COMMON CONCERNS AS WE AGE

In our senior years, we hope to enjoy retirement while checking the fun items off our bucket list. Those senior years can be fulfilling however, they sometimes bring physical pain.

285x285_Arthritis_Rashes_2

Arthritis is the #1 condition experienced by seniors, affecting more than 50% of adults over 65 years of age.  It can be painful, but the good news is that it can be managed.  Most important is to keep moving, under the supervision of your physician, in order to manage the discomfort.  “Move it or lose it” is a great motto. Here’s a useful link with information from the Arthritis Foundation: http://www.arthritis.org/living-with-arthritis/tools-resources/

Fall-Prevention-Pic-1-300x201

Falls and Injuries contribute almost 30% of emergency room visits with over 20% of those occurring from accidental falls in the senior population.  This risk increases with age and occur largely in the home where loose rugs and slippery floors are major hazards. Fall Prevention week was in September but it’s never too late to read up on how to avoid common accidents. This link from the Mayo Clinic has practical advice on how to avoid becoming a statistic: http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/fall-prevention/art-20047358

osteoporosis

Osteoporosis affects over 52 million Americans.  This condition of low bone mass can limit mobility. October 20 is World Osteoporosis Day and the National Osteoporosis Foundation has assembled pertinent information to help understand prevention and treatment of osteoporosis. Here is their website:  http://nof.org/

At SOA we are committed to helping our patients get back on their feet, back to work, back in the game, and back to life. Call us at 941-951-2663 (BONE) for an appointment at any of our three locations in Sarasota, Lakewood Ranch, or Venice.  Be well and stay healthy!

 

 

WHY SEE AN ORTHOPEDIC FOOT & ANKLE SURGEON IF YOU DON’T WANT SURGERY?

Foot pain

Foot and ankle pain affects a large part of the population at any given time and can be quite disabling. Even if your pain doesn’t keep you from work or play, it can significantly affect your quality of life.

I frequently have patients that are surprised when I give them exercises, medications or other lifestyle modifications to help with their foot and ankle pain. They are often even more surprised when their pain gets better with simple changes! Many of the conditions that cause significant pain in the foot and ankle result from mild biomechanical imbalances and can be addressed without surgery.

happy foot

As an orthopedic foot and ankle surgeon, I consider myself an expert in treating disorders of the bones, muscles, tendons, and ligaments of the foot and ankle. Taking care of foot and ankle problems can be challenging and requires extensive knowledge of the anatomy and biomechanics of not only the foot and ankle, but the entire body. Knowing how to expertly perform the surgery is important, but perhaps more important is knowing when it is appropriate. My approach is to use surgery as a last resort when non-surgical options have been exhausted.

If you have been dealing with pain, instability or weakness in the foot and ankle, come see me, Eric R. James, MD at Sarasota Orthopedic Associates to discuss the options we have to get you back on your feet, back to work, back in the game, and back to life. We have three locations in Sarasota, Lakewood Ranch, and Venice and offer same day appointments.

dr james cropped  Eric R. James, MD / Orthopedic Foot & Ankle Surgeon

 

How much do YOU know?

SKELETON THINKING

Try our fun orthopedic quiz …

  1. What is the meaning of the word orthopedic?
  2. How many bones in the adult human body?
  3. In what part of the body are most of our bones located?
  4. What does PRP stand for, and what is it?
  5. Where is the largest bone in the human body?
  6. What is Radiofrequency Ablation?
  7. Where is the smallest bone in the human body?
  8. What is the most commonly broken bone in the adult human body?
  9. How are falls best prevented?
  10. What is the number one cited reason for seeing an orthopedic physician?

answers

How did you do?   Check your answers here:

  1. Orthopedic comes from the Latin “ortho” (meaning free from deformity) and “pais” (meaning child). Early orthopedists would brace children to grow upward, strong, and straight. At SOA we treat children as well as adults.
  2. The human skeleton at birth is composed of 270 bones. By adulthood, some of these have fused together and decrease to 206, reaching maximum density at around age 30.
  3. Hands have the most bones, 27 in each hand. Feet are a close second with 26 in each foot.
  4. PRP stands for Platelet Rich Plasma. Blood is drawn, then centrifuged to separate the blood from the platelets; it is then injected into the appropriate site. The theory is that a large quantity of platelets might contribute to healing factors.
  5. The femur, or thighbone, is the largest bone in your body.
  6. RFA is a procedure where a specialized needle uses heat at a nerve site to block pain signals to the brain.
  7. The smallest bone is found in the middle ear, called the stapes.
  8. Almost half of adult broken bones are in the arm.
  9. Exercising may reduce injuries and improve balance.
  10. Knee pain was cited as the number reason in the U.S. for visiting an orthopedic physician.

