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From the Desk of LK Orthopedics


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Winter Exercising Injuries


Winter Exercising Injuries


Winter in Michigan is here to stay, at least for now that is. Some individuals choose to stay indoors during the frigid months or even take their New Year's workout regimen to the gym instead of subjecting themselves to the bitter cold. Trying to find the motivation to squeeze a workout into a busy day is already tough enough without freezing winds and piles of snow, creating additional willpower roadblocks. However, for those dedicated to tough out the winter air, there are some key factors to staying safe and injury free.


Common Winter Injuries:


  1. Falling on the ice or snow
  2. Muscle strains or tendonitis from shoveling snow
  3. Motor vehicle collisions
  4. Fractures and sprains while playing winter sports


Not all injuries are considered severe; for the elderly falling and breaking a hip could be catastrophic. 

Winter Injury Prevention Tips:

  • Regularly salt driveways, sidewalks, and stairs.
  • Walk carefully across parking lots; provide children and seniors with additional support.
  • Stay hydrated while exercising and shoveling snow.
  • Ensure proper foot wear, gloves, and a hat when shoveling snow or cleaning off the car.
  • Wear a helmet and protective equipment during winter sports.
  • Always supervise children playing outdoors in the snow.
  • Most businesses and shopping centers take precautions to salt their parking lots and sidewalks once winter hits. Even still, patches may be missed, or ice may have formed since the last salting. When rushing into the stores and shopping centers, slow down and take your time to carefully walk across the parking lot.










Winter Exercising

Winter Exercise


         Overview of the basics:


  1. Dressing in layers: Whether you are going for a stroll or plan to run for miles, staying warm and not overheating is an essential part of your everyday activity regimen. From ski pants to thermal under layers, the variety of clothing to keep warm is endless. How do you decide what is right for your exercise routine? If you plan to break a sweat, layering with a thermal under layer that is specifically designed to pull moisture and sweat away from the body is a great way to keep your body temperature even. If sweating isn't in your game plan for the day, make sure to bundle up with a warm jacket and even snow pants.


  2. Protect your extremities: Those fingers and toes are important to everyday life, make sure you utilize gloves and warm socks or even insulated boots to protect them! Wearing a hat in the frigid cold has shown to help maintain your core temperature, so don't forget to cover your head!


  3. Staying Hydrated: Some may forget the importance of hydration due to the cold. If you are out for a run the snow sure doesn't seem like the cleanest way to rehydrate, make sure you have a water bottle close by for drinking.


  4. Know the signs of Hypothermia and Frostbite: When your body tissue begins to freeze, frostbite sets it. The first signs are tingling, stinging, and numbness on exposed skin such as your fingers, nose,  face, and ears. Hypothermia on the other hand is when your core temperature drops, which typically happens after being in the cold too long. Even though your bundled up, hypothermia and frostbite are still possible!


  5. Line of communication: Some people take a jog on the side of the road while others prefer to run through the woods. Unfortunately, if you get injured or take a fall there may not always be someone to flag down for help. Keep your phone on you, and let a family member or friend know where you plan to be with an estimated time of arrival back home.


  6. Know when it is just too cold: Negative ten degrees? If the internal debate arises that it could be, "just too cold" know your limit! Whether you take your work out to the gym, keep it at home, or use an indoor track, there is nothing wrong with avoiding the chill of the outside air. Bust out an old exercise video or come up with a new and improved gym routine until the warmer weather resurfaces.





6 FAQ'S for Stem Cell Therapy
6 FAQ'S for Stem Cell Therapy
Stem cell therapy is an exciting area of research that holds tremendous potential for helping chronic pain patients reduce their pain. Rapid advances in this field of medicine are buoying doctors’ and patients’ hopes that the exciting therapy could change lives. Advances are being made nearly every day, and as scientists further understand the nature of these cells, even more uses for them are becoming known. If you’ve ever wondered about how stem cell therapy could help you, these 15 questions delve into how this therapy works and who it could be used for.

What is stem cell therapy?

