"...
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Happy to have had the opportunity to present this information to the physicians at Banner Health last week. Compartment Syndrome is such a tricky diagnosis, and I've written about it here as well. Feel free to share or ask questions for more information. Compartment Sydrome: A Sports Medicine Physician's Perspective from Dr. David Carfagno...
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Posted by on in Patient Success Stories
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This patient story hits very close to home for me, as it's by my father! I really appreciate him sharing his experience. In mid-January of this year, my son, Dr. David Carfagno, gave me a thorough physical exam. In addition to routine requirements (blood profile, urine, etc.) he requested that I complete a CT Heart Score evaluation through an outside facility although it wasn't covered by my Medicare insurance. David advised me that there is no protocol for ordering a CT Heart Score test at my age. Medicine requires this evaluation below 60. But David had a feeling. Being the obedient patient an father that I am, I agreed. Subsequently, David got the results of my test. It was a startling 1700. The normal range for a 70 year old male is 0 to 400.  It's important that you understand my then state of health -- and this is very important!! My...
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Posted by on in Health News
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Overtraining in the AthleteBy David G. Carfagno, DO, CAQSM and Joshua C. Hendrix, MS-III Competitive athletes are pushed routinely to the limits of their physical abilities. When tempered with periods of rest and recovery, a highly demanding training schedule can have tremendous benefits. However when an athlete is pushed too far, overtraining syndrome (OTS) can develop and result in career-ending damage. Overreaching and overtraining are part of the same spectrum that can lead to OTS. The pressure to perform placed on elite athletes is a real danger. Athletes and coaches understand the importance of rest days, but the insidious onset of OTS slowly saps the efficacy of recovery times so the athlete is no longer able to reach previously attainable goals. Identifying markers that correlate with overreaching and overtraining can arrest progression of a potentially negative cycle. We will examine the c urgent literature and discuss possible screening tests and red...
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I'm looking forward to presenting to the 2014 Jobing.com Women's Cycling Team this weekend -- even if they mispelled my name!  It's a great opportunity to share and gain information with presentations on Stretching, Nutrition, Training, Injury Prevention, and bike maintenance. Led by local experts and PROS! An I'm one of them. For registration information, visit their web site....
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Want to win a free Rock and Roll Marathon/Half Rock 'n' Roll Arizona Marathon & 1/2 Marathon Entry fee plus all VIP access? The first person to answer these 3 questions correctly win the prize!! 1. Name the three tendons of the hamstring. 2. How much energy (in kilokalories) is stored in muscle and liver glycogen, respectively? 3. What are the two most common sites of stress fracture in the lower extremity, and of the two, which is the most common? Answer on Facebook or via email!...
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Posted by on in Patient Success Stories
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Meet LC. She's 88 years young and one of our patients here at SSMI. She's been suffering from osteoarthritis of the spine and hip. To treat it, she's done physical therapy, taken medications and had injections in her back. The biggest relief and what helped her start to walk again has been platelet rich plasma, or PRP Therapy. PRP is blood plasma with concentrated platelets. The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process. This video is short and sweet, but the smile on her face says it all! So happy for LC. If you'd like to learn more about PRP from SSMI, please visit our web site....
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We are happy to announce that our monthly Botox/Juvederm events over the year of 2013 were a huge success! We have had excellent results and extremely positive feedback. And for those of you who couldn't make it, we are offering upcoming events for the 2014 season! We have always strived to provide the best and most comprehensive internal medicine and sports medicine to our patients. We are happy to now be integrating aesthetic injectables and skincare with the goal of keeping you healthy and feeling well, both on the inside and out. As always, our aesthetic treatment offerings will be administered by licensed medical professional, David Carfagno, D.O., CAQ, in order to provide the consistent positive results you've come to expect from us as one of our valued patients. Dates: January 23rd, 2014 & February 20th, 2014Time: 8 am- 5 pmLocation: Scottsdale Sports Medicine Institute Special event pricing: Botox: $9.00 per...
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As we get closer and closer to the big holiday time, it's harder and harder to stay on track! Here are some more tips to help you feel good during this time of good cheer! The first tip appeared here as well as on Health2Fit.com, but I want to be sure you see them here, too. Drink in moderation. Limit your alcohol consumption to one or two alcoholic beverages during the party or holiday dinner. Anything extra will hinder your judgment and lead to a tendency to overeat, not to mention put your safety at risk. Don't drink and drive. Take a cab or have a friend or spouse drive if you have too. Also, the extra alcoholic beverages are extra calories that will lead to weight gain. Pre-empt the party buffet. Have a healthy snack before heading to a holiday party. You will be less likely to not overindulge at...
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Cortisol, a stress hormone, is raised by high sodium and processed foods like chips and crackers. To help reduce cortisol levels, munch on unsalted nuts and carrots, peppers or cucumbers with hummus. Magnesium, found in nuts, dark leafy greens and beans, can help keep cortisol levels low and prevent headaches and fatigue.   This article is part of a series appearing on Health2Fit.com...
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Posted by on in Sports News
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Skier's thumb (yes, it's really a thing) is a sprain of the ulnar collateral ligament (UCL) of the thumb. It occurs when the wrist straps on the ski poles get stuck in the snow, and the thumb gets caught up and bends back. It can also occur in football, judo, and skeet shooting as well. On exam, I'll see pain over the proximal part of the thumb joint and may have laxity with stressing the UCL in abduction (moving the thumb away). On imaging, stress views of thumb can show an avulsion or fracture. If so, these are called a Stener's lesion and may need to be seen by an orthopedic hand specialist. Depending on the amount of laxity on exam, mild to moderate sprain can be treated nonsurgical with ice, immobilization for up to 4 weeks and then hand therapy. Complete tears or the avulsion Stener's lesion need to be...
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