orthopedic doctor

orthopedic doctor

Soda is a Four Letter Word

By Matthias H. Wiederholz

America has an obesity problem.  And it seems the rest of the developed world is following suit.  A question that many people wonder is whether soda consumption increases the likelihood of weight gain. The short answer is YES.

Soft drink consumption has increased globally from 9.5 gallons per person per year in 1997 to 11.4 gallons per person per year in 2010.  Simply a 1% rise in simoft drink consumption contributes to an additional 4.8% overweight adults, 2.3% obese adults, and 0.3% adults with diabetes.1  If this trend of increased consumption of caloric beverages continues, it is clear that these rates will rise drastically.

There is an alarming statistic. Consumption of sugar sweetened beverages (SSB) in the United States is increasing.2,3  About half of mothers with children age 2 reported that their children drank SSB’s at least one day per week.  Moreover, there is a much higher likelihood that children who drink the highest amount of SSB come from low-income families.  These families are the same families that likely have limited access to quality healthcare.

So what does this mean for society in general?  Well, SSB consumption is increasing and the obesity epidemic is worsening.  Insulin resistance is becoming commonplace.  Based on the studies outlined above, we can conclude that soda consumption is certainly contributing to this problem.  In fact, as mentioned earlier, soda consumption predicts weight gain.

Therefore, if you don’t want to gain weight, don’t drink soda!

don’t drink soda


  1. Basu S, et al. Relationship of Soft Drink Consumption to Global Overweight, Obesity, and Diabetes: a Cross-National Analysis of 75 Countries. American Journal of Public Health. Nov 2013; Vol 103, No. 11: pp. 2071-2077.

Treat Your Migraines (and your wrinkles too)

By Matthias H. Wiederholz

Do you suffer from migraine headaches? Migraine headaches can be debilitating and some people have more headache days than non-headache days. Migraines typically start as a dull ache and progress to a throbbing pain. You may have sensitivity to light or sound with this headache. Some people even get nausea/vomiting with this headache. The headache typically lasts between 4-72 hours and interferes with daily activities.

If you suffer from migraine headache at least 15 days of the month that last at least 4 hours per day, you may be a candidate for treatment with Botox. Yes, I said Botox. Botox is FDA-approved for the treatment of chronic migraine. If you have tried multiple medications that have failed you are likely frustrated with the lack of pain relief. In fact, sometimes taking too much medication can actually worsen your headaches!

Botox is a simple injection technique for the treatment of chronic migraines. It involves injecting the medication into specific sites in the face, head and neck. It relaxes the muscles and relieves the headaches. In patients with 15 headaches per month or more, Botox reduced the headache days by 9 or more.

The best part… Your wrinkles will disappear too! Seriously. Many of the injection sites to treat migraine also happen to be the same sites that we inject when using Botox for cosmetic purposes.

If you have more headache days than non-headache days, consider calling for a Botox consultation today.

Rotator Cuff Tendinopathy, By Mahmud Ibrahim MD

By PPSM Staff

Rotator Cuff TendinopathyThe shoulder is one of the most mobile joints in the body. The rotator cuff is a group of muscles that attaches to the shoulder joint via tendons. These tendons not only control the movements of the shoulder, but also help to stabilize the shoulder joint. Over time, patients can develop “wear and tear” of the rotator cuff, called tendinopathy. Tendinopathy can range from slight inflammation of the rotator cuff to a tear of the tendon. Rotator cuff tears are rarely seen in patients under the age of 40. Other risk factors for rotator cuff tendinopathy include repetitive overhead movements, weak shoulder muscles, forward posture of the shoulders, heavy lifting, and a direct blow to the shoulder. Diabetics are at increased risk for developing tendinopathy. Symptoms can include shoulder pain, especially with overhead activities or reaching behind, pain when lying on the affected shoulder, popping or clicking in the shoulder, and limited motion of the shoulder. Initially, symptoms may improve with rest; however, as the degeneration continues, the pain can become constant and occur even at rest. Eventually, the pain can interfere with daily activities. In addition to a physical exam, rotator cuff tendonapathy can be diagnosed with an MRI or ultrasound of the shoulder. Ultrasound is useful as it is (1)noninvasive, (2)can be performed in the office, (3)does not involve being placed in a small tube like structure, (4)and takes only about 5-10 minutes. Ultrasound has actually been found to be more sensitive than MRI in detecting rotator cuff problems. In addition, the physician can show the patient the affected areas in real time.



