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Sports Medicine Clinic

Our physicians are experts in musculoskeletal and medical sports conditions and they understand what drives athletes. They will help you recover from injury as quickly and safely as possible and get back in the game!

Our services include (but are not limited to) assessment and treatment of:

  • Acute injuries (strains, sprains, joint pain, fractures)
  • Overuse injuries (tendonitis, stress fractures)
  • Back pain in young athletes
  • Shortness of breath and fatigue in athletes
  • Athletic skin disorders
  • Athletes with illness (mononucleosis, asthma, and diabetes)
  • Sports Concussion (treatment and management)

Athletic Training Services

Cayuga Medical Center has seven certified athletic trainers (ATC) on staff. They are skilled professionals who specialize in athletic health care and work closely with physicians and other allied health personnel as integral members of the sports medicine team.

Cayuga Medical Center’s certified athletic trainers work on site at area high schools, colleges, and with club teams, as well as in the sports medicine clinic at the Island Health Center.

Athletic Training at Area High Schools

Cayuga Medical Center provides athletic training services to ten area high schools: Cortland, Homer, Ithaca, Lansing, Moravia, Newfield, Spencer / Van Etten, Trumansburg, Watkins Glen and Whitney Point. The level of service ranges from full time practice and game coverage to bi-weekly injury clinics. The injury clinics are held in the school nurses office, our athletic trainers work collaboratively with the school nurse to ensure athletes receive the highest level of care and return to play safely. Athletes are given instructions for self care or referred to the appropriate health care professional.

Our athletic trainers are on site at each school to:

  • assess injuries
  • make recommendations for treatment and further care
  • assist with injury rehabilitation
  • modify activity to allow an injury to heal while continuing to practice
  • help with injury prevention
  • design sport-specific strength training programs.

Athletic Training Event Coverage

If you have an event such as a football game, wrestling tournament or 5k race we can provide an athletic trainer to care for your athletes. Our athletic trainers will arrive prior to the event equipped with a fully stocked medical kit to tape and prep your athletes. After the competition is over they will evaluate any injuries and make recommendations for self care or further medical follow up.

If your school does not offer Athletic Training, or you would like to learn more about our Athletic Training services, please contact Margaret Vence, Director of Sports Medicine and Athletic Performance at (607) 252-3580.

Sports Concussion Management

Concussions occur when a blow to the head or neck interrupts brain function. The effects of these concussions vary among individuals, and many mild concussions are undiagnosed and unreported. Most athletes recover completely and can return to play following an appropriate period of recovery. However, it is important to understand that suffering a second blow to the head while recovering from an initial concussion can have catastrophic consequences, including death. Knowing when it is safe to return to play in order to avoid serious brain injury is crucial.

Assessing concussions

At Cayuga Medical Center we believe that all concussions should be properly assessed. Our Sports Concussion Team includes sports medicine doctors, athletic trainers, and physical therapists who specialize in concussion management.

The cornerstone of our management includes ImPACT Neuropsychological Testing. ImPACT testing allows us to evaluate, measure, and document various brain functions such as memory, symptoms, processing speed, and reaction time. Based on this information our physicians are better able to return the athlete to play safely.

Contact sports

Athletes, especially those who participate in contact sports, should take a baseline ImPACT test prior to the start of their athletic season. The baseline test takes approximately 30 minutes and can be performed at one of our participating schools or in our Sports Medicine Clinic. After an athlete has suffered a concussion, we recommend a medical evaluation followed by a post-concussion ImPACT test.

We recommend that schools and athletes participate in ImPACT baseline testing to help in the event of a concussion. If a baseline test is not available, ImPACT has developed norms that can be used to evaluate the recovery process of a concussed athlete. While these norms can be used to monitor recovery, they do not replace the value of an athlete being compared to a baseline test.

Safe return to play

The goal of our program is to make sure athletes who have suffered from a concussion are returned to play safely and on an individual basis.

To schedule an appointment to see one of our sports physicians or to have a baseline concussion ImPACT test please call (607) 252-3580.