Stem cell therapy, also known as regenerative medicine, promotes the reparative response of diseased, dysfunctional or injured tissue using stem cells or their derivatives…Researchers grow stem cells in a lab. These stem cells are manipulated to specialize into specific types of cells, such as heart muscle cells, blood cells or nerve cells. The specialized cells can then be implanted into a person.”

What’s the difference between stem cell therapy and regenerative medicine?

Stem cell therapy is a type of treatment within the larger umbrella of regenerative medicine. Our longer post on regenerative medicine discusses the types of treatments available, including stem cell therapy and platelet-rich plasma injections.

What is a stem cell?

Stem cells are essentially blank canvases that can transform into any type of cell in the human body. Specialized cells like bone cells, liver cells, and heart cells begin as stem cells. The process of the cells transforming from blank slates into specialized cells is called differentiation. Stem cell therapy is the process of injecting these cells into damaged areas of the body, such as arthritic knees or shoulders. The stem cells then differentiate into damaged tissue, helping to regenerate the entire area.

Where do stem cells come from?

In adults, stem cells are present within a variety of tissues and organs.  The most common and richest source comes from your bone marrow, and your hip bone is one of the best and most convenient locations to withdraw bone marrow.

How are adult stem cells obtained, prepared and delivered?

During your adult stem cell therapy procedure, the doctor will use a needle to withdraw bone marrow from your posterior Iliac crest (lower back area).   A trained nurse or technician then uses specifically designed equipment to concentrate the adult stem cells and growth factors present in the bone marrow and provides the cells back to the physician for implantation into the targeted area(s).

How does stem cell therapy for pain help?

Stem cell therapy is being studied for many chronic pain conditions, especially pain in the: knees, back, hips and elbows.

What can stem therapy treat?

-Knee injuries (MCL, ACL, PCL or LCL sprains or tears
-Hip or Labral Tears
-Shoulder damage (rotator cuff, tendinitis in the shoulder)
-Wrist, Elbow and Ankle damage and pain
-Foot pain
-Planar Fasciitis

Essentially, if you have damage to a ligament or lingering pain to a specific area of your body, stem cell therapy can help. It is the best non-invasive regenerative therapy available and a groundbreaking advancement.
While adult stem cells have been used for decades to treat a variety of diseases, their application in the treatment of pain is relatively new.  Because of this, insurance companies do not currently cover the therapy.

Speak to the doctors at Lederman Kwartowitz Center for Orthopedics & Sports Medicine about costs and your treatment plan for stem cell therapy.

Fall Sports Injury Prevention
Fall Sports Injury Prevention

Here is a blog I wrote a while back about Sports Injury Prevention.  Not much has changed since I wrote this article, other than the trend of coaches and trainers incorporating Yoga into their weekly warm up routine.  This has been proven to increase flexibility, strength, and agility - effectively preventing injuries.

Here is a reprint of an article recently featured in USA Today about Sports Injury August 11, 2017.

One of the biggest youth sports injuries can be prevented

                                                                                                                 (reprint from USA Today August 11, 2017)

According to the Centers for Disease Control and Prevention, more than 2.6 million children ages 19 and younger are treated in emergency departments each year for sports and recreation-related injuries. And those are just the incidents that make it to the ED.

The injuries fall under the terms traumatic or non-traumatic (overuse injuries that develop over time), but that’s not to say one is less of a problem than the other.
“Some injuries are just a part of playing sports, but there are a good number of things we can prevent,” said Christopher Brown, M.D., sports medicine medical director for Rochester Regional Health. “Overuse injuries are responsible for up to half of all sports injuries in middle and high school kids.”

Prevention and proper treatment are key—but in the real world, it’s not that simple.

Trauma drama

“The youth sports injuries that typically occur are concussion, shoulder dislocation, and knee and ankle sprains and strains,” said Gregg T. Nicandri, M.D., an orthopedic surgeon and assistant professor in the University of Rochester Medical Center Division of Sports Medicine.

But in recent years, it’s the concussion debate that rages on, especially among parents concerned about lasting effects. According to the New York State Department of Health, “every year, about 4,000 New York children age 19 and younger are treated at hospitals for sports-related traumatic brain injuries.”

Awareness has helped. The likelihood that a concussion will be reported and treated is improving, said Robert O’Malley, president of the New York State Athletic Trainers’ Association.