First line treatment for rotator cuff tendinopathy usually includes physical therapy to help strengthen the rotator cuff muscles, correct the poor posture, and teach proper form for lifting and overhead activities. Medications can include oral anti-inflammatories as well as other pain medications. Ice is also helpful to reduce inflammation. When oral anti-inflammatories are not enough, it may be necessary to perform a corticosteriod injection into the shoulder to help reduce the inflammation. Ultrasound can also be used when injecting the shoulder as it allows the physician to directly visualize the needle and ensure the medication is being injected directly into the affected area. Newer treatment options also include Platelet Rich Plasma, also known as PRP. This treatment involves taking the patient’s own blood, spinning it down, concentrating and extracting the growth factors in the blood, and injecting those growth factors directly into the affected area. This has been shown to actually promote the healing of degenerated tendons. There are also several surgical options available, but they are more invasive and are therefore rarely considered first line treatment options.

Shoulder pain is a common problem. With the proper treatment, the pain can be significantly reduced and improve a patient’s quality of life.  For more information or to schedule a consultation, please call our office in Lawrenceville, NJ at 609-588-8600.

Gluten: Far Beyond GI Distress by Mike Dougherty, DC

By PPSM Staff

The prevalence of gluten intolerance and sensitivity is on the rise.  Although testing has largely remained the same, we see more non-Celiac diagnosed people avoiding gluten and wheat and seemingly curing some of their ailments. While we have identified those suffering from disease directly associated with Gluten, i.e. Celiac Disease, there is still much we don’t understand.  We hear about “gluten sensitivity” all the time but could it just be a myth or a trend?  Is this a ploy by the gluten-free industry to get us as consumers to buy their product?  While the industry has capitalized on this population, I still believe gluten, wheat, and even dairy products can have detrimental effects on health.  Let’s look at how those undiagnosed with Celiac Disease can still be affected by wheat and gluten.

There are two proteins associated with gluten, found in the wheat seed.  These are gliadin and glutenins.  Gliadins have four “types,” known as alpha, beta, gamma, and omega.  Wheat also contains proteins that bind to sugar and proteins involved in cellular communication.  When wheat is ingested and broken down, an enzyme called transglutaminase (tTG) helps.    When this happens, two more proteins are formed and lumped into a category called gluteomorphins.  The problem lies in the fact that Celiac disease is characterized only by the detection of the alpha form of gliadin and only transglutaminase #2.  Of course, we know there are four gliadins and multiple transglutaminase.  We also know that people do often react to these other gliadins, gluteomorphins and transglutaminase, as some of which are found in the skin and brain.  This may be the preliminary explanation of why symptoms of Celiac disease or gluten sensitivity can be so widespread.  Statistics reveal that fifty percent of new patients diagnosed with Celiac disease do not have gastrointestinal symptoms.  Celiac disease and non-celiac gluten sensitivity have been associated with disease affecting multiple body regions including the central nervous system, the endocrine system, bones, skin, and even the peripheral nerves.

With better testing comes better understanding of the human body.  The ever-changing nature of agriculture, and wheat in particular (another topic), coincides with the prevalence of Celiac and non-Celiac conditions.  Food sensitivity testing is an easy way to assess if any of these foods are potential problems.  The ALCAT panel is a blood test done by our doctors at Performance Spine and Sports Medicine that tests over 300 potential allergenic foods, food additives, molds, herbs, and even environmental chemicals.   Knowing if your food is contributing to your health, or lack thereof, is the foundation of your personal healthcare.

