Nyack Fall 2021

HealthWorks F AL L 2021

LIFESAVING MEDICAL IMAGING

HEART ATTACK COMEBACK

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NOW OPEN: PEDIATRIC EMERGENCY DEPARTMENT BREAST CANCER AND YOUR GENES

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Montefiore Nyack Hospital Updates

SHOULD YOU GET GENETIC TESTING?

FROM THE PRESIDENT Dear Readers, As we continue efforts to end the COVID-19 pandemic and pause to reflect upon the 20th anniversary of 9/11, I can’t help but stand in awe at the bravery and resilience of our selfless first responders and frontline workers who risk their lives and personal well-being every day in support of the health and safety of our community. A huge thank you to each and every one of you!

While the year 2020 was memorable and historic for so many reasons, it also was the year that marked Montefiore Nyack Hospital’s 125th Anniversary. Battling the pandemic and having come full circle from those darkest and most difficult of times has, upon reflection, been a deeply humbling and extraordinary experience. We are happy to finally reach a point where we can host a formal outdoor celebration on September 30th at Palisades Credit Union Park in honor of this landmark moment in the Hospital’s history, our 125th Anniversary. We hope to see you there.

There are so many reasons to celebrate Montefiore Nyack Hospital at this time. Among them is the Hospital’s massive Transformation Project which has made tremendous strides toward completion with the full opening of the newly expanded FJ Borelli Family Emergency Center in July. This new facility, which includes a new Pediatric Emergency Department, enables our Emergency Medicine team to treat both our adult and pediatric patients in a comfortable space sensitive to their unique medical and emotional needs. Please go to pages 8-9 to read more about this novel facility.

For further inspiration, I encourage you to read our incredible patient story—how the Emergency Department and new Cardiac Catheterization Lab at Montefiore Nyack Hospital saved a young father’s life after a near-fatal heart attack and his journey toward a full recovery with the help of our Cardiopulmonary Rehabilitation Center.

If a year can be summed up in two words, I would say they are hope and resiliency. I can’t think of a better example of an organization living those two words than Montefiore Nyack Hospital and our team. We could not be more proud! With that, I wish you and all you hold near and dear a very happy and healthy fall and holiday season.

Stay well,

TO LEARN MORE, TAKE OUR 4-QUESTION QUIZ ON BREAST CANCER RISK AT www.breastcare.health/quiz

Mark Geller, MD President and Chief Executive Officer

facebook.com/MontefioreNyack @MontefioreNyack @MontefioreNyack To unsubscribe, please email us at publicrelations@montefiorenyack.org.

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@Montefiore_Nyack LinkedIn.com/MontefioreNyackHospital

THE BREAST CENTER AT MONTEFIORE NYACK HOSPITAL

EDITORIAL STAFF Lauren Malone, Sr. Dir. of PR and Marketing Rose Croke, Marketing Manager Briana Tolve, Marketing Manager Celia Vimont, Contributing Writer John Halpern, Cover Shot Photographer

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SURVIVING A ‘WIDOW MAKER’ HEART ATTACK

Former All-Ireland football champion Mickey Coleman receives lifesaving treatment at Montefiore Nyack Hospital.

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PEDIATRIC EMERGENCY CARE CLOSE TO HOME At our new Pediatric Emergency Department,

kids get the specialized care they need.

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HOW ADVANCED IMAGING IMPROVES CARE

Critically important for both diagnosis and treatment, the latest imaging technology leads to better outcomes.

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NEW TREATMENT FOR CHRONIC KIDNEY DISEASE Promising medications reduce risk of kidney

failure and more.

ON THE COVER: Prompt treatment saved the life of Rockland County resident Mickey Coleman.

Cover photography © John Halpern Photography.

2021

IN THIS ISSUE

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ARE YOU AT INCREASED RISK FOR BREAST CANCER? Understanding

your personal risk lets you act now to try to reduce it.

