Concussion Update
In the wake of a sports-related brain injury causing a student-athlete’s death in New Jersey, Tua Tagovailoa’s on-field seizure activity, and the 2022 International Concussion in Sport Group meeting set to release updated guidelines from Amsterdam, it is a perfect time to think…
Heart Rate Variability & Monkey Mind 🧠
During my sports medicine fellowship in the Fall 2007 I was introduced to a heart-mind-body connection that has fascinated me since. The beat-to-beat change in rate of cardiac rhythm known as heart rate variability (HRV) is a measure of the automated response to…
History Through a Modern Lens
A patient said to me the other day, “you cannot view history through a modern lens.” I thought a lot about this. She vocalized something in a way the left my mind unresolved. To add to her idea, you can, but you must…
“Admin Day” for Doctor
Navy SEAL teams say slow is smooth and smooth is fast. In my day-to-day activities as a physician I can feel this in my bones. Methodically I turn the door knob and remind myself over and over that, “every moment is a new adventure” to reset my mind and treat each encounter with the uniqueness…
Surgery, Should I or Shouldn’t I
“Doctor, is this really necessary?” What are the risks? What are other options? What happens if I do nothing?” These questions outlined by neurosurgeon, Christer Mjåset, should be part of every dialogue between doctor & patient in shared decision making for intervention. If the doctor doesn’t prompt this conversation, the patient should. Also ask, “what…
Change Yourself, Change the World.
Leadership can be defined in many ways. Possibly the most important thing a person can do in order to be more adept in this arena is to be self-aware. So what is the fear? “What got you here, won’t get you there.” – Joel Brockner. Leaders push into the unknown. As we rise up the…
Brain fog to Brain expert
Brain injury can have far reaching impact on the trajectory of a person’s life. When I was injured in my Sophomore year at Wagner College Football, The American Academy of Neurology’s (1997) guidelines suggested retiring an athlete for life after three diagnosed concussions. I had three documented brain injuries in the first 5 weeks of…
Surgery, Should I or Shouldn’t I
Read this before your surgical consult: “Doctor, is this really necessary? What are the risks? What are other options? What happens if I do nothing?” These questions outlined by neurosurgeon, Christer Mjåset, should be part of every dialogue between doctor & patient in shared decision making for intervention. If the doctor doesn’t prompt this conversation,…
Communication Corner – Email Barrage
If you are like me, then you have a love/hate relationship with email. Mostly hate. Except when you are the sender and need to communicate something to someone. The concern about an email inbox that is never ceasing and ever more time-consuming is no trivial matter. In fact it is identified as a driver of…
SIRVA – Shoulder Injury Related to Vaccine Administration.
Shoulder pain is typical after you receive a vaccine. That being said, the pain should be fairly well localized. It may be associated with some …SIRVA – Shoulder Injury Related to Vaccine Administration.
SIRVA – Shoulder Injury Related to Vaccine Administration.
Shoulder pain is typical after you receive a vaccine. That being said, the pain should be fairly well localized. It may be associated with some redness and swelling which can be treated with Acetaminophen, cold packs, and light massage. When vaccine administration is performed correctly this is a self-limited problem with minimal concern. When vaccine…
Four Pillars of Fitness
1. Cardiovascular 2. Resistance strength/power/stability 3. Flexibility 4. Proprioception These four main building blocks form the foundation of overall physical fitness. Depending on your background experience with sport, dance, or even labor, you will likely identify more with one or two of these than the others. Football players will most strongly identify with strength and…
Communication Corner – Toolkit for Conflict
No matter your position in a company, there will be times that a visceral response to a situation threatens your professionalism. I have found my own “Monkey Brain” reacting unproductively to perceived threats, mostly unconsciously. It is important to recognize your reactions and modify behaviors to achieve desired outcomes. If we allow ourselves to react…
Gratitude can shape perception
This has been a difficult year for so many people. The challenges we encountered were unexpected. In the face of the adversity we have an opportunity to pause and remember what is truly important, a practice that can often be overlooked when things are coasting along. A disruption to our normal can be an opportunity…
Trauma and Growth.
Adaptations to stress are what allow living things to thrive in a hostile world. Many people have suffered some insult to their existence from which they needed to adapt. The changes to a person’s character from childhood trauma, moments of failure and embarrassment, and seemingly immovable obstacles can become ingrained in one’s personality. Many times…
Value Yourself, Set Your Course, Navigate Challenges
Every day is a new adventure. We are faced with expectations and tasks, but always with the possibility of unexpected circumstances that can derail the best laid plans. There are day-to-day processes that function on autopilot, which saves energy and allows for efficient work. When obstacles arise, we can perceive these as a nuisance or…
WEEKLY NEWSLETTER: 7.10.2020
Phase 1 of return to sports has allowed for group activities up to 10 people, outdoors. As we ramp up towards the next phase, we will see larger groups convening, but at least 14 days of practice at this introductory level are recommended in this trial-and-error approach to reopening. The idea is to slowly titrate…
See Dr. Bottiglieri with Virtual Visits
Virtual Visits allow you to connect with your doctor from the comfort and safety of your own home. They are available for all ages. We will offer you the same high level of expert, compassionate care that you expect in an office visit. More and more people are scheduling virtual doctor’s appointments in order to…
Time to Talk About a Second Wave? COVID Update 06.24.2020
Will schools be ready for classes in the fall? Will there be a second wave? Are school based sports going to return? Is travel going to be allowed into and out of hard hit areas? In this update we present our current state and expectations for the coming weeks and months. As always it is…
Mastery During Transition
Each day during the isolation, over the past few months, and as we ramp up now with re-opening, we have been faced with uncertainty and change. During our day-to-day, predating COVID, our routines were likely well established. At the least we may have had a vision of what we wanted to work on and towards.…
House Calls are Back..