For more information or to schedule a consultation for the ALCAT food sensitivity test, please call our office at 609-588-8600.  We serve the greater Mercer County area including: Lawrenceville, Hamilton, Princeton, West Windsor and Princeton Junction.  We are conveniently located 1.5 miles south of the Quaker Bridge Mall on Quaker Bridge Road (cross street Village Rd.)

Orthopedic Doc in Lawrenceville Discusses Surgery Prevention For Knee Arthritis (3 of 3)

By PPSM Staff

Now that you’ve got the exercise program down, it’s time to make sure you are eating your best!  Maximize your health by eating foods that are good for you, paired with supplements that keep you feeling your finest.

Two MAJOR super foods that help with arthritis:

*Fish. Why?  Fish has tons of omega-3 nutrients which are natural anti-inflammatories AND help keep your hearth healthy.  The natural compounds in fish are proven to not only fight inflammation but as a result of that, also relieve pain.

*Yogurt!  Yogurt not only has anti-inflammatory ingredients but get this-it also boosts your immune system and helps fight off that pesky cold that comes around once a year.  Yogurt is a great food to have as breakfast, a mid-day snack or with lunch.  Check out for some great ideas on how to prepare healthy meals or snacks with yogurt.

Last by not least, don’t forget Prime Joint Support from Nutrametrix.  It’s an easy to swallow formula and the effects of it are well worth the reasonable price tag. Joint Support when taken as directed, helps increase the cushion in arthritic joints so you can keep up with the kids or grandkids!

Nutrametrix products


Check out the complete line of Nutrametrix products at our home page Joint Support 


Prime Joint is in Nutrametrix exclusive Isotonic Formulation:  What does this mean? Superior Absorption Over all the supplement formulations.  I gave this analogy at my recent talk.  Everyone takes it for granted but the average person needs swallows about 1-2Liters of their own saliva a day! The theory is your body does not digest your own saliva or body fluids….you simply absorb it directly in you gut and completely bypassing the body’s need to get processed and digested by the stomach’s acid.  Well imagine taking a supplement in liquid form that has the same concentration (aka “tonicity) as saliva…such a supplement will get absorbed directly and bypass the stomach’s digestive process as well!!! So while most capsules and tablets that you swallow NEEDS to get digested and processed by the stomach, the supplements that you may be taken are quickly destroyed by the STOMACH ACID!!!!  If you’re lucky, you can get 50% of the ingredients or the supplement that you take!


Prime Joint Support has Glucosamine, Hyaluronic Acid and Pycnogenol in isotonic formulation!!! Glucosamine and Hyaluronic Acid are the raw ingredients for all the cartilage (the soft cushions in all your joints to prevent bone from rubbing against each other) in your body and studies have shown to improve arthritic symptoms!!  Pycnogenol is an extract of Pine Bark which acts like a natural anti-inflammatory….some of the most powerful of it’s kind!!! In fact, it acts like your regular over the counter ibuprofen or naprosyn without the dangerous side effects!!!


On our next Blog, we will present a series of supplement that will change your life and your joints!!!

Orthopedic Doc in Lawrenceville Discusses Surgery Prevention For Knee Arthritis (2 of 3)

By PPSM Staff

Now that you’ve been doing the beginner program for a couple of weeks, you can move on to some intermediate exercises to help strengthen the knee.  This exercise program, similar to the beginner program will consist of 4 intermediate exercises. First lets begin with the Bulgarian Squat:

Bulgarian Squat





Using a short bench, position your left foot on the top.  Slowly lower you body keeping your back straight until your right leg is at a 90 degree angle.  Make sure to do 2 reps of 15 with each leg!  Rest 30 seconds to one minute between sets.