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4 TIPS FOR A SAFE RETURN TO FITNESS

Many have taken a break from exercise during the pandemic.

Here’s how to get back in shape, safely.

RECOGNIZING COVID-19 VACCINE DEVELOPMENT HEROES On June 2, 2021, Montefiore Nyack Hospital’s Medical Staff recognized the Pfizer Pearl River Research and Development Center for its heroic efforts developing in record-breaking time the COVID-19 vaccine that has already saved, and will continue to save, countless lives worldwide.

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SURVIVING A ‘WIDOW MAKER’ HEART ATTACK FORMER ALL-IRELAND FOOTBALL CHAMPION MICKEY COLEMAN RECEIVES LIFESAVING TREATMENT AT MONTEFIORE NYACK HOSPITAL.

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Greenberg notes. “When a person is transported by ambulance, the EMT team can notify the hospital that the patient is coming, so the Cardiac Cath Lab can be ready when they arrive,” he says.

LIFESAVING TREATMENT

Fortunately for Mickey, Montefiore Nyack Hospital’s Cardiac Cath Lab had just opened the previous month. “In the past, we would transfer patients with life-threatening heart attacks to another hospital with a Cardiac Cath Lab, and that would add 30 minutes to an hour of time before a lifesaving procedure to open up blocked arteries in the heart could be done,” says William Greenhut, MD, Medical Director of Emergency Medicine at Montefiore Nyack Hospital. “Now, the patient comes into the Emergency Department for immediate treatment, and we move them one level above to the Cardiac Cath Lab for an emergency procedure.”

When Mickey arrived at the Cardiac Cath Lab, Dr. Greenberg performed a procedure to open the blocked artery and place a stent, after which he was on a ventilator for several days. Dr. Greenberg placed a stent in a second artery the following week, and Mickey spent more than a week in the Intensive Care Unit.

REGAINING STRENGTH AND STAMINA Mickey met with exercise physiologists while still in the hospital and started cardiac rehabilitation two weeks after being discharged. “He had shoulder pain from when he was resuscitated and could barely

Photography © John Halpern Photography

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all 911,” yelled Mickey Coleman as he ran upstairs to alert his wife, Erin. He knew the pain he felt in his chest was not normal. Mickey recalls the police arriving, and the next thing he remembers is waking up in the hospital three days later.

What began as a typical Monday for 41-yearold Mickey—driving to his office in New York City, returning home to go for his regular run and then having a sandwich—quickly changed into anything but ordinary. “At first my wife thought I was joking,” says Mickey. “I worked out four to five times a week and was very fit.”

Mickey, who lives in Rockland County with Erin and two young sons, had suffered a massive heart attack—a “widow maker.” This type of heart attack occurs when a key artery that moves blood to the heart gets almost or entirely blocked. Without emergency treatment, a person may not survive.

“Telling his wife to call 911 saved him,” says Mark Greenberg, MD, Director of the Cardiac Catheterization (Cath) Lab at Montefiore Nyack Hospital. “There’s a big difference in outcomes between a person who has a heart attack and has immediate CPR and someone who doesn’t have CPR, or has ineffective CPR.” Mickey’s heart had fibrillated—the heart muscle was contracting in an uncontrolled, rapid and irregular way and wasn’t pumping blood effectively. The EMTs had to shock his heart to get it back into a regular rhythm.

Calling 911 instead of having his wife drive him to the hospital was important in another way, Dr.

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ALL-IRELAND FOOTBALL CHAMPION MICKEY COLEMAN IS WELL ON HIS WAY TO RECOVERY AFTER A HEART ATTACK.

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lift his shoulder,” says James Dowling, his exercise physiologist at The Cardiopulmonary Rehabilitation Center at Montefiore Nyack Hospital.

“When I first met him, he was eager to get back to his active lifestyle in a safe and effective manner,” Dowling says. “We talked about his goals, like getting back to running, which he is now doing on a treadmill.”

