Summer 2014

By Brett P. Frykberg, MD


Stretch Summer 2014

JOI Rehabilitation is proud to announce that Brett P. Frykberg, M.D., Michael Yorio, M.D., and Scott McGinley, M.D. will be joining the JOI family this summer.

Brett P. Frykberg, M.D. Currently completing his fellowship at the Hospital for Special Surgery in NY, NY for Adult Reconstruction and Joint Replacement. BS from the University of Tennessee (Go Vols) Knoxville, Tennessee, Medical Degree from the Medical College of Virginia Campus in Richmond, Virginia, Residency from the University of Florida College of Medicine Department of Orthopaedics and Rehabilitation , Jacksonville, FL. He will join JOI on September 2, 2014 specializing in total joint replacement and general orthopaedics.

Michael Yorio, M.D. Dr. Yorio specializes in Primary Care Sports Medicine with a focus directed toward the complete care of the active individual, which involves injury prevention, treatment, and recovery. He was the Director of Player Medical Services at the US Open and will be bringing a wealth of experience to JOI that includes programs like Tennis and Running Medicine programs, injury risk assessments, sports injury assessments, and exercise prescriptions. He has managed concussion injuries as part of his current practice in New Jersey and will begin the JOI Concussion Center to help diagnose, manage, and establish return to play protocols for our patients. He will starting on August 1st, 2014.

Scott McGinley, M.D. Specializing in Sports Medicine, Dr. McGinley has experience in Pediatrics, Geriatrics, Trauma, and has completed a Residency in Orthopedic Surgery at UMDNJ and a Sports Medicine Fellowship at UF. He has experience as a team physician for high school and college football, he has been published in the Journal of Neuroscience Research and is bilingual with Spanish as his second language. He will be starting at JOI Fleming Island early this summer.

Summer Diets

With the arrival of summer, some are finding that their resolution diets just don’t live up to the hype. It would be nice to think scientists will find a “magic diet” that will live up to all the empty promises the current fad diets give. Unfortunately, it has been proven repeatedly that fad diets don’t work and permanent, healthy weight loss requires limiting caloric intake, exercise and eating a healthy, balanced diet.

The media has been a powerful driving force for fad diets over the years. Although most diets only end in wasted money and frustration, some actually end in serious health problems. Most often though, the end result of a fad diet is regain of weight lost and a sense of failure that sets up the pattern of unhealthy dieting and binge eating. The following are “red flags” that the diet discussed is unhealthy, invalid and possibly unsafe:

  • Causes consistent weight loss of more than 2 pounds per week
  • Causes permanent weight loss (even when you stop using product)
  • Causes substantial weight loss without diet or exercise
  • Causes substantial weight loss no matter what/how much is eaten

Other empty promises include miracle foods, the elimination of “toxic” foods, and a combination of foods that will equal weight loss. Learn to look for and avoid these dangerous diet traps and focus on learning how to find the right balanced healthy diet for your body. Major fallacies with fad diets include unrealistic short term goals, frustration that results in a return to poor eating habits, return to unhealthy weight, and the continuation of undertaking another fad diet. This is a dangerous cycle that many people continue to fall into.

Some examples would include the Atkins diet and the cleansing diet. The Atkins diet was created by an MD and is based on the principle that weight loss can be achieved safely through the significant limitation of carbohydrates in your diet. Although research has shown this to result in quicker weight loss in the first 6 months than diets that reduce caloric intake, there are health risks involved. It causes significant water loss in the body which can result in side effects such as nausea, headaches, fatigue and constipation, as well as kidney damage over time. The cleansing diet is much simpler in principle because its products are based on the theory that the body must be “cleansed” regularly to eliminate wastes and toxins. This principle is simply false because the body is naturally self-cleansing which is evidenced by our digestive system and elimination of waste products. Over time, these cleanses deplete your body of essential vitamins and minerals and can cause damage to your heart, liver and colon.

Although fad diets change with time, they all reinforce the fallacy that weight loss can be achieved quickly and easily. They appeal to the emotional aspect of losing weight without effort and with no regard to adopting lifestyle changes that will ensure permanent weight loss and healthier habits. There is no single diet that is right for everyone if you consider all the factors that are involved

  • Food allergies/sensitivities
  • Digestive and systemic diseases such as diabetes, heart disease and elevated cholesterol/blood pressure
  • Food preferences (likes and dislikes)
  • Food availability due to affordability, what’s available in the region/season

So, even if you aren’t fooled by the false promises of a fad diet, how do you know what foods are right for you and your specific needs? The best options for finding a healthy, balanced diet are to follow the standard nutritional guidelines set by the FDA. If you have special considerations due to some of the factors listed above, consider seeing a licensed nutritionist for a consult. It should only take a couple visits to set up a reasonable list of foods that will be safe and healthy with guidelines to the desired amount to be eaten. These visits are sometimes covered by insurance if your physician recommends it. If not, the cost will most likely still be less than any fad diet will cost and the results will be safe, healthy, and permanent.