Next up- Traditional Squat:

Traditional Squat





Hold your arms out straight in front of you and space your feet shoulder width apart.  Slowly lower both legs to a 90 degree angle.  Make sure to keep your back straight!  Do 2 reps of 15; rest 30 seconds to 1 minute between sets.






Halfway there! Next on the list are Lunges!













Next, the Single Leg Bridge:

Single Leg Bridge



Lay on your back with your knees up and feet on the floor.  Bring your right knee up to your chest and hold.  Lift your pelvis up and hold the position.  Repeat 2 sets of 15.






And finish up with the Plank:




Hold the plank position for 1 minute.  Repeat 3 times.

Stress Incontinence

By PPSM Staff

Stress Incontinence

Does Your Pelvic Floor Fail You when you Laugh, Sneeze, Run or Jump?                                  You are not alone!

Many women ages 25 – 50 suffer from Stress Incontinence.  Stress Incontinence is caused by weakening of the muscles that keep urine stored in the bladder.  Stress Incontinence can be prevented & treated with CONSERVATIVE treatment.                 Physical Therapy can help!

The following are signs that your bladder is not functioning properly:

• You cannot sit through a movie without having to pee.
• You have to get up at night to pee.
• You have a strong urge to pee, but void less than a coffee cup worth.
• You have to strain or have pain with urination.

Dr. Aisling Linehan

Learn more!  MARK YOUR CALENDAR!  Gold’s Gym of Lawrenceville, NJ, is proud to host some of Performance Spine & Sports Medicine’s healthcare seminars, designed for you!  Make PSSM at Gold’s Gym your FREE access to expert advice.

Dr. Aisling Linehan, Physical Therapist at Performance Spine & Sports Medicine, will be presenting this informative seminar & is ready to answer your questions.  Save the date:

 TIME  >  6:00PM
 WHERE  >  GOLD’S GYM of Lawrenceville, Mind & Body Room
Knowledge really is power!                                                              

NFL Draft 2013 News and Orthopedic Doctors Reveal the FAST (Fasciotomy and Surgical Tenotomy) for Athletes!!

By PPSM Staff

NFL Pre- Draft Party at EVR Lounge in NYC with Performance Spine & Sports Medicine Doctors sponsor a party for NFL Draft Candidate, Xavier Rhodes  (click his name and hyperlink for his NFL profile).
Xavier Rhodes from Florida State, is a Corner Back and His Combine numbers are amazing…He runs a 40 yard dash in 4.43 seconds and can jump 40.5 inches vertically.

Doctors Reveal

new blog

On NFL Draft Day, Xavier Rhodes was drafted in the First Round at 25th overall and sent to the vikings and full report is available at


As with any sport, Athletes can be injured any time from nagging tendon, ligament or joint injuries.  Performance Spine & Sports Medicine (PSSM) introduce the FAST procedure which stands for (Fasciotomy and Surgical Tenotomy) which is a minimally invasive procedure to repair ligaments and tendons of any joint.

The doctors at PSSM are one of the first physicians in New Jersey and Pennsylvania to offer this cutting edge Procedure which takes minutes.  We first use ultrasound to visualize the injury.
ultrasound image
We then use a sophisticated probe to suction out the scar tissue (which is the black and dark gray areas in the ultrasound image and cause very TINY MICRO-TEARS in the tissues to STIMULATE REGROWTH and REGENERATION of tendon, muscles and ligaments!! This procedure can treat Shoulder Injuries like Rotator Cuff Tears, Knee injuries like patellar tendon injuries, and TENNIS or GOLFER’S ELBOW!

The procedure is done in minutes and patient requires minimal to NO stitching.  It is a same day procedure and the athlete or patient can start rehabilitation the next day (of course at the discretion of the doctor). At our clinic, we are seeing over 90% success rates  in terms of pain improvement and athletes can be completely healed within 2 – 4 weeks depending on the injury!

Below is a video of the procedure. We are publishing our first scientific abstract showing the effectiveness of the procedure which is coming soon!!

Video for ELBOW REPAIR!!