Dowling says that Mickey has been going to cardiopulmonary rehab three times a week and has regained some of his former abundant energy. “He’s now exercising about an hour at a time three days a week. He still has a way to go, but so far he’s made great progress in meeting the initial goals he set for himself. He’s building up his stamina for longer runs, while keeping his heart rate at a safe level.”

As a safety precaution, Mickey wore an external defibrillator for several months following his discharge from the hospital. This device is lightweight and portable and delivers an electric shock through the chest to the heart if necessary.

The shock can potentially stop an irregular heartbeat and allow a normal rhythm to resume following sudden cardiac arrest.

A TALENTED ATHLETE AND MUSICIAN

JAMES DOWLING, CARDIAC EXERCISE PHYSIOLOGY PROGRAM MANAGER, SUPERVISES MICKEY COLEMAN’S CARDIAC REHABILITATION SESSIONS. LAURA BRUNO, EXERCISE PHYSIOLOGIST, MONITORS MICKEY’S HEART RATE.

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Mickey is the president of Shoreline Builders—a company that specializes in drywall, ceiling, concrete and fireproofing installations. He’s also well-known in the Irish American community as a talented musician and songwriter who hosted several virtual shows during the pandemic. Mickey was a star footballer for his home county, Tyrone, and was a member of its All-Ireland winning teams in 2003 and 2005. His wife, Erin, is an accomplished fiddler who owns an Irish music school with locations in Pearl River and Woodlawn in the Bronx.

He came to New York when he was 32 and continued to participate in Gaelic sports through his involvement with the Tyrone Gaelic Athletic Association (GAA) club in New York and the Rockland GAA. News of his illness has been covered by the media all across Ireland. In Belfast, Northern Ireland, The Irish News reported his release from the hospital on the front page of its April 12 edition.

“Before I had my heart attack, I thought I was in good health,” Mickey says. “I wasn’t well-educated in nutrition, and I now know that my sodium intake was pretty high, from packaged foods that are advertised as being healthy.”

After consulting a nutritionist, Mickey is now eating a mainly plant-based diet, with fresh fruits

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MICKEY COLEMAN WITH HIS WIFE, ERIN, AND THEIR TWO SONS.

and vegetables, legumes and salmon. Mickey’s advice to everyone is to go to the doctor for a checkup and make sure you’re eating a healthy diet. “It’s very easy to get caught up eating a poor diet,” he says. “But heart disease is crippling the country. Looking after your nutrition is key. This can happen to anyone if you’re not careful. I wish I had that advice prior to this happening to me.”

Now his goal is to build up his stamina and his confidence. “After having a massive heart attack, it’s easy to worry about it happening again,” he says. “I feel like I’m making progress mentally and physically. I have a long way to go, but I’m on my way.”

While Mickey doesn’t remember the first few days of his hospitalization, he does remember Dr. Greenberg speaking with him, his wife and his mother. “He was fantastic and explained everything to us,” Mickey says.

He’s extremely grateful to the doctors and nurses in Montefiore Nyack Hospital’s Emergency Department, Cardiac Cath Lab and Intensive Care Unit. “They saved my life, and I received amazing care,” Mickey says. “I’m forever indebted to them.”

To learn more about Montefiore Nyack Hospital’s Interventional Cardiology Program, please visit www.montefiorenyack.org/interventional-cardiology or call 845-348-2650.

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PEDIATRIC EMERGENCY CARE CLOSE TO HOME AT MONTEFIORE NYACK HOSPITAL’S NEW PEDIATRIC EMERGENCY DEPARTMENT, KIDS GET THE SPECIALIZED CARE AND ATTENTION THEY NEED. 8

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hildren can end up in the emergency department for many reasons, including illness, sports injuries, playground spills, bike accidents and accidental poisoning, among many others. For parents, having an emergency department nearby that’s dedicated to children provides great peace of mind.