“Definitely, there has been an increase in reported symptoms both to athletic trainers at schools and to parents. In addition, fewer parents are objecting to their children being removed from play due to a reported symptom compared to the past.”
Experts agree that rest is critical to recovery. “Rest” is defined as both physical and cognitive, which means eliminating or limiting reading, screen time, loud or bright environments, work and any aerobic or other physical activity that results in increased symptoms.

The problem is, many players get frustrated when they can’t jump back on the field. “Modified and high school athletes must complete a ‘return-to-play’ protocol even if they only reported symptoms of a head injury, as opposed to a physician giving a diagnosis of a concussion,” O’Malley said.
Injuries are a part of sports, but experts say that more can be done to prevent them.

According to the University of Rochester Medical Center, “most people recover completely from a concussion in a matter of days; however, it can take up to a year or longer for some athletes to recover.”

Players want to get back in the game. But a concussion that’s ignored can result in ongoing cognitive symptoms that affect academic performance. An untreated concussion is also associated with mental health challenges, including depression and anxiety. And a subsequent brain injury before a concussion has healed can lead to permanent damage or death.

But detecting concussions isn’t simple. Some players want to “shrug it off” and keep playing if they think it might not be an actual concussion. So scientists — including Jeffrey J. Bazarian, M.D., an emergency medicine physician at UR Medicine who has gained national prominence for his research — are trying to develop definitive, on-field blood tests, and also determine how brains recover from a concussion.

Another traumatic injury affecting more and more athletes is major damage to the knee.
“The biggest trend I see currently is an epidemic of ACL injuries,” said Dr. Nicandri. The ACL is the ligament that stabilizes the knee when planting or pivoting. “An ACL tear is something that usually requires surgery to repair and typically requires a year-long recovery, which is devastating for somebody who is a high school, collegiate or professional athlete,” Dr. Nicandri said.

According to the American Academy of Orthopedic Surgeons, about 70%of sports-related ACL injuries happen through movements like pivoting, cutting, sidestepping and awkward landings, while about 30% result from collisions with other players.
Overuse it and lose it
Doctors are reporting a significant rise in preventable sports injuries among young athletes.

“What we’ve seen in the past decade is an increase in what we call overuse injuries — kids doing too much, too fast, too often without enough rest,” Dr. Brown said. “Kids involved in sports and recreation under the age of 14 are skeletally immature — they are not done growing. They are much more vulnerable to overuse and the lack of rest.”
Stress fractures, tendonitis, jumper’s knee, tennis elbow and shin splints are a few of the common overuse injuries experienced by young athletes. Even more problematic, overuse can also make a young athlete more vulnerable to a traumatic injury.

O’Malley observed that children playing one sport year-round and on multiple teams “leads to less rest and more muscle fatigue, even in children who seemingly have unlimited energy. The muscle fatigue can result in poor mechanics, and that usually results in injury,” O’Malley said.

Over-training is something coaches, athletic trainers and medical care providers are keeping an eye on, as well. Athletes who are approaching the over-training stage experience “prolonged muscle soreness, greater fatigue — and throwing athletes will notice decreases in velocity or accuracy,” Dr. Nicandri said. “With pitchers, it’s often grip strength that decreases.”

Dr. Nicandri warns that a young athlete can get into a state of over-training “where the muscle tissue breaks down and structurally changes to the point that, even with maximum rest, the damage can become permanent.”

The risk of both overuse and over-training injuries increases as younger and younger athletes specialize in a single sport. “Back when young people played three sports, they exercised different muscle groups in different ways and kept muscle balance throughout the body,” Dr. Nicandri explained. “With specialization, young athletes do the same thing over and over, the body system can get out of balance, and that’s a prime cause of injuries such as stress fractures, tendonitis and rotator cuff impingement.”

“In the event of an overuse or over-training injury, the affected area usually responds to rest, ice, elevation and compression,” Dr. Brown said. “Rest is part of the recovery process in anything we do, particularly as we are preparing to compete,” he said. “Our bodies need time to recover and make those strength gains.”