Did you learn something new about orthopedics?  Want more?  Be sure to check all our blogs for information on many of these subjects, or, goto our home page at  www.SOA.md and learn all about us. Our goal is to get our patients back on their feet, back to work, back in the game, and back to life!  Call us at 941-951-2663 (BONE)  for an appointment at one of our three locations with one of our thirteen orthopedic physicians.

ANATOMY OF A GOLF SWING

golf-swing

With today’s modern golf swing, there are numerous muscle groups and joints which need to be on the same page to best provide one with an effective, powerful stroke while minimizing the risk of injury. An often neglected part of the body with regards to many players’ swings is the hip joint and its surrounding structures.

Prevention

Placing focus on properly preparing the hip joint to maintain appropriate flexibility will best ensure that it can withstand the forces seen with one’s golf swing. Basic stretching exercises for the hamstrings, hip flexors, and rotators are essential. The average PGA golfer has roughly 45° of hip internal rotation. Lacking internal rotation leads to increased extension of a golfer’s pelvis which can result in low back pain and decreased drive. In addition, recent studies have shown that golfers with strong hip musculature have lower handicaps and longer driving distances compared to those with weak hip muscles. Combined with safe core strengthening, these steps will help one produce the maximum power with their swing while reducing the risk of back and other joint injuries.

Causes

Hip pain in golfers may be the result of minor strains, soft-tissue inflammation, such as bursitis, and even arthritis. The modern golf swing, with its requirement for large amounts of body rotation, can subject one’s body and hip joint to perhaps more than it can tolerate, rendering it vulnerable to injury. Labral tears, while perhaps more common in other sports, can also be a cause of hip pain in golfers. A stabilizing and supportive structure, the labrum can be damaged when subjected to increased pressure in a hip joint which lacks the necessary flexibility to withstand the forces seen with the modern golf swing. This may result in groin pain, clicking or locking sensations, discomfort when squatting to read a putt or pick up a ball, or even restricting one’s swing.

Treatment

The first steps to take in treating hip pain associated with golf involve the usual conservative measures, including rest, ice, and over the counter pain relievers and anti-inflammatory medications. If these fail to alleviate the discomfort, formal physical therapy with an experienced provider familiar with golf related injuries can often target the specific muscle imbalances and tightness which made one prone to such an issue in the first place. Injections, such as steroid and platelet-rich plasma (PRP), can also be useful for a variety of hip related pathologies. Lastly, when non-operative treatments fail, surgery can be considered. For labral tears, recent advances in hip arthroscopy have enabled surgeons to repair this important anatomic structure through minimally invasive techniques, and best preserve the hip joint for countless rounds of future golf.

Our commitment at Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life.  Trevor Born, MD is fellowship trained in Sports Medicine at SOA and will help you get back in the game. Same day appointments are available at any our three locations by calling 941.951.2663.

SEND IN THE CLOWNS … THE 24 HOUR GIVING CHALLENGE

GivingChallenge-SOA-REVISED

A few months ago, we announced our official orthopedic partnership with the Circus Arts Conservatory (CAC). You may wonder what orthopedics has to do with a circus.