Montefiore Nyack Hospital’s new Pediatric Emergency Department (PED)

opened in July 2021 and features eight private treatment rooms. It’s staffed by board-certified pediatric emergency medicine physicians and nurses experienced in pediatric emergency medicine, and supported by inpatient hospital pediatricians.

“We’re well-prepared to treat a variety of issues that a child may have, whether medical or trauma-related,” says William Greenhut, DO, Medical Director

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environment that is sensitive to their unique medical and emotional needs.

The new PED is separate from the adult Emergency Department (ED), but is part of the newly expanded FJ Borelli Family Emergency Center. “The focus is entirely on pediatric patients and providing what they need as quickly as possible,” says Dr. Greenhut. “We offer a protected environment with an emphasis on high-quality, evidence-based care.”

Decorated with art created by local children, the department is designed to be a comforting space. The stations for doctors and nurses are centrally located so they’re visible to patients and their families. “This visibility facilitates good communications with a patient’s doctor and nurse,” says Dr. Greenhut.

When needed, the staff works with their colleagues at Children’s Hospital at Montefiore (CHAM), a premier academic children’s hospital located in the Bronx that is nationally renowned for its clinical excellence, innovative research and commitment to training the next generation of pediatricians and pediatric subspecialists. “The specialists there are a resource for us in cases where pediatric subspecialty support is required,” Dr. Greenhut notes.

PARTNERING WITH YOUR PEDIATRICIAN

of Emergency Medicine at Montefiore Nyack Hospital. The PED commonly sees children with fevers, abdominal pain and upper respiratory infections, as well as injuries from sports or accidents.

Some pediatric patients can be treated and discharged quickly through the Emergency Department’s Express Care service. For those who need more extensive care, the PED offers the prompt attention they require in an

If you’re headed to Montefiore Nyack’s PED, call your pediatrician’s office if you can. The pediatrician can call ahead and tell the emergency staff to expect you.

“We work with patients’ pediatricians to provide continuity of care,” says Dr. Greenhut. “We’re happy to partner with them and ensure they have access to patients’ lab results after discharge.”

Once your child comes home, check with their pediatrician to see if they want to schedule a follow-up exam. “When a child is discharged, we provide a plan for the family and their physician,” says Dr. Greenhut. “We ensure that all of the parents’ questions are answered from the time their child comes in until they’re discharged.”

EMERGENCY

IF YOUR CHILD NEEDS EMERGENCY CARE If you’re heading to the emergency department with your child, remember, if possible, to bring: • Health insurance card • Names and contact information for any physician your child sees • Known allergies • Past medical and surgical history • List of current medications (including prescriptions, over-the-counter painkillers, vitamins and supplements) • Your child’s immunization history Be prepared to explain the events that led up to your child’s emergency visit.

For more information about Montefiore Nyack Hospital’s Pediatric Emergency Department, visit www.montefiorenyack.org/emergencycare.

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HOW ADVANCED MEDICAL IMAGING IMPROVES CARE

CRITICALLY IMPORTANT FOR BOTH DIAGNOSIS AND TREATMENT, THE LATEST IMAGING TECHNOLOGY LEADS TO BETTER HEALTH OUTCOMES FOR PATIENTS.

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edical imaging, including CT scans and MRIs, has dramatically improved the practice of medicine. For example, in some cases it can reduce or eliminate the need for exploratory surgery. “Imaging can make diagnosis more accurate, improve early detection of diseases, help guide procedures and help monitor a patient’s progress,” says Evan M. Kaminer, MD, Director of Radiology.

Montefiore Nyack Hospital offers patients stateof-the-art medical imaging to help detect and treat diseases including cancer, heart disease and liver disease. Below is an overview of our imaging resources.

CANCER

• New CT scanners: “These machines have software that improves detection and allows us to give less radiation to the patient,” says Dr. Kaminer.

• SPECT-CT: This is a type of nuclear medicine scan where the images or pictures from two different types of scans are combined together. “The SPECT-CT helps us identify certain types of tumors and pinpoint them in the body so we can treat them more effectively,” says Dr. Kaminer.