Shortness of Breath Clinic

Many people struggle with shortness of breath during exercise. They are often given a diagnosis of asthma or exercise-induced asthma but treatment sometimes does not help. In order to evaluate breathing difficulties during exercise, it is essential to recreate your symptoms with an exercise challenge. We feel the key to finding the answer is to obtain good objective data via cardiopulmonary exercise testing as well as pre- and post-exercise lung function, and upper airway visualization.

We understand how important exercise is for everybody’s health. If breathing limits your ability to exercise, we want to help you.

If you exercise and you find that your symptoms are limiting your ability to perform at your best, we want to help you reach your full potential.

Getting Started

  1. Make an appointment with Dr. Getzin for an initial consultation
    If traveling, you will be asked to provide pre-Shortness of Breath Clinic information that can be reviewed by Dr. Getzin to determine if you are a candidate for our Shortness of Breath Clinic. This will include a chest x-ray, complete blood count, ECG, and spirometry: pre- and post-bronchodilator. Please contact our office to schedule an appointment.
  2. Exercise induced asthma testing
    Typically you will be running on a treadmill, riding a bike, or rowing on an ergometer.Our team will test your lung function at baseline and then again after exercise to see if exercise provokes and asthmatic response.
  3. Continuous Laryngoscopy with Exercise (CLE)
    Once again you will exercise to provoke your symptoms. CLE testing allows direct visualization of the larynx during exercise to help with diagnosis of Exercise Induced Laryngeal Obstruction (EILO) which is commonly misdiagnosed as asthma. We are one of the few clinics in the United States performing CLE.

FAQS

Q: What do I bring to test day?
A: On the day of testing you will need to bring athletic clothing and shoes. You will also need to bring a form of identification and insurance card.

Q: Can I bring my coach?
A: Yes, feel free to bring your coach.

Q: Will my insurance cover it?
A: In most instances insurance will cover all testing. It is always a good idea to check with your insurance company to ensure that you are fully covered for testing.

Q: Will I be able to share information with my doctor?
A: We encourage you to share this information with doctors involved in your care. We will fax a copy of your final report to your referring provider and primary care physician.

Q: How long will the testing take?
A: Testing typically takes about an hour. This can vary from person to person depending on findings during the testing.

Q: Will I leave with an answer?
A: At the end of your visit we will discuss our findings with you and outline a clear treatment plan. In most instances, we will have a diagnosis by the end of testing, but there are occasions where more testing is needed.

Q: What do I do to improve after I leave the shortness of breath clinic?
A: After testing, we will provide you with recommendations to help with your shortness of breath. These will be reviewed after testing and included in you final report.

Q: How will I exercise at the clinic?
A: Usually we have our patients run on a treadmill; however, we try to best replicate when symptoms occur so we are able to test you in a variety of ways including biking, rowing, and swimming.

Q: Should I continue to take my medication prior to testing?
A: We ask that you discontinue medications that are currently used to treat your shortness of breath. Below you will find a common list of medications and how long you should be off of them prior to testing. Please check with your physician or call the Shortness of Breath Clinic if you have any concerns.Short acting medications (should not be taken for 24 hours prior to testing):

  • Ventolin, Proventil (Albuterol)
  • Xopenex (Levalbuterol)
  • Brethaire (Terbutaline)
  • Alupent, Metaprel (Metaproterenol)
  • Tornalate (Bitolterol)
  • Maxair (Pirbuterol)
  • Combivent (Ipratropium and Albuterol)

Long acting medications (should not be taken for 48 hours prior to testing):

  • Beclovent, Vanceril, Qvar (Beclomethasone)
  • Pulmicort (Budesonide)
  • Flovent (Fluticasone)
  • Azmacort (Triamcinolone)
  • Singular (Montelukast Sodium)
  • Accolate (Zafirlukast)
  • Zyflo (Zileuton)

Q: Where will my testing be done?
A: We test our patients on the 5th floor of the Island Health Center building at Cayuga Medical Center Sports Medicine and Athletic Performance. Address: 310 Taughannock Blvd Suite 5A, Ithaca New York 14850

Osteoarthritis Clinic

Osteoarthritis is a degenerative disease of joints. Arthritis pain limits activity and negatively affects quality of life. For those patients with chronic medical problems, activity limitations from osteoarthritis can affect their ability to control diabetes, high cholesterol, and high blood pressure*. An estimated 27 million Americans age 25 and older have osteoarthritis. Our goal is early detection and comprehensive management and improving the quality of life.