The obvious answer is the circus is comprised of athletic performers and SOA specializes in Sports Medicine, so it’s a PERFECT match.  MOST important, SOA supports the educational aspect of the CAC. When people think of the CAC, they first think of spectacular entertainment.  What many don’t realize is the phenomenal contribution the CAC makes to our community from their Education curriculum. Did you know:

  • the Circus Education program teaches in 15 area schools across Manatee and Sarasota Counties
  • 80% of ticket revenue supports community outreach
  • Sarasota is known as  the Circus Capital of the World
  • the CAC Circus Education program teaches Newton’s physics, law of Universal Gravitation, through juggling
  • the CAC donates over 5,000 tickets annually to over 50 non-profit organizations
  • they depend on 300 volunteers annually to run their programs
  • their educational program is designed to include students who would otherwise not respond to traditional instruction
  • their outreach program proves when children are actively engaged, they are able to understand
  • their Humor Therapy educational program goes far beyond entertainment, improving the quality of life for those in hospitals and ALFs…Humor Heals
  • the Humor Therapy team made 368 visits to local care facilities this year
  • physical activity in children = higher academic achievement in school … Circus Education reaches out to grades K-8

 Wow, that’s a lot … and there’s so much more as to how the Circus Arts Conservatory reaches out to folks of all socio-economic circumstances, ethnicities, gender, and ages.

So why are we telling you this?  The Circus Arts Conservatory needs our help and we need yours. Beginning September 1st and continuing for 24 hours, the CAC will participate in the 2015 Giving Challenge. Over 400 local non-profit organizations work tirelessly without sleep to garner donations for their cause as well as vie for grant money through the Community Foundation of Sarasota and the Patterson Foundation. Over the past three years, the Giving Challenge has raised over $8 million dollars for local non-profits. Special grants will be awarded for Most New Donors, Best Overall Campaign, Best Video, and Best Business Partnership … as the CAC Business Partner, SOA is encouraging all our patients, staff, family, friends, and social media followers to join the challenge.

On September 1st at noon (not before!), please go online to www.circusarts.org/givingchallenge and make a donation.  This year, new online donations between $25 and $250 will be matched, making your gift even more important.   At the online site, you will be able to follow the 2015 Giving Challenge leaderboard of all the local non-profits to see how much is being raised in real time.  For a closer look at the CAC educational program, watch this video:  https://vimeo.com/134961942   … then donate on September 1st.  Everyone one of us at SOA appreciates your participation … WE APPLAUD YOU FOR HELPING!

CONCUSSION: Causes, Symptoms, and Treatment

concussion-word-art4

What is it and what causes it? Concussion in sports involves a complex process whereby trauma induced to the body or head creates abnormalities in processing of the brain.  While most people believe that a concussion requires a direct hit to the head, many athletes can develop a concussion even from blows to the body, which involve a sudden acceleration or deceleration force.  An estimated 3.8 million concussions occur in the US during recreational and competitive play with many more going unreported.

What are the symptoms of concussion? The symptoms from a concussion are extremely variable and no one concussion is the same as another.  Many athletes will experience headache, fogginess, dizziness, sleep difficulties, irritability, and difficulty concentrating just to name a few. Unfortunately, the symptoms of dizziness and fogginess can be associated with a longer time to recover completely.

Who is at risk of a concussion? Unfortunately some athletes may be a greater risk for a experiencing a concussion.  Younger athletes, female athletes, athletes with Attention Deficit Disorder (ADD/ADHD) as well as those who have experienced a previous concussion are at greatest risk for experiencing a concussion.

Concussionsgirls_400

How are concussions treated? This area of sports medicine continues to evolve and clinicians are changing the way concussions are managed.  With appropriate history, physical examination, and testing, clinicians are better able to gear specific treatment strategies towards an athlete’s symptoms.  While 90% of athletes will recover from a concussion in 3-4 weeks with relative rest and modifying aggravating activities, the other 10% may need dedicated rehabilitation strategies to help them overcome symptoms.  Once an athlete is symptom free, they can begin a graded exercise program that helps return them back to the sport safely.

At SARASOTA ORTHOPEDIC ASSOCIATES we have physicians who are trained at identifying high school athletic concussions and are able to recommend appropriate treatments, which will help them get back on their feet, back to work, back in the game, and back to life.