Dr. Brown observes that children being active in sports and recreation year-round “isn’t bad, if they are doing different things and engaging in different sports.” The risk, he said, is that “if kids engage in only one sport, then they don’t give that one body part time to rest. That’s when they get hurt.”

The most important element of recovery from any injury is to follow the advice of doctors, physical therapists and trainers. And don’t take injuries too lightly.

So how serious is it?

For many families with active kids, injuries are a part of life — a temporary interruption of an otherwise active lifestyle. But even apparently minor injuries should be watched carefully.

“If you catch an overuse injury—tendonitis, a sprain—it can be temporary. But if the injury goes on untreated, it can cause permanent damage,” Dr. Brown explained.
Even a stress fracture that is not allowed to heal can bring consequences. “Every once in a while, you’ll see somebody running and all of a sudden their tibia snaps due to a stress fracture. That’s a worst-case scenario,” Dr. Nicandri said.

“The issue with ACL tears is, we can fix the ligament and provide stability to the knee, but that injury can lead to big problems later on, mostly in the form of arthritis,” Dr. Nicandri explained. “We know there is a 50 percent chance you are going to go on to get arthritis within 20 years.”

Over-training is risky, too. “Once you reach a certain threshold of muscle injury or muscle change, sometimes the body can’t fix it again,” Dr. Nicandri explained. “When I see athletes heading in that direction, I throw up the red flag and try to make them understand, because there is nothing more frustrating than having to tell a patient, ‘This is something we can’t fix.”


How do young athletes avoid many of these negative outcomes? Preventing injury in the first place.

For example, preventing the most severe consequences of concussion is a growing priority.

“We know that the most at-risk time is the young, developing brain,” Dr. Nicandri said. “We are especially concerned about multiple, cumulative concussive blows.”

A key preventative measure is immediate removal from play, which research shows can speed recovery time and reduce the risk of re-injury.

“Everyone involved in a game, practice or physical education class can report a suspected head injury and have the child removed from the activity,” O’Malley said. “This includes the coach, athletic trainer, nurse, referee, teacher and school officials. This comes from the New York State Concussion Act of 2011.”

ACL injury prevention programs have also shown great results. “A lot of foundational exercises that focus on identifying movement dysfunction, core and hip control — especially during lower body deceleration — will reduce the rate of ACL injuries,” O’Malley said.

Dr. Nicandri agrees. “We found that we were able to decrease the rate of ACL injury by about 70% in the group of athletes that did the program.”

O’Malley said, “It cannot be looked at as a ‘six weeks and done’ part of training. For sports teams, the program needs to be included as part of a daily warm-up, with some specific exercises added weekly to challenge each athlete.”

Many sports and recreation injuries can be prevented by focusing on general health and fitness, using the right equipment, and allowing the body to rest. Dr. Brown recommends a strength-and-conditioning routine. “Just like nature, our bodies like balance between strength and flexibility in muscle groups, and it’s extremely important as our kids age and get into higher-level sporting activity.”

In addition to proper nutrition and good hydration, Dr. Nicandri urges young athletes,
in particular, to get enough sleep.

“Deep sleep is when growth hormone levels spike and you get the most muscle repair and recovery. The body does most of its healing while you sleep,” he said. “And poor sleep increases the risk of injury.”

6 Benefits of Physical Therapy
6 Benefits of Physical Therapy
What Is the Role of a Physical Therapist?

After a sports injury or other injury, many doctors send their patients to physical therapy to help them make a full recovery. But what exactly does a physical therapist do to heal your injured body?

Lederman Kwartowitz Center for Orthopedics & Sports Medicine trained and certified, physical therapists alleviate pain and stimulate movement in patients’ bodies to help them perform functional and everyday activities. Some physical therapists treat a broad range of patients with different injuries, while others specialize in a physical therapy. In any case, a physical therapist is there to help you gain strength, stretch muscles and ease the pain

Physical therapists are used in various locations including physical therapy offices. They spend their days working with patients on a day-to-day basis. In hospitals, they work with patients who have severe injuries and need immediate attention to regain body function.