Let our comprehensive team of experts diagnosis and provide evidence based high quality treatment to get your osteoarthritis your symptoms to get you back to the healthy life style you deserve.

Exercise

Exercise is one of the best treatments for osteoarthritis. It is recommended that you complete at least 150 minutes of moderate exercise per week. Exercise has been proven to improve mood and outlook, decrease pain, increase flexibility, strengthen the heart, improve blood flow to the heart, help with maintain weight, and promote general physical fitness. Walking, swimming, and water aerobics are a few popular types of exercise for people with osteoarthritis. Please speak to your doctor and/or physical therapist about specific types of exercise depending on your particular situation. People with osteoarthritis often develop muscle weakness due to inhibition from joint pain. Appropriate exercise can rebuild muscle strength, which has been shown to in turn decrease pain and improvement function.

  • Strengthening exercises: strengthen muscles that support joints affected by arthritis. They can be performed with weights or with exercise bands
  • Aerobic activities: brisk walking or low-impact aerobics, that get your heart pumping and can keep your lungs and circulatory system in shape.
  • Range-of-motion activities
  • Balance and agility exercises

Weight Loss

For those who are overweight losing weight can improve symptoms of osteoarthritis. One pound of extra weight is four pounds on the knee joint. Diet plus exercise is better than either alone. A dietitian can help you develop healthy eating habits.

Physical Therapy

Physical therapy can help you to improve strength and range of motion. In addition, physical therapy can address any biomechanical issues that may be contributing to your pain from osteoarthritis. This includes assessing the need for insoles, orthotics, or kneecap and foot taping.

Braces

Hand splints provide pain relief and support. Knee braces reduce pain, improve stability and diminish risk of falling.

Medications and Ultrasound Guided Injections

Tylenol (acetaminophen) is primarily prescribed as the first line of treatment. If that doesn’t produce the desired results NSAIDs, such as aspirin and ibuprofen are often prescribed. If the pain is severe, Tramadol and opioids can be prescribed based off a full evaluation. These medication are typically only used for short durations.

Oral corticosteroids like prednisone are not routinely used to treat osteoarthritis.

*medications can interact with one another and certain health conditions put you at increased risk of drug side effects, it’s important to discuss your medication and health history with your doctor before you start taking any new medication.

Injections

A Corticosteroid injection contains powerful anti-inflammatory hormones and is often used to provide relief from osteoarthritis, especially if symptoms are not responding to oral therapy. It’s effective for painful flares and can provide relief for several months. Injections can be done every three months (about 4 times per year).

Viscosupplementation (Synvisc, hyalgan). Hyaluronic acid substitutes are designed to replace a component of the joint involved in joint lubrication and nutrition. It is a lubricant and anti-inflammatory that helps with inflammation in the joint fluid. It is a series of injections 1 per week for 3-5 weeks. These products are approved only for osteoarthritis of the knee.

PRP (Platelet Rich Plasma): Recent studies suggest PRP is more effective than viscosupplementation in knee osteoarthritis. Larger randomized controlled studies are needed to make it a routine part of management.

Non-invasive treatment options

TENS unit: TENS is a technique that uses a small electronic device to direct mild electric pulses to nerve endings that lie beneath the skin in the painful area. TENS may relieve some arthritis pain. It works by blocking pain messages to the brain and by modifying pain perception.

Acupuncture: Some people have found pain relief using acupuncture, a practice in which fine needles are inserted by a licensed acupuncture therapist at specific points on the skin. The needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system.

