Author: Thomas Bottiglieri, DO
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Patella (kneecap) Dislocation
The patella, also known as the kneecap, is the structure at the front of the knee that connects the muscles of the anterior thigh to the leg, allowing for forceful contractions that propel human beings in walking, running, and jumping. The alignment of the patella can impact its function. In cases in which there are anatomical […]
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Biologic Injections
Many patients ask about biologics for their sports injuries and arthritis. Biologics are not a holy grail, but have tremendous promise for a variety of conditions ranging from acute sprains to chronic tendinitis and osteoarthritis. While the science is not complete in this realm, and is relatively new in sports medicine, the overwhelming evidence so […]
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What is Post-Concussion Syndrome?
Post-concussion syndrome (PCS) is a disease state in which the injured brain does not recover completely after a concussion (brain injury). There is a disruption immediately following a brain injury in the electrical and chemical signaling pathways in the brain as well as a disruption in cerebral blood flow and brain metabolism. The symptoms associated […]
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Is my personality delaying my concussion recovery?
After a sports related brain injury (concussion) academic work should be put on hold until symptoms begin to improve. The brain uses energy to send signals in the form of electrical and chemical messages. In addition to the energy needs of cognition (thinking) and autonomic brain functions, healing requires energy and adds to the metabolic […]
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Post-concussion syndrome exertion protocol
After a brain injury the metabolic processes in the brain are impacted negatively. Exercise can regulate cerebral blood flow and stimulates the inherent healing mechanisms of the brain including BDNF (brain derived neurotrophic factor). While the brain was thought to lack plasticity and healing potential in times past, we now know that the process of […]
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Getting Healthy
Lifestyle modifications for general health: For patients that wish to manage osteoarthritis of the hip and knee, nothing is more impactful than lifestyle modification including weight loss and muscle strengthening. The pain relief from lifestyle modification can help forego the need for medications, injections, and even surgery. In situations where medical and surgical treatment is […]
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Training the heart for brain injury
In this post I would like to briefly describe a practice that has been utilized for my patients with post-concussion syndrome since 2010, heart rate variability biofeedback. Among the many symptoms adolescents and young adults will report after a concussion are brain fog, depressed mood, and social detachment. Fortunately we have learned that absolute rest […]
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When your brain has had enough
There are so many questions regarding the implications of brain injury (concussion) in sports and so my colleagues and I initiated a paper, published January 2018 in Neurology: Clinical Practice , as a way to systematically approach the discussion with patients about the need to step away from an offending sport before it is too […]
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Ask Doc Botts!
This website is intended to summarize educational discussions I have with my patients everyday! It is my hope that the platform will be utilized as an educational tool to help keep active people moving. Of course medical decisions can be complex & require personalized evaluation and treatment plans based on empirical information gathered with a […]
Thomas S. Bottiglieri, D.O. 