New Year, Real Expectations!

As this year departs, and a new one touches down yet again, your social network feeds must be absolutely swamped with all sorts of generally cheesy ‘New Year, New Me’ captions and sound bites. Of course, there’s nothing wrong with a bit of optimism and renewed sense of positivity at all.

Yet, people often have unrealistic expectations. We all know that one person who goes through a pack and a half of Marlboro Reds and says he or she is ‘Gonna quit!’, or how about your couch potato mate whose swears he’s going to  “run the Shanghai Marathon” in 2018. Lucy could actually quit her chain-smoking and take up Bikram Yoga, and old Lee might just about finish the Shanghai marathon quicker than Mo Farah, but as we all know, the key to meeting your expectations is first and foremost to set realistic ones.

Here are a few REALISTIC health and well-being solutions as an alternative to last year’s great, yet ultimately failed expectations!Read More

  • Carpe Weekly!

Take it one week at a time. It’s much easier to plan to go running three times this week than vow to run three times a week indefinitely. If you make your fitness goals week by week, rather than for long into the distant future, you’ll have more success, and that in itself is motivating.

Tips: Go for a medium-intensity 3k run, and then reward yourself with a nice, cold pint after. Build your distances up fortnightly by a kilometer each time, and see where that takes you!


It’s all well and good putting yourself through a tough workout, but if you’re many others, you probably neglect this aspect of your fitness regime, even though stretching has major benefits. Stretching is the unsung hero of exercise that keeps your muscles flexible, free from injury and feeling fresh for your next planned workout.

Tips: When it comes to post-workout stretching, there are a 3 golden rules

  1. Instead of trying to stretch your whole body after every time you exercise, focus on a key area of the body each time.
  2. Always stretch your muscles after you have warmed up your body first, and perform each stretch gently, without bouncing or pulling.
  3. Breathe deeply throughout and pay attention to the sensations you feel in your body as you stretch.
  • H20

Whether you’re a serious athlete or simply exercise for recreation or even perhaps an ordinary human being in general, it is vital to stay hydrated. Water regulates your body temperature and lubricates your joints. It helps transport nutrients to give you energy and keep you healthy. If you’re not hydrated, your body can’t perform at its highest level. You may feel tired, have muscle cramps, dizziness, or other serious symptoms. This year, easy as it sounds, drink more water!

Tips: So how much fluid does the average, healthy adult living in a temperate climate need? The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is:

  1. About 15.5 cups (3.7 liters) of fluids for men
  2. About 11.5 cups (2.7 liters) of fluids a day for women

  • Plan to Sleep

We plan when we wake up in the morning, important meetings and even what we want to have for dinner, and yet most of us rarely think of falling asleep as actively doing something, so we don’t plan for it. Dr Holly Phillips, author of the Exhaustion Breakthrough says that “when you put sleep in your calendar, it becomes a priority, the same way your gym time and work meetings are priorities.”

Tip:  Set a reminder to go off a half hour before you plan to hit the sack.

  • Green is the Colour!

“Finish your vegetables!” often screeched not spoken, has been heard by generations of children, since mankind first established its huge nutritional role in maintaining health and wellbeing. 2018 is the time to actually take it seriously.

Tip: “Instead of making an ‘I want to lose weight’ pledge, try “I’m going to put more fruits and vegetables on my plate, so the resolution is a positive action that you can perform over and over.” says Joy Bauer, a New York City-based nutritionist.

We hope these tips will get you prepped and primed for 2018. Wishing you a happy new year, with realistic expectations, which will hopefully not just be met, but surpassed by this time next year!


Plane Pains — Spine and Leg Preventative Care for Airline Travel

With the upcoming holidays, many people will be taking long flights.  While air travel is safe, fast, and convenient, it can be stressful, both mentally and physically.  Flights are usually full, seats are smaller, and leg room is more restricted.   So to minimize discomfort and the possibility of illness and injury, we suggest the following strategies.


Try to keep your luggage and carry-on small and light.  Not only will you get through the airport quicker, you’ll be less likely to injury yourself by lifting heavy bags.

Pre-hydrate. The air in the cabin isn’t humidified very much, which can contribute to chapped lips, dry nasal passages, skin that feels papery, and an increased likelihood of blood clots.  Start drinking water at the gate.

Stretch to fight off aches and pains.  Perform these quick stretches for 30 seconds while waiting at the gate:

  • Standing calf stretch;
  • Heel to buttocks hip flexor stretch;
  • Fingers to toes hamstring stretch;
  • Seated twist back rotator stretch;

Take some deep breaths.  When you find out your flight is delayed – or worse -, it is easy to become stressed which can have a detrimental effect on your immune system and health.  Remind yourself to breathe deeply during stressful situations  – it will help calm your mind, lower your stress level,  and often help prevent a bad situation from getting worse.


On long flights we tend to remain seated for extended periods of time which can cause muscle stiffness and pain, and in susceptible individuals, prolonged periods of immobility can slow down blood flow in the leg veins.  This can lead to ankle swelling and, in predisposed individuals, increase the risk of blood clots to form inside the veins, known as Traveler’s Thrombosis.