Massage: In this pain-relief approach, a massage therapist will lightly stroke and/or knead the painful muscles. This increases blood flow and brings warmth to the stressed area. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.

Massage: In this pain-relief approach, a massage therapist will lightly stroke and/or knead the painful muscles. This increases blood flow and brings warmth to the stressed area. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.

Glucosamine/chondroitin: Sometimes Glucosamine and/or chondroitin can be used to improve symptoms, however, results can vary. Treatment can be conducted over the course of 3-6 months and if there is no improvement, other options may be explored. Research is still being conducted on the benefit of these supplements.

Surgery

Patients with hip or knee osteoarthritis who are not obtaining adequate pain relief and functional improvement from a combination of pharmacological and non-pharmacological treatment should be considered for joint replacement. A decision to have a joint replacement is not based on imaging but is made collectively between a patient and an orthopedic surgeon with expertise in surgical management of osteoarthritis. Replacement arthroplasties are effective and cost-effective interventions for patients with significant symptoms and or functional limitations not responsive to conservative care. The appropriate time to have a joint replacement surgery is different for every patient. However, in my experience, after my patients have their surgery, they usually retrospectively feel they waited too long.

Endurance Sports Performance Center

Welcome to the Cayuga Medical Center Endurance Sports Performance Center. In designing our center, we envisioned a place where endurance athletes can go to have all of their performance needs met from testing, to nutrition, to biomechanics, to coaching, and even medical treatment and rehabilitation. Our team has a broad range of expertise within the fields of medicine and exercise. Like you, we too are athletes. We want to help you reach your goals!

VO2 Max Test

A VO2 Max Test is the gold standard for cardiovascular fitness assessment. The data obtained is helpful in designing training programs, establishing heart rate zones, measuring current fitness level, and preventing overtraining syndrome. In our lab, the protocol we most commonly use starts at a relatively easy level and increases intensity in two-minute stages until the subject is no longer able to continue. Total work time is usually 8 -12 minutes. During the test, your nose will be plugged so all gas exchange occurs by breathing through a mouthpiece connected to a metabolic analyzer. You will wear a heart rate monitor or be connected to an ECG machine while you run or walk on the treadmill. You do not need to have this test done in order for us to provide you with good information about your running. However, it can provide useful additional information.

Metabolic Profile Tests and Assessments

Sport Nutrition Assessment and Consultation
Initial Nutrition Consultation and Assessment:
This 1-hour nutrition consultation and assessment is provided by our Board Certified Sports Dietitian. The initial consult determines an athlete’s nutrition needs based on short- and long-term performance goals. Each consultation is unique to the individual athlete and includes specific recommendations to help the athlete reach and maintain peak performance.

Follow-up Nutritional Consultation: As modifying diet for maximal performance is an on-going process, follow-up appointments with the sports dietitian are important. During these ½- hour follow-up appointments, athletes work with the sports dietitian to achieve and fine-tune their diet to maximize sport performance.

Resting Energy Expenditure
Resting Energy Expenditure is used to determine the number of calories an individual needs to consume in order to lose, maintain or gain weight. Since REE accounts for approximately 70% of your caloric uptake, it is a great tool to help regulate one’s desired bodyweight and a critical measure when trying to achieve optimal athletic performance. This test is performed at rest and no exercise is involved. With the nose plugged, you will breathe through a mouthpiece connected to the metabolic analyzer.

Body Fat Analysis
Using calipers and taking readings from various sites on your body we will assess your current body fat content which can then be used to help provide a baseline for weight loss, weight gain and for athletic performance purposes.

Bike Fitting

One of the biggest performance upgrades you can make to your bike is a proper fit. Your bike and its contact points must be selected and positioned in a manner that promotes the 3 key measures of a perfect fit. More Comfort, More Power and More Aerodynamic Speed.

Run Gait Analysis

Biomechanical analysis of gait to optimize your running ability. Individualized attention to running style and ways to optimize running performance.

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