Before developing a plan for rehabilitation, a physical therapist consults with a patient about their accident or injury and the symptoms they are having. After conducting a thorough examination that includes tests, physical therapists stretch, move and massage the injured area. They also teach students proper exercise techniques to restore, maintain and promote body function and physical wellness. With each treatment, physical therapists perform re-examinations to determine progress and modify the treatment plan accordingly so that the patient can reach their goals.

6 ways it may benefit you:
  1. Reduce or eliminate pain

  2. Avoid surgery

  3. Improve mobility

  4. Recover from or prevent a sports injury

  5. Improve your balance and prevent falls

  6. Manage age-related issues

Sports Injuries - 3 Reasons to See a Doctor
Sports Injuries - 3 Reasons to See a Doctor
Sports Injuries and why you need to be seen by a Doctor

The body is an amazing machine, working hard to keep you mobile and thriving no matter what. Sometimes sports injuries, chronic pain, or conditions such as arthritis arise, causing pain and limiting your mobility in an instant, though it may also occur slowly over time. These shifts in the way the body moves and responds are often subtle, yet wreak havoc on your mobility and pain response. Offering on-site rehabilitation, with expert physical therapist. The experienced team of physical therapists create personalized treatment plans matched to the patient’s specific symptoms, to regain movement without pain.

Collaborating with Lederman Kwartowitz Center for Orthopedics & Sports Medicine to achieve optimum patient outcomes, the physical therapists understand how important independence and ability to control one’s own body is to the patient. Whether the therapy is necessary for an upcoming procedure, rehabilitation after surgery, heal a sports injury or other trauma, or to reduce fibromyalgia or other pain, the goal is to help you regain functional mobility.

Three common sports injuries are:
  1. Strains & Sprains: While strains are essentially pulled muscles that have been stretched too far, sprains can occur when a ligament is torn. Both injuries have varying degrees of severity, but they should never be ignored.

  2. Knee Damage: The knee can be a sensitive area for many athletes, especially runners. If athletes run too hard or turn the wrong way, they can suffer from excruciating knee injuries. The following four major ligaments are most commonly wounded during sporting activities: posterior cruciate ligament, medial collateral ligament, anterior cruciate ligament , and lateral collateral ligament.

  3. Dislocations: The force from an activity can push the body’s bones out of alignment. This type of sports injury is most common in athletic activities like football, where players typically stretch, fall, and get hit frequently. While the actual bone can be moved back into place by a doctor, the surrounding tissue may require significant physical therapy for the area to properly heal.

4 Indicators That Your Workout Has Gone Wrong
4 Indicators That Your Workout Has Gone Wrong
Your workout is going great, and then suddenly something feels off.  You feel a pain, a tingling sensation, or a wave of nausea comes over you. Or maybe you don’t feel anything until later, in the form of soreness or shin splints or even swelling. Whatever the symptoms may be, the cause is likely that you’re doing something about your workout wrong.

At Lederman Kwartowitz Center for Orthopedics, our goal is to keep you doing what you love to do safely. Beware of the following signs that your activity could be harmful to your body.
  1. You’re Super Sore the Next Day:  A little soreness can be good, but if you’re so sore you can’t move, you need to tone your workout down a bit.

  2. Your Feet Keep Falling Asleep:  This is a typical problem of gym goers who like to multitask during their workouts. Possibly you are on the treadmill, the rower and you are watching a movie or reading a book. Distractions can cause you to focus less on your form which makes your feet fall flat and asleep.
  3. Shin Splints Turn Your Run into a Hobble:  This is another problem runners can experience. If your shins are begging for mercy, it may be because you have suddenly increased the duration or intensity of your runs. Other possible explanations include using the wrong shoes or running exclusively on hard surfaces. Instead of trying to improve by huge leaps increase a little each week.
  4. Cramps are Cramping Your Running Style:  If you’re cramping when you exercise, it’s likely you didn’t wait for food or drink to be digested before you started. Other causes could be dehydration or breathing that is too shallow.  Eat 1-2 hours before so that you are fueled but not still digesting your food and drinking water throughout the day and not just when you’re active will keep you properly hydrated.