Traveler’s Thrombosis manifests as pain and/or swelling in the legs during travel or even several days or weeks afterwards.  It can be a serious and, on occasion, a life-threatening situation if a clot breaks off and travels to the lungs causing what is called a pulmonary embolism.

  • Wear loose clothing (conversely, avoid tight, restrictive garments);
  • Place nothing under the seat in front of you, for more leg space;
  • Keep yourself hydrated by drinking water while minimizing alcohol, sugary and caffeinated beverages;
  • Try to stand as often as possible. Reach for the ceiling, for a good stretch. Continue your pre-flight stretches;
  • Stretch, and periodically exercise your feet and ankles while seated;
  • The muscle pump: squeeze your toes, then pump your ankles, squeeze your calves, tighten your quads, flex your butt in the seat; follow this sequencing to help return blood back to your heart;
  • Tummy tucks: sit up straight and engage your abdominals by sucking in your belly button;
  • Sit with a pillow or rolled up sweater behind your back for extra support;
  • March in your seat: hold a neutral posture with your abdominals engaged and march your legs.

Follow these easy steps and you’ll arrive health and happy. We at IWS wish you safe holiday travels!

Knee Pain Relief without Surgery

Do you have knee pain?  There are some facts you need to know.

  • Knee pain is a common problem with many causes ranging from acute injuries to complications of medical conditions.
  • Knee pain can be located in a specific area of the knee or be diffuse throughout the knee.
  • Knee pain is often accompanied by physical restriction.
  • A thorough physical examination will usually establish the diagnosis of knee pain.
  • The treatment of knee pain depends on the underlying cause.
  • Most knee pain can be treated without surgery.  A sports or pain medicine doctor can offer you cutting edge treatments to help you avoid surgery.

What kind of treatments are used for knee pain?

About 80 percent of all knee problems can be treated without surgery. There are many types of conservative treatments for knee pain. Sometimes the wide variety of choices can be more confusing than helpful. Your sports and pain medicine doctor will work with you to help determine which ones are most likely to be beneficial for your condition.

  • Rest, ice, compressive wraps and elevation are usually recommended for acute knee pain.  Avoiding or reducing aggravating activities and losing weight are good strategies for chronic pain.
  • Medications. These can range from over-the-counter supplements, muscle rubs and pain relievers to prescription anti-inflammatory pills and creams and other categories of medication.
  • Exercises. Strengthening of muscles around the knee is important but treatment also involves correcting muscle imbalances, weakness, or alignment problems of the lower back, pelvis, hip, or lower extremities.  Strengthening hip and abdominal muscles could correct abnormal alignment of the low back, hip, and pelvis and relieve knee strain. Appropriate flexibility exercises may also be used. Your sports medicine doctor may show you how to do these exercises or direct you to a physiotherapist.
  • Orthotics may be helpful for those who pronate excessively (or have flat feet), as this condition is thought to increase the risk for some knee problems. A good pair of well-cushioned walking shoes can help some conditions.
  • Bracing and taping can be effective in reducing pain severity, but do not cure the problem
  • Acupuncture can provide relief for arthritic knees, but again, does not cure the problem.
  • Injections. Patients today have more choices then ever when it comes to different injection techniques for the knee. The well-known steroid or “cortisone” injection directly into the knee is helpful for acute inflammation and is effective for relieving pain quickly. Lubricant (or hyaluronate) injections are intended to replace the joint fluid of arthritic knees. These injections don’t work as quickly as steroid injections at reducing pain, but they can provide longer lasting relief and are generally considered healthier for arthritic joints. Orthobiologics is an exciting new area that is rapidly becoming a good choice for certain knee conditions. This is a medical treatment that uses your own blood and cells for injection therapies. Platelet rich plasma (PRP) is an orthobiologic treatment that can be done in the office and has been found to be as effective as hyaluronate injections.


5 Tips for Preventing Sports Injuries in Kids and Teens

Young athletes today are often participating in their favorite sport year-round. However, more time on the field brings a greater risk of experiencing sports-related injuries, like ACL and meniscus injuries in the knee and growth plate injuries in the shoulder and elbow.

IWS orthopedic and sports medicine surgeon Dr. Frank DiFazio provides these 5 injury prevention tips to help keep your young athlete off the sidelines:

  1. Talk with your young athlete

Make sure your young athlete understands that he or she should talk with you and seek help if experiencing pain or something that doesn’t feel right. “Some kids just push through pain and this can lead to a more serious condition that could have been prevented with earlier intervention,” says Dr. DiFazio.

  1. Encourage cross-training and a variety of sports

Parents should consider limiting the number of teams their athlete is on at any given time and changing up the routine regularly so that the same muscles and tendons are not overused.

  1. Stress the importance of warming up

Stretching is an important prevention technique that should become habit for all athletes before starting a sport or activity. A mix of both static and dynamic stretching during warmups helps to loosen the muscles and prepare them for play. Toe touches and stretches where you hold a position for a certain amount of time are considered static. Jumping jacks and stretches where the body continues to move during stretching are considered dynamic.