• 3D mammogram: Women who come to Montefiore Nyack Hospital for breast screening receive a 3D mammogram, which takes multiple images, or X-rays, of breast tissue to recreate a three-dimensional picture of the breast. It’s the most advanced imaging available for breast cancer detection at the lowest possible radiation dose.

3D mammography is more effective than traditional 2D mammography in detecting cancers earlier and decreases the need for women to be called back for additional testing. (To learn more, visit www.breastcare.health/breast-screening.)

HEART DISEASE

• Cardiac Catheterization Lab: Opened in February 2021, this well-equipped lab provides diagnostic angiogram, stent placement and a variety of electrophysiology procedures. (See “Surviving a ‘Widow Maker’ Heart Attack” on pages 4–7 for one story of how this lab is helping to save lives.)

• CT coronary angiography: This noninvasive version of an angiogram is used to diagnose coronary artery disease.

• CT coronary calcium scoring: Quick and noninvasive, this test determines how much calcium is

in the coronary arteries, which can help doctors decide if further testing is necessary. “It’s a noninvasive way to get a general idea of how much plaque a person has in their heart, which helps guide treatment decisions,” explains Dr. Kaminer.

• Coronary SPECT/CT: This technology improves on a nuclear stress test, giving higher-quality images.

• Contrast-enhanced ultrasound echocardiography: An echocardiogram uses sound waves to produce images of the heart. Your doctor can use the images from an echocardiogram to identify heart disease.

“Contrast-enhanced echocardiography improves image quality, especially in overweight patients,” says Dr. Kaminer.

• Cardiac MRI: The hospital’s Cardiac MRI program, in collaboration with Montefiore Medical Center, performs advanced MRIs of the heart to assess function, find blockages and look for masses. It’s currently the most sophisticated tool to assess complex heart valve problems, congenital heart disease and diseases of the heart lining (pericardium).

LIVER DISEASE

• MR and ultrasound elastography: Elastography measures liver stiffness, or fibrosis. This new technology can be used with either ultrasound or MRI in place of a liver biopsy, a more invasive test that involves removing a piece of liver tissue for testing.

Fibrosis can be caused by several diseases including alcoholism and a type of fatty liver disease called nonalcoholic steatohepatitis (NASH). If a patient has elevated liver function tests, their doctor will order an ultrasound first. If that suggests the presence of fat in the liver, the doctor can order elastography to determine if fibrosis is present.

“We used to think having fat in the liver was benign, but now we know it can go on to cause fibrosis, cirrhosis and even liver cancer,” says Dr. Kaminer. “It’s an increasing problem as obesity becomes more common in adults and children.”

TRAUMA Montefiore Nyack Hospital’s new Emergency Department (ED) has a dedicated trauma center. This summer, the ED received a new CT scanner. “For trauma patients, time is of the essence, so having a CT scanner in the ED will improve patient care,” says Dr. Kaminer.

To schedule an imaging appointment, call 845-348-SCAN (7226). We are open seven days a week from 7 a.m. to 7 p.m. Same day appointments are available.

To make a Cath Lab appointment, call 845-348-2650.

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NEW TREATMENT

FOR CHRONIC KIDNEY DISEASE DRUGS CALLED SGLT2 INHIBITORS REDUCE RISK OF KIDNEY FAILURE, HEART FAILURE AND HEART-RELATED DEATH.

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eople with moderate chronic kidney disease now have medications available that can significantly improve their health. The medications, called SGLT2 inhibitors, reduce the risk of kidney failure, heart-related death and heart failure, according to nephrologist Michal Tracz, MD, with Highland Medical, P.C. Rockland Renal Associates. A recent study found one SGLT2 inhibitor, called dapagliflozin (Farxiga), reduced the risk of kidney failure and cardiovascular death by about 30 percent. “It’s revolutionizing our field,” says Dr. Tracz.