PAUL LENTO, MD / FAAPMR (click here for more on Dr Lento) / Triple Board Certified in Physical Medicine and Sports Rehabilitation

 

CHRONIC PAIN: A new innovative, minimally invasive treatment

back-pain-manture-woman-white-e1313440331753

Chronic pain is a largely under-treated and misunderstood disease that affects more than 1.5 billion people worldwide according to the American Academy of Pain Medicine. Sarasota Orthopedic Associates offer an alternative solution that has proven to be quite successful for many of its patients:  spinal cord stimulation (SCS) which was approved by the FDA in 1998. In a 2009 study published in the Journal of Clinical Monitoring and Computing, researchers noted that SCS is “effective in reducing intensity, duration and frequency of pain experienced by the patient.”

SCS is for those who have endured chronic pain in the neck, back, arms or legs, neuropathic pain (burning, tingling or numbing sensations), or inadequate surgeries.  Think of it as analgesia “on demand,” though the patient must go through a broad prescreen before the trial can be done.

HOW IT WORKS

The SCS system consists of a pulse generator with remote controls, implanted to stimulate electrodes and conducting wires, known as “leads”, connecting the electrodes to the generator, similar to a pacemaker. To qualify for permanent implantation, a patient must undergo a trial period of about a week. During this time, a temporary stimulator device is implanted by the physician after a local anesthetic or sedative is administered. The physician places the leads under the skin, guided by an X-Ray machine and a radiology technician. The leads are then attached to a small, hand-held generator that the patient controls. The generator sends electrical pulses to the spinal cord, thus interfering with the nerve impulses that cause the pain sensation.

scs - Azeem

The system replaces pain with a feeling of massaging – or merely just the absence of pain. It may allow for reduced pain medication and help the patient improve mobility. Often times patients experience relief immediately, though the leads may occasionally need to be adjusted for optimum performance.

The spinal cord stimulation devices at Sarasota Orthopedic Associates are supplied by St. Jude Medical, whose motto is “Power over pain.” The company has a longstanding relationship with physicians and are able to directly answer patients’ questions or help them out with maintenance of the device. Says Dave Moss of St. Jude Medical, “We provide the stimulation device and become the first line when dealing with it. We have an excellent relationship with Sarasota Orthopedic Associates and Dr. Nomen Azeem and, we are very ingrained in the practice while working efficiently with their staff.”

“As an interventional pain physician, I witness the debilitating effects of chronic pain physically, mentally, and psycho-socially which impact individuals’ quality of life” said Dr Nomen Azeem. “All pain physicians worry of the long term systemic effects of pain medications. Fortunately, the technological advances being made in the field of neuro-modulation are astounding and have revolutionized how we think about treating neuropathic pain.” Dr. Azeem, Interventional Pain and Sports Medicine Specialist at Sarasota Orthopedic Associates, has seen a vast increase in quality of life for many of his patients, without having to resort to invasive surgery or increased medication.

Dr. Azeem is double board-certified  in Interventional Pain Management and Physical Medicine and Rehabilitation, and an expert in minimally invasive procedures for treating chronic back pain (with or without leg pain), chronic neck pain (with or without arm pain), pain that persists after back or neck surgery, peripheral neuropathy, Reflex Sympathetic Dystrophy (RSD), Occipital Neuralgia, and Post-Herpetic Neuralgia.  Click HERE to learn more about Dr Azeem or HERE to learn more about Sarasota Orthopedic Associates.

 

9 SMART FOODS FOR HEALTHY BONES

OPENER__Skeleton

You’ve heard calcium and vitamin D are essential to maintaining strong bones and slowing osteoporosis. Here’s a list of bone-smart foods to include in your diet that will pack a punch in elevating your calcium and vitamin D intake:

  • Hearty greens like kale and spinach have an added plus of iron
  • Sardines may be off-putting for some but even a tiny portion will add to bone health
  • Salmon, as little as 3 ounces, has 100% of your daily vitamin D and an added bonus of Omega-3 fatty acids
  • Fresh OJ but watch your portion of sugar intake
  • Yogurt; not the Greek style … it has less vitamin D than the regular
  • Milk – choose low fat, fortified with vitamin D
  • Eggs; don’t be afraid of the yolk which is where the vitamin D is located
  • Cheese, in moderation please … two small cubes should suffice
  • Fortified cereals

What are YOUR “go-to” healthy favorites? Let us know in