There’s never been a better time for a house call — and our team is here for you, bringing healthcare directly to your home with Virtual visits. Using our secure Connect patient portal, Virtual Visits are an easy, safe way to stay connected with your doctor. The teams at ColumbiaDoctors have already seen more than…
WEEKLY NEWSLETTER: 6.5.2020 COVID-19 UPDATE
No communication at this time can go without mention of the current national crises. While we have been focused on re-opening and getting back to normalcy a different kind of plague reared its ugly head – that of racism & police brutality. To stay within my lane I will simply say that if our nation…
COVID-19 & the Heart
Moderate exercise to boost immune function has been at the forefront of exercise recommendations during the Sars-CoV-2 pandemic. In this piece I will identify the most common athletic concerns & what to do if you had COVID before return to sport. The immunologic benefits of moderate exercise, and conversely the potential for increasing inflammation and…
Weekly Update 5_29_2020
New York and New Jersey continue to record declining numbers of new infections as does the entire nation. A big announcement was made this week by Governor Phil Murphy, that the class of 2020 will have their opportunity to join their classmates, educators, and families to celebrate graduation starting July 6. Outdoor graduation ceremonies…
Adhesive Capsulitis
Adhesive capsulitis, also known as Frozen Shoulder), is a condition that impacts shoulder joint motion. The joint capsule becomes inflamed, irritated, and contracted. Adhesive capsulitis is uncommon in young people and is almost always found in patients ranging from 40-70. Those with metabolic disease such as diabetes are at greater risk. This condition is thought…
Weekly Newsletter 5_23_2020
COVID-19 has increased stress & uncertainty for individuals and families. This is import to recognize. A focus on the “controllables” is vital to healthy response to the isolation and ambiguity of what is to come next. As many athletes want to get back to their normal sports activities, we need to also remind them that they…
Mindfulness Update during COVID Pandemic
Hi everybody. Today I want to talk a little bit about waves of grief and the way in which we’re all dealing with this and pandemic and crisis where people are out of work isolated and lonely. I think it’s important for us all to find meeting in this crisis. I had a meeting…
Weekly Update for Schools 5/18/2020
Good morning everyone, Newly identified cases of COVID in New Jersey & New York State continue to decrease. Here at Columbia Orthopedics, we have some exciting news! As of Monday, 5/18 we will be re-opening our office for in-person visits according to Phase-1 guidance on a limited basis. As of Monday, May 18th, steps toward…
Phase 1 – (Returning to the Office)
As a first line of contact with our team, Columbia Orthopedics will continue to offer telehealth visit for patients. However, the offices will be reopening in a limited fashion on Monday, May 18th following guidelines which continue to enforce physical distancing. We want all of our patients to feel comfortable coming into the office when…
*SPECIAL COMMUNICATION
Suicide Awareness – by Mark Weidenbaum, MD & Thomas Bottiglieri, DO Mental health awareness requires a recognition that stigma is an obstacle. No one asks for disease of the mind, the same way a person would not ask for hypertension or rheumatoid arthritis. Like all diseases, environment and self-care influence disease. That doesn’t suggest that…
Visual Therapy After Concussion
“The eyes are the window to the soul.” They are also an excellent avenue for evaluating and treating concussion. There are measurable changes in ocular coordination that experienced concussion experts will look for when evaluating your concussion. There are muscles that move your eyes in controlled and coordinated ways. The brain pathways that control these…
COVID-19 Update
https://youtu.be/7YLn7Ce3egE Good morning everyone, With over 133,000 confirmed cases of COVID-19 in New Jersey and 300,000 in New York State, and a slowly decreasing rate of infection, we are looking to the future and starting to see a glimpse of hope. I encourage you all to get outdoors and get some vitamin D, and if…
Bearing witness
What does it mean to “bear witness” ? “Everyone can be great, because everyone can serve” – Martin Luther King, Jr. In this time of the COVID pandemic we are faced with the fear and uncertainty of what is and what will be. Many have used this as a call to action. At Columbia-Presbyterian we…
❤️️ Be Well. Stay Active.
