Staffed by world-class physicians from ColumbiaDoctors Orthopedics, NewYork-Presbyterian Lawrence Hospital’s Orthopedics and Sports Medicine program offers comprehensive, interdisciplinary care for elite athletes, children and weekend warriors alike. As the hospital broadens its services in Westchester County, patients will benefit from personalized treatment plans built upon careful observation of their movement habits.
NYP Lawrence’s relationship with ColumbiaDoctors has transformed orthopedic care for the hospital’s current patient base by offering an unprecedented level of care in Westchester County. It’s a powerhouse partnership brought about under the leadership of Michael Fosina, President of NewYork-Presbyterian Lawrence Hospital, William Levine, MD, Chair of Columbia University’s Department of Orthopedic Surgery, and Jeffrey Geller, MD, Chief of Orthopedic Surgery at NewYork-Presbyterian Lawrence. The collaborative partnership continues to draw new physicians to join NYP Lawrence’s cadre of talented orthopedic surgeons and primary care sports medicine physicians.
One of the orthopedists in the new Bronxville office is Elan Goldwaser, DO, a primary care sports medicine specialist. Dr. Goldwaser’s clinical expertise includes sports injury rehabilitation, runners’ health, shoulder pain, sports injuries of female athletes and tennis elbow.
Charles Popkin, MD, a pediatric and adolescent sports medicine specialist at ColumbiaDoctors Orthopedics and NYP Lawrence and Assistant Professor of Orthopedic Surgery at Columbia University Irving Medical Center, began seeing patients at NYP Lawrence a few years ago and now treats patients at the hospital on a weekly basis.
As mergers transformed the New York medical market, Dr. Popkin says, aligning ColumbiaDoctors’ already-strong presence in Westchester with NYP Lawrence made sense.
“The decision came from the top. Dr. Levine has been our Chair for a number of years,” Dr. Popkin says. “He is everything you want in a chair — someone incredibly involved in mentorship and a leader with a vision of where to take ColumbiaDoctors Orthopedics. I’ve worked in orthopedics 11 years, and I’ve never seen anyone work harder. Dr. Geller exhibits similar qualities.”
Dr. Popkin views the expansion of services in Westchester as having far-reaching clinical and logistical advantages for patients.
“We offer the benefit of seeing a ColumbiaDoctors physician or surgeon without the drive into the city — cosmopolitan expertise without the transportation and parking hassle,” he says.
As NYP Lawrence and ColumbiaDoctors Orthopedics continue to grow their footprint, the range of services provided in Westchester County is expanding. Whether offering repairs for childhood injuries, advanced care for elite athletes, or medical or surgical intervention to keep the active elderly functioning at a high level, these physicians are committed to giving each patient optimal, individually tailored care.
Primary Care Sports Medicine for Active Individuals
One innovative service NYP Lawrence is bringing into Westchester County is primary care orthopedics, a unique service offering for patients who do not require surgical care but require musculoskeletal medical care related to a chronic or acute condition affecting their health or athletic performance. Primary care orthopedists specialize in noninvasive modalities, developing long-term relationships with patients as they help them move more effectively, whether their goals include climbing a flight of stairs or pitching a curveball.
Board-certified in both orthopedic surgery and sports medicine, Charles A. Popkin, MD, specializes in the treatment of sports-related musculoskeletal injuries and conditions affecting the pediatric, adolescent and collegiate athlete. As a local member of the ColumbiaDoctors Orthopedics & Sports Medicine team in Bronxville, Dr. Popkin now also performs surgery in NYP Lawrence’s spacious and state-of-the-art operating suites.
“This is a very fast-growing service line,” explains Elan Goldwaser, DO, CAQSM, specialist in primary care orthopedics and interventional sports medicine at ColumbiaDoctors Orthopedics and NYP Lawrence and Assistant Professor of Sports Medicine at Columbia University Irving Medical Center. “Since I’ve started working for ColumbiaDoctors in Westchester County, my patient panel has filled rapidly. We’re looking at hiring more primary care sports medicine physicians.”
The service line is unique because patients may visit — much as they would a typical primary care provider — when they are not necessarily ill or injured. Instead, they are often looking to build, maintain and improve sports health.