Chronic kidney disease (CKD) means your kidneys are damaged and can’t filter blood the way they should. CKD sometimes can progress to kidney failure. Patients also are at high risk of cardiovascular disease, including heart disease and stroke.

In April 2021, the U.S. Food and Drug Administration (FDA) approved Farxiga oral tablets to reduce the risk of kidney function decline, kidney failure, heartrelated death and hospitalization for heart failure in adults with CKD who are at risk of disease progression. Farxiga was originally approved in 2014 to improve blood sugar control in adults with Type 2 diabetes (in conjunction with a healthy diet and exercise).

Three other SGLT2 inhibitors are canagliflozin (Invokana), empagliflozin (Jardiance) and ertugliflozin (Steglatro).

“We have the most data on Farxiga, but

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it’s likely that the other SGLT2 inhibitors work just as well,” says Dr. Tracz.

SIDE EFFECTS SGLT2 inhibitors work by preventing glucose from being absorbed in the kidneys. As a result, they decrease glucose in the blood and cause it to spill into the urine. “For reasons we don’t understand, this causes a dramatic reduction in kidney failure and cardiovascular death outcomes,” says Dr. Tracz.

The most common side effects of Farxiga are dehydration and urinary tract infections (UTIs). “The medication can cause dehydration because when you urinate out glucose, water comes out with it,” says Dr. Tracz. “A person can dehydrate easily, especially if they’re taking diuretics for high blood pressure or heart failure.” If a person becomes dehydrated by taking Farxiga, the doctor can lower the dose.

Another common side effect is a UTI, especially in women. “If you develop frequent UTIs when taking Farxiga, this may not be the drug for you,” Dr. Tracz notes.

Patients have had several rare but significant side effects. These include a slight increase in leg amputations in patients with diabetes who have very poor leg circulation. “If you’re a diabetes patient with very poor leg circulation, and have had leg ulcers, Farxiga is not recommended,” he says.

Studies of another SGLT2 inhibitor, Invokana, have found the drug slightly increases the risk of bone fractures. “The fractures generally occur when a person gets dehydrated, feels dizzy and falls and breaks a bone,” says Dr. Tracz. “While this study was not done on Farxiga, the drugs are similar, so I believe the bone fracture risk is similar.”

The FDA is also looking into a possible increased risk of bladder cancer in people taking Farxiga.

Other people who should not take the medication include those with a complication of diabetes called diabetic ketoacidosis and people with advanced kidney disease.

“Because Farxiga can affect the body in different ways, a person taking the medication is best cared for by a team of doctors, including a nephrologist and an endocrinologist, who will make sure they are getting the right dose, without side effects,” says Dr. Tracz. “This medication is going to make a big difference in improving the health of people with chronic kidney disease. It is an important new tool to help reduce chances of going on dialysis in those patients.”

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“This medication is going to make a big difference in improving the health of people with chronic kidney disease. It is an important new tool to help reduce chances of going on dialysis in those patients.”

Michal Tracz, MD Nephrologist, Highland Medical, P.C. Rockland Renal Associates

To schedule at appointment with a board-certified nephrologist at Highland Medical, P.C., call 866-550-4672.

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ARE YOU AT RISK FOR

BREAST CANCER?

HAVING ONE OR MORE RISK FACTORS FOR BREAST CANCER DOESN’T MEAN YOU’LL INEVITABLY GET THE DISEASE. IT DOES MEAN THAT YOU SHOULD ACT NOW TO TRY TO REDUCE YOUR RISK.

WHAT TO KNOW Factors that increase breast cancer risk include:

FAMILY HISTORY. Having a firstdegree relative (mother, sister, daughter) or multiple people on either side of your family who have had breast cancer.

PERSONAL HISTORY. Having had breast cancer or previous treatment using radiation therapy to the chest or breasts.

“DENSE” BREASTS. Breasts that have more connective tissue than fatty tissue can increase risk and might require additional imaging to better visualize tissue.