Recognizing and Preventing Dehydration

By Meghan Sink, MS, ATC, LAT

Dehydration is a common and easily preventable condition, which can affect everyone from weekend warriors to elite athletes. Dehydration occurs when the body loses more fluids than are taken in. Common causes include vomiting, diarrhea, fever and excessive sweating. Not drinking enough water during hot weather or exercise can also cause dehydration.

There are different stages of dehydration. Symptoms of mild to moderate dehydration include, but are not limited to, dry mouth, thirst, decreased urine output, headache, dizziness and fatigue. Symptoms of severe dehydration include, but are not limited to, extreme thirst, lack of sweating, little or no urine output, low blood pressure, rapid heartbeat, and unconsciousness.

Treating dehydration is usually as easy as drinking fluids. Healthy adults should drink more fluids, such as water or a sports drink (Gatorade, Powerade, etc). For those with severe dehydration, medical attention should be sought immediately. If dehydration is not treated properly, many complications may occur. These include heat stroke, swelling of the brain, seizures, low blood volume shock, kidney failure, coma and death.

Anyone is prone to dehydration, but there are certain populations who are more at risk. Those include infants and children, older adults, people with chronic illnesses, endurance athletes, people living at higher altitudes, and people exercising outside in hot, humid weather.

Dehydration can easily be prevented by drinking plenty of fluids. When exercising, water and sports drinks should be consumed to combat fluids lost while sweating. Fluids should also be consumed when a person is ill. Medical attention should be sought when fluid replacement at home is not enough. An easy way to tell if one is well hydrated is by looking at urine output. A hydrated person will have high urine output with clear to light yellow colored urine. A person who is dehydrated will have a low urine output with dark yellow to amber colored urine.

Medicine From The Kitchen

By Renan Abagat, PT

Making Bodies Better

The philosophy of using food as medicine has been around for a long time. Cultures from around the world have adhered to this practice for centuries. Food’s primary purpose is nutrition, providing different minerals, vitamins, enzymes, antioxidants, carbohydrates, fats and proteins needed by our bodies to function at an optimum level. Food has also been known to help the body heal itself. Proper nutrition is the fuel that maintains, cleanses and regenerates our bodies. There are several pantry items that can enhance the flavor of our food as well as help heal our bodies.

GINGER ROOT This is said to alleviate nausea, morning sickness, motion sickness, indigestion and bloating. Research also shows that a daily dose of ginger extract can actually help reduce inflammation and the pain from osteoarthritis.

CABBAGE Cabbage is packed with antioxidants and cancer-fighting enzymes. It helps our bodies fight free radicals and clear up toxins. The fiber in cabbage helps to keep blood sugar levels stable and regulates bowel movements. It also contains glutamine which heals the cells that line the stomach.

CINNAMON Cinnamon has been proven to help control blood sugar and cholesterol. It has an antimicrobial action and is the perfect remedy for nausea. It also boosts the performance of insulin, helping those who suffer from adult onset diabetes. It is a good source of vitamin K, iron, fiber, calcium and manganese.

TURMERIC Turmeric has anti-inflammatory, pain killing and liver detoxing capabilities. It is a natural antiseptic and antibacterial agent. It enhances the immune system.

TOMATOES Tomatoes contain lycopene, a strong antioxidant that has been shown to reduce the risk of prostate, colon, lung and bladder cancer. It has been reported that it also protects our white blood cells, the body’s defense against infection


Where is Telemedicine frequently used?

All JOI Physicians, Physical Therapists and Occupational Therapists now offer Telemedicine services for virtual visits from the convenience of your home. If you feel that it is best to stay in your own home during this time, we can still provide orthopaedic Telehealth services for you. Through the download of the free Zoom app on the your phone, tablet or laptop. Our physicians and Telehealth for Physical Therapy can evaluate you and provide the care you need.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP Fracture care. Make an appointment by calling (904)JOI-2000. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care.


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