  1. Make sure they rest

Athletes of all ages need to rest between practices, games and events. A lack of sleep and muscle fatigue predispose an athlete to injury. In fact, the most common injuries seen in young athletes are overuse injuries: too many sports and not enough rest. Dr. DiFazio suggests parents should plan an offseason for their athlete allowing him or her adequate time to recuperate before the next season.

  1. Recognize injury and get help early

If parents (and/or coaches) notice that there is a change in their athlete’s technique, such as a limp when running, throwing differently or rubbing a leg during activity, they should consult with an athletic trainer or coach and find out how long the problem has persisted and make sure activity is curtailed.  If the problem persists or is accompanies by significant pain, parents should seek assessment for their child with an orthopedic sports medicine specialist prior to allowing the child to resume play.

“I have seen many young athletes who have had ignored their symptoms allowing their condition to progress prior to seeking treatment,” says Dr. DiFazio. He warns: “We need to get these kids in to see a doctor earlier to prevent this from happening.”

When to see an orthopedic sports medicine specialist for your young athlete’s sports-related injury:

  • Consistent pain during or after sports
  • Persistent or new swelling around a joint
  • Recurrent instability – joint “gives way/buckles”
  • Painful pops (non-painful pops are OK)
  • Pain that does not respond to a period of rest

Sitting Down for Hours Speeds up Aging

Elderly People who spend most of their time sitting down age significantly quicker than more active contemporaries, according to new research.

A study of 1,500 pensioners found those who kept to a sedentary position for ten hours or more a day and who did less than 40 minutes moderate physical activity had the bodies of people eight years older.

They were discovered to have shorter telomeres, the tiny caps found on the ends of strands of DNA which protect chromosomes and which are associated with faster aging.

Experts have said the research represents a “wake-up call” for Britain’s growing elderly population and that pensioners should aim to stand up and walk around every 20 minutes if they can.

“People don’t realize that if you sit down all day it can undermine all the exercise you do,” said Professor James Goodwin, head of research at Age UK.

Current Government advice recommends 150 minutes of moderate aerobic exercise a week for older people, however this latest research suggests the benefits from that amount of activity can be easily undone by a sedentary lifestyle.

Published in the American Journal of Epidemiology, the study describes how participants aged between 64 and 95 wore devices on their right hip nonstop for seven days to record their movements; they subsequently completed a questionnaire.

“Our study found cells age faster with a sedentary lifestyle,” said Dr Aladdin Sahdyab, the lead author from the University of California.

“Chronological age doesn’t always match biological age.

“Discussions about the benefits of exercise should start when we are young, and physical activity should continue to be part of our daily lives as we get older, even at 80 years old.”

As cells age, their telomeres naturally shorten and fray, but health and lifestyle factors, such as obesity and smoking, are believed to accelerate the process.

Shortened telomeres are also associated with cardiovascular disease, diabetes and major cancers.

“If you’re sitting down for prolonged period of time, getting out of your seat every 20 minutes and walking about for 2 or 3 minutes is probably very advantageous,” said Professor Goodwin.

“It could make a big difference to your long term health, to your risk of chronic illnesses and could help to slow down the rate of aging in your body.”

Previous research has indicated that prolonged sitting could be especially dangerous for women by raising their risk of developing cancer.

A study found that those two spent more than six hours a day sitting down were 10 per cent more likely to develop the disease compared to those who sat for less than three hours.

Stephen Ward, executive director of UK Active, said sedentary lifestyles were sending the aging crisis “into overdrive.

“With health and social care budgets stretched to the limit, it’s time to end our love affair with the chair and get people moving again,” he said.

“Health professionals need more support in signposting older patients toward activities, while care and residential homes should consider activity plans to get residents moving and reduce social isolation.

“It’s never too late to get active and simple things at home such as carrying the groceries, climbing more stairs and pottering around the garden can play a huge role in staying healthy and independent as we get older.

“But whatever age we are, keeping active is the surest way to look after our physical, mental and social health, adding life to our years and years to our life.”

IWS Partnership with the Andrews Institute for Orthopedics & Sports Medicine

We are pleased to announce that the Andrews Institute has formed a global orthopedic alliance with the Institute for Western Surgery (IWS) in China to expand its global reach.

Celebrating it’s 7th anniversary in China this month, IWS is the only Western specialty care practice treating expatriates living in China and offering China’s first sports medicine training program for Chinese doctors.

As a result of this new global orthopedic alliance with IWS, Andrews Institute Fellows now have access to be a part of this unique international practice opportunity.  We are aligning the top orthopedic and sports medicine surgeons to advance the provision of orthopedic care in China through the recently established IWS & Andrews Institute Global Orthopedic Alliance.

We encourage Andrews Fellows who share our interest in delivering outstanding patient outcomes, advancing surgical care, and working with local Chinese doctors to join our team of American surgeons working in a modern international outpatient setting in China.  Take advantage of the opportunity of a lifetime to treat American and European expatriates and train local Chinese doctors on advanced sports medicine techniques while experiencing the adventure of living abroad.