GENETIC DISPOSITION. Having a higher likelihood of developing breast cancer based on your genetic makeup. Genetic testing can uncover this.

ASHKENAZI JEWISH HERITAGE. Inherited mutations to certain genes that increase risk, such as BRCA1 and BRCA2, are more common in those of Ashkenazi Jewish descent.

PREVENTIVE ACTIONS Women at high risk of breast cancer are recommended to start screening earlier, have a clinical breast exam twice a year and have regular breast cancer screenings (most commonly, 3D mammogram and ultrasound). To reduce your risk, follow these lifestyle tips:

EAT WELL. Decrease or eliminate fried food; increase fruits and vegetables; include healthy fats (such as those found in fish, avocados and nuts); and avoid excess alcohol.

DON’T SMOKE. There’s evidence of a link between smoking and breast cancer, especially in women who haven’t gone through menopause yet.

CONTROL YOUR WEIGHT. Being overweight may increase your risk, especially after menopause.

EMBRACE PHYSICAL ACTIVITY. Many studies have shown that physically active women have a lower risk than inactive women.

To learn more about your breast cancer risk and screening eligibility, take our four-question quiz at www.breastcare.health/quiz. To make an appointment at The Breast Center at Montefiore Nyack Hospital, call 845-348-7579.

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4 TIPS FOR A

SAFE RETURN TO FITNESS MANY HAVE TAKEN A BREAK FROM THEIR REGULAR PHYSICAL ACTIVITY ROUTINES DURING THE PANDEMIC. HERE’S HOW TO GET BACK IN SHAPE, SAFELY.

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s people emerge from more than a year of spending so much time at home, some are rushing to get back into shape—with potentially harmful consequences.

Jason Fond, MD, Director of Orthopedic Surgery at Montefiore Nyack Hospital, says he’s seeing a number of young athletes and older fitness enthusiasts who have ended up injuring themselves.

“I’m seeing tweens and teens who lost a year of sports and are very eager to get back to where they were,” says Dr. Fond. “They feel they need to go from zero to 100 very quickly. But, even if you’re young, healthy and in good shape, if you don’t get back to your sport in a stepwise process, you risk injury.”

This spring, he saw young baseball pitchers who started throwing at a high velocity over and over. The result: shoulder and elbow injuries. “They had to stop for a period of time, get into physical therapy and then get back into activity much more slowly and in

a controlled fashion,” he says. He also saw a number of gymnasts who ended up with injuries because they didn’t ease into their return.

Dr. Fond has seen adults who started lifting heavy weights at the gym or running long distances after being sedentary and ended up with tendinitis, sprains and strains.

If you or your children are gearing up for fall sports like football, basketball and soccer, or just want to get in shape, Dr. Fond offers four important tips below.

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TAKE A WALK. If you haven’t done any exercise in a long time, try walking. Invite a friend to help keep you motivated.

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GO SLOW. If you’re a runner and used to run three miles a day but stopped during the pandemic, start with one mile and work up gradually.

The same goes for lifting weights. “You have to allow your muscles to gradually

get used to the amount of weight you used to lift,” he says.

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MIX IT UP. Do more than one activity over the course of a week to give muscle groups a chance to rest.

For instance, you can lift weights one day and use the elliptical machine the next.

Dr. Fond notes that you can strengthen muscles without lifting weights. “Yoga and Pilates can help you build muscle,” he says. “So can a rowing machine.”

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KNOW WHEN TO SEEK HELP. If you start to experience warning signs of injury, such as swelling or discomfort, take a break. “Ice the area and stretch,” advises Dr. Fond. “And when you’re feeling better, don’t overdo it.” If the discomfort doesn’t subside in a few days, consult your doctor.

“The best way to keep in shape is to find something you enjoy,” says Dr. Fond. “That way you’ll be more likely to stick to it. Staying in shape is a lifetime commitment.”

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