“Many of my patients want to enhance their athletic ability to achieve peak performance and optimize their health without going through a surgical route,” Dr. Goldwaser says. “That being said, orthopedics has traditionally been a surgical field. Patients enter the office with a little skepticism. ‘How can you make me better without doing surgery?’ they ask. As a primary care orthopedist and interventional sports medicine physician, I advocate for my athletes. They are hesitant to disrupt their bodies, but they want to be ‘tuned up.’ In my specialty, we pride ourselves on meeting athletes’ needs without invasive procedures and lengthy recovery times away from their favorite sports.”
Though Dr. Goldwaser and his colleagues frequently use the word “athletes” — and often work with elite sports figures at the top of their games — the term encompasses a wide range of patients.
The newest surgeon to join the ColumbiaDoctors Orthopedics & Sports Medicine team in Bronxville is David Kovacevic, MD. Dr. Kovacevic has extensive experience as a team physician for several sports teams, including football, men’s collegiate baseball, men’s and women’s collegiate rugby, and professional soccer.
“We may think of a high school student or an aspiring college athlete, but in reality, an athlete is anybody performing any activity — anyone trying to maintain their physical endurance, their health, their form.” Dr. Goldwaser says. “I see patients from birth to well into their 90s, all of whom are active and moving. Everyone is athletic in their own way. I work with each person in a tailored, individualized way so they can achieve their goals. I help them make sure their biomechanics are aligned to optimize healing. This may include, for instance, ensuring their rolled ankle is not hindering them from enjoying their granddaughter’s birthday party, or helping a student be able to walk during their graduation.”
In this mission, noninvasive treatment modalities are at the forefront — a theme that recurs over conversations with multiple NYP Lawrence sports medicine physicians.
“We have many tools at our disposal,” Dr. Goldwaser says. “We examine functional movement. Everybody moves as an individual. Often, injuries result from poor biomechanical posture and from abnormal movement patterns. Physical therapy is an excellent option for these patients.”
Even when chronic or traumatic injuries are beyond the reach of physical therapy alone, the physicians of NYP Lawrence have numerous low-acuity modalities at their fingertips.
“We use ultrasound-guided diagnostic tools and injection-based therapies, medications including corticosteroids, and ortho-biologics, such as platelet-rich plasma and stem cell injections,” Dr. Goldwaser says. “These are a few of our options for minimizing inflammation and restoring or regenerating damaged tissue.”
Advanced Care for Elite Athletes
Especially at the highest levels of performance, athletes may prefer or require noninvasive or minimally invasive care modalities. Expert surgeons with ColumbiaDoctors Orthopedics at NYP Lawrence offer a host of approaches to injury care and management, including cutting-edge medications as well as advanced surgical techniques.
Dr. Goldwaser’s training as an osteopathic physician allows him to offer patients additional treatment approaches to promote healing through a variety of options and tailored patient care. He is an experienced team physician to high school, collegiate and professional athletes and is accustomed to treating injuries sustained at sporting events, such as concussions, ligament injuries and leg somatic dysfunctions (including Achilles/patellar tendinitis).
For instance, David Kovacevic, MD, Assistant Professor of Orthopedic Surgery at Columbia University Irving Medical Center and Chief of Shoulder, Elbow and Sports Medicine at NYP Lawrence, has a special focus on medical interventions for damaged joint tissue. He has received research grants to investigate the role of human amniotic tissue in improving healing in rotator cuff tear and repair. Dr. Kovacevic, who completed his fellowship training in shoulder, elbow and sports medicine at Columbia Orthopedics, says he was drawn to NYP Lawrence in significant part by the leadership of Dr. Levine.
“Dr. Levine is transformational,” he says. “When he reaches out and calls you to bring you back home, the answer is quite simple.”
In his new position in Westchester County, Dr. Kovacevic, who cared for the New York Yankees during his fellowship at Columbia, will also draw on his experience as head team physician for Yale Men’s and Women’s Rugby as he cares for elite athletes as well as patients at all levels.
“We individualize treatment plans depending on the patient’s expectations and goals,” he says. “We may modify our recommendations based on the work or sporting demands placed upon them and their level of play — whether they’re a professional athlete or they’re officiating at sporting events, for example.”