5 Reasons Why Your Knee May Hurt
5 Reasons Why Your Knee May Hurt
Why does my knee hurt?

Most people have experienced knee pain in their life, but how server and how long depends on the complexity of the condition.  Here are five possible conditions that are common sources of knee pain:
  1. Bursitis:  Inflamed bursae may cause knee pain in some people. Bursae are small pockets of fluid that lubricate the tendons of the hips, shoulders and knees for them to move freely along joints. Pain from bursitis builds up gradually or can be sudden and severe, especially if calcium deposits are present.

  2. Knee Ligament Injuries:  The ligaments are what connect your thigh bone to your lower leg bones; they hold your bones together and keep the knee stable. Knee ligament sprains and tears are very common sports injuries, and can occur to the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL). These injuries cause significant pain, and they require medical attention and oftentimes surgery.

  3. Patellar Tendinitis:  If you have this condition, you have inflammation in the tendon that connects the kneecap to the shinbone.

  4. Osteoarthritis:  Commonly known as “wear and tear arthritis” – may affect men, women and children, with women over the age of 55 at the highest risk.

  5. Damaged Meniscus:  A torn meniscus is one of the most common knee injuries in adults. If too much stress is placed on the knees, the meniscus may tear, which can cause pain and interfere with the knees proper functioning. A torn meniscus causes pain, swelling and stiffness. You might also feel a block to knee motion and have trouble extending your knee fully.

15 Questions to Ask your Orthopedic Surgeon
15 Questions to Ask your Orthopedic Surgeon
Lederman Kwartowitz Center for Orthopedics & Sports Medicine provides you and your family with the finest orthopedic care available, including fractures, athletic injuries, and chronic conditions.

We specialize in arthroscopic surgery and joint replacement of the knee, hip, and shoulder, using minimally invasive surgical procedures and MLS laser therapy to reduce pain and recovery time. MLS laser therapy kick starts the healing process after surgery and benefits patients with chronic pain and swelling. Additionally, our staff has extensive experience helping patients with work or automobile-related injuries.

If a physician has told you that surgery is needed, here some of the top questions to ask your orthopedic surgeon:

  1. Are you Fellowship Trained in Orthopedics?
  2. How much improvement can I expect from my surgery?
  3. Will you provide me with either written materials or videotapes about this surgery and/or other pre-operative counseling?
  4. What type of anesthesia will be used and what are the risks?
  5. Which, if any, medications will I need to stop taking prior to surgery?
  6. How long will I be in the hospital and will I need to go to a rehabilitative center after the surgery or will I be able to go home?
  7. What are the signs of these complications?
  8. On average, how many of these surgeries are done annually at the hospital with which you are affiliated?
  9. How soon after surgery will I start physical therapy?
  10. How much post-operative pain can I expect and what medication will I be given for pain?
  11. Will I need to arrange for any type of at-home assistance and if so, for how long and will my medical insurance cover this?
  12. What are the risks involved with this type of surgery and how common are they? What types of complications might occur after surgery?
  13. What limits will there be on activities, such as bathing, driving, diet and other routine physical activity and if so for how long?
  14. How long will I be out of work and when can I drive?
  15. For how long and how often will I need to return for follow-up visits?

Get outside and Get Moving
Get outside and Get Moving
The sunshine is coming with warm weather. Time to move your workout from the gym to the outdoors.

Michigan weather keeps us trapped indoors for many months, try these five tips to help make your transition from inside to outdoors a safe and rewarding one.
  1. Start by viewing the world as a big outdoor gym. Enjoy the fresh air, a change of scenery and be creative! Plan a new walking route, find a peaceful hiking trail or join an outdoor pool.  
  2. Learn your route beforehand. Whether you decide to power walk down the city streets or mountain bike along a remote wooded trail, the distractions of your surroundings take your mind off the work of working out.
  3. Transition from treadmill to terrain. Now that you have your route or activities in mind, understand that walking or running on uneven surfaces engages more muscles, particularly the ones in your feet, ankles and shins.
  4. Suit up right. Regardless of the temperature, wearing properly fitted, supportive clothing and sneakers is crucial for any outdoor workout.
  5. Find your group to keep you motivated. If you need some added structure to help you get out the door, check out your local community centers and your department of parks and recreation for free or low-cost memberships to pools, tennis courts and more.

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