During the COVID-19 Pandemic it is more important that ever for us to focus on the controllables in our lives. There is a significant benefit to exercise for immune system function at EVERY age. Below I will offer some suggestions and the latest from EIM for working and staying fit at home. Exercise is Medicine…
How to use the iPhone for step counting
Those that have an Iphone have access to the health app which can be useful during these times of pandemic. It has the ability to track your steps, stairs climbed, and running/walking distance. Open the Health app and click “Show All Health Data”. Tap on each of the Fitness categories and enable the three currently…
Update: Treatments, Exercise, Mental Health during COVID shutdown
Hey everybody, it’s been a little while since I recorded one of these and, there is lots of information to share. I’m going to start with herd immunity. Then we’re going to talk a little bit about some treatments, and then going into what you can do at home, what we can use, & how…
Allergies or COVID?
The recent weather & springtime blooming of trees & grasses has lead to an allergen response that has people confused as to an appropriate course of action. How can you know if the symptoms you have are allergies or COVID? The symptoms of COVID, caused by the SARS-CoV-2 virus, include headache, muscle aches, fevers, and…
The good and the bad, and the way to win
A special communication with Michael Deitrich co-authoring How can we beat the coronavirus? Does mindful breathing actually improve survival? What can we learn from this global moment of pause? The first gift we are given when we exit the womb is our breath. From the very first moment until the very last it is our…
PRP (Platelet Rich Plasma)
What is PRP?PRP = Platelet-Rich Plasma. Platelets are normal components of your blood that assist with blood clotting, and contain growth factors. Blood is made up of plasma (fluid), red blood cells, white blood cells and platelets. The growth factors found in platelets are essential for healing. The process of deriving PRP includes a centrifuge…
AIDS in 1983 v COVID-19
I trained in pediatrics with James Oleske, MD in 2007, my final year of residency. He was amongst the first in the world to report on the infectious nature of the disease he observed taking the lives of infants born to sick mothers in New Jersey. https://jamanetwork.com/journals/jama/fullarticle/386504 The time I spent with Dr Oleske changed…
There is Always an Opportunity for Gratitude
Today is a day I will not soon forget. I will keep this post short and sweet. For the next month I will be taking some shifts at New York Presbyterian at the front lines of the pandemic that now finds its epicenter in New York City. https://youtu.be/OLVKKD2vfz8 To say I am not at…
Persist into the unknown.
In any athletic endeavor there is a moment in which self-doubt creeps up. You start to move, your body becomes aware of itself, your breath deepens, sweat forms, muscles begin to ache with anticipation and fatigue, and then the voice in your head grows louder, “I can’t do this!” That voice is there for all…
Trajectory of Fear
Stop what you are doing for a moment. Take enough time and space to give yourself permission to be afraid, and then to awaken to the possibility that we are all in this moment experiencing something similar. In this moment we are doing what we need to do. And that can mean self-care. Time to…
Don’t get caught in the hype
Social media is a blessing and a curse. We have unlimited access to data and connectivity. With overwhelming voices it can be difficult to separate fact from fiction. Conspiracy theories somehow excite something inside of us, but the reality of the actual pandemic is harsh and it is necessary to be 100% present so that…
Working From Home
The pandemic COVID-19 is taking the world into uncharted territory. We have not had the experience in our lifetimes of a mass strategy of quarantine to the extent we are seeing in our nation and around the world. There has been a complete change in our routines and schedules requiring us to adapt quickly. My…
Stress is Trauma
As the COVID-19 pandemic becomes a reality we are being asked to make sacrifices and work together to prevent unnecessary deaths. While the United Kingdom is experimenting with a herd immunity strategy, containment and mitigation are the strategies the United States is engaged in at the recommendation of the World Health Organization (WHO). Italy had…
COVID_19
While my practice is sports medicine, assessing risk and understanding multiple variables, competing interests, and population risk versus individual risk are things I consider everyday. It has been two years since my last blog post and it is a good time to get back into writing about sports medicine. Outdoor activities, free play, & physical…
Athletic Pubalgia
Sports Hernia is a term that has evolved with emerging knowledge regarding the anatomical causes of athletic hip, groin, and lower abdominal pain. The most commonly injured athletes are soccer, hockey, gymnastics, & dance. Athletes generally complain of pain that is not well localized to the groin and lower abdomen and often begins insidiously. Some…
Experiencing Pain (Mindfulness)
A conversation with your doctor about a chronic medical condition might include the suggestion that stress is a contributing factor. For people experiencing chronic pain this is likely true as well. Of course our perception of pain and relieving its source is an important tool in survival, but not all perceived pain benefits our survival. …
Single Leg Squat for Patella Femoral Pain Syndrome
The term that is used to describe the conditions associates with anterior knee pain from insult to the cartilage is chondromalacia patella, which literally means sick cartilage of the kneecap. For many patients pain at the anterior compartment (front part of the knee) starts in adolescence and persists into adulthood, and can even lead to osteoarthritis.…
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…
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…
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…
Thomas S. Bottiglieri, D.O. 