Serious bodybuilders, he illustrates, may develop mild arthritis in the knees or shoulders in their 40s or 50s; however, replacement surgery would sharply curtail their participation in the sport. Instead, Dr. Kovacevic may select from alternatives to joint prosthetics, such as injectables or cartilage restoration procedures.
“As a first line, we frequently use corticosteroids or lubrication injections known as hyaluronic acid,” he says. “If additional approaches are necessary, we may try different types of ortho-biologics. Some, like platelet-rich plasma or human amniotic fluid, are still in the investigative stages. We do employ them sparingly in certain situations. I may also refer a patient to a sports medicine primary care physician, such as Dr. Goldwaser, for ultrasound-guided injections of topical steroids, dry needling, or other alternative modalities and complementary therapies.”
For patients who still experience joint pain and loss of function, Dr. Kovacevic employs a “keyhole” arthroscopic approach to access the joint.
Dr. Kovacevic specializes in shoulder, elbow, knee and sports medicine at the new ColumbiaDoctors practice location in Bronxville. His area of expertise is in advanced shoulder and elbow repair, complex reconstruction, and joint replacement. Dr. Kovacevic performs advanced arthroscopic, arthroscopic-assisted and open surgical techniques that can relieve pain, restore function and improve quality of life.
“When we do perform surgery, it is minimally invasive,” he says. “Similarly, when an athlete has a small tear and requires repair, we work through a small opening to get the athlete safely back on the playing field as soon as possible, hopefully able to do what they love free of pain. Our surgical patients also benefit from having their procedures done in a low-stress community setting without compromising on quality. The surgical facilities at NYP Lawrence are outstanding, from beautiful new operating rooms to state-of-the-art surgical equipment.”
Balanced Care for the Growing Body
Mastering safe, skillful and powerful movement begins with the first steps, and some physicians in NYP Lawrence’s Orthopedics and Sports Medicine program focus specifically on pediatric sports medicine. One of the distinct challenges of working with this patient population, Dr. Popkin says, is balancing the patient-physician relationship with the parent-physician relationship and the child’s larger social context — as well as his or her proprioceptive sense and relationship with his or her body.
Dr. Popkin is committed to staying abreast of the latest trends in sports medicine for both adult and pediatric patients. He is currently conducting research on ice hockey-related knee injuries, ACL injury prevention, ACL reconstruction techniques in the pediatric athlete and advanced arthroscopic techniques for the elbow. Dr. Popkin is also looking at the influence of parents on sports performance among young athletes.
“Children are growing into their bodies, so they have unique injuries, primarily relating to that dynamic,” he says. “Then they have to balance school and sports and manage parents’ expectations as well. There is definitely a healthy balance we are striving to achieve. One challenge facing Westchester County sports medicine pediatricians is the pressure for athletic achievement. When kids push the envelope, adults around them may urge them to use their bodies too hard before they are ready for that workload. We see many overuse injuries related to such pressure, including pediatric tendinitis and Osgood-Schlatter disease.”
Pediatric sports medicine physicians use many of the same modalities as their colleagues in adult sports medicine, treating injuries with rest, nonsteroidal anti-inflammatory drugs and physical therapy. However, Dr. Popkin says, some challenges, such as growth plate injury, require specialized management.
“When appropriately guided, children heal and do well, whereas adult sports medicine in some cases comes down to counseling and acceptance of limitations as the body ages,” he adds. “I like the mix of adults and children; they present challenges in different ways.”
Because of the unique challenges presented by pediatric and adolescent patients, Dr. Popkin recommends a referral to a specialist when a child experiences swelling around a joint, such as the knee, limps while playing a sport, or suffers a more acute musculoskeletal injury.
“We’re using a model of pairing therapists with a background in a particular sport with athletes who are returning to that sport. This is a very niche offering; the athlete will be able to receive counseling and physical therapy from someone knowledgeable in his or her sport.”
— Charles Popkin, MD, pediatric and adolescent sports medicine specialist at ColumbiaDoctors Orthopedics and NYP Lawrence and Assistant Professor of Orthopedic Surgery at Columbia University Irving Medical Center
Advanced Sports Medicine for Westchester County
Emblematic of NYP Lawrence and ColumbiaDoctors Orthopedics’ commitment to the Westchester community is a new sports performance center scheduled to open in early 2019. This program will bring world-class performance analysis and training to athletes of all ages and ability levels, as well as a host of other orthopedic, nutritional and physical therapy services.
The NewYork-Presbyterian Lawrence Hospital Physical Medicine & Rehabilitation Department actively supports the ColumbiaDoctors sports medicine program. In collaboration with orthopedists, physical therapists offer patients a high level of care during their rehabilitation regimen. John Reda, DPT, OCS, ATC, assesses as a patient utilizes a slide board to build strength in her hip musculature and improve alignment of her hips, knees and ankles. The physical therapy facility located in Eastchester is staffed with a team of therapists who regularly treat pediatric, adolescent and adult athletes.
“The sports performance center grew from the vision of Dr. Levine and Dr. Chris Ahmad,” Dr. Popkin says. “We’re focusing on bridging the gap in sports medicine between when an athlete finishes physical therapy and is ready to return to play at full power. We’ll have sports medicine specialists and physical therapists who can help patients who are winding down therapy and getting back to the field.” Joseph Ciccone, DPT, a physical therapist and former Fordham baseball player, will be among the staff.
“He’s spent a lot of time rehabilitating Yankees players and brings deep expertise in physical therapy for that sport,” Dr. Popkin says.
“We are giving athletes of all ages and levels a greater range of care,” Dr. Kovacevic adds, “providing a holistic, whole-body approach to treating and preventing injuries.”
Another key aspect of the sports performance program will be movement analysis, in which physicians and technicians employ advanced techniques to observe and analyze everything from gait to sports-specific movements. “We will monitor kinematics, such as how people throw or kick,” Dr. Kovacevic explains. “We place markers on the athlete, then track them via video and motion analysis software. We can then assess any deficit they may have and how to correct that.”
“From a research point of view, we can perform pre- and post-surgical analysis of movement,” Dr. Popkin adds. “We can also track movement to pick up patterns that may result in injury — this technology can be used in multiple ways.”
These new capabilities reflect NYP Lawrence and ColumbiaDoctors Orthopedics’ larger mission of caring for athletes in a collaborative multispecialty environment.
“As physicians, we work closely with physical therapists to look for abnormalities in gait patterns, postures and throwing mechanics,” Dr. Goldwaser says. “We have access to resources such as the Columbia RunLab, which lets us examine gait patterns and perform running analysis through 3-D reconstruction. We can actually slow down a runner’s technique and evaluate it in slow motion, pinpointing errors down to the individual muscle. We can observe how a runner moves differently in different shoes, for instance. It’s a very successful way to rehabilitate patients and tease out nuances of performance that could be optimized.”
“The sports performance center represents the commitment of both NYP Lawrence and ColumbiaDoctors to bring nationally recognized, expert orthopedic care into the community and deliver cutting-edge treatments to patients. But we hope to do more than just correct any issues patients may have. We’re looking to teach our patients and be taught by them in return. We want to prevent injuries from occurring in the first place but also never miss an opportunity to continue educating ourselves through each patient’s unique circumstances.”
— Elan Goldwaser, DO, CAQSM, specialist in primary care orthopedics and interventional sports medicine at ColumbiaDoctors Orthopedics and NYP Lawrence and Assistant Professor of Sports Medicine at Columbia University Irving Medical Center
Only the Beginning
NYP Lawrence and ColumbiaDoctors Orthopedics are committed to helping local athletes perform to the best of their abilities. They are also dedicated to partnering closely with local physicians.
The new ColumbiaDoctors Orthopedics & Sports Medicine practice in Bronxville has assembled an experienced and caring team of support staff and clinicians to assist its patients. Some of the team members include, from left, Lilah Oasman, front desk reception; Amanda Finklea, RN; and Danielle M. Annis, MAT, ATC. For more information about the ColumbiaDoctors sports medicine program at NewYork-Presbyterian Lawrence Hospital, visit nyp.org/lawrence-ortho.
“We want referring physicians to know that we will do whatever it takes to get their athletic patients better,” Dr. Kovacevic says. “Collectively, we believe in providing compassionate, first-rate care in the least invasive, most effective fashion.”
“We do more than care for the presenting injury — we work to heal the individual as a whole,” Dr. Goldwaser adds. “I want to work with the patient to rehabilitate him or her to their peak performance level.”
To learn more, visit nyp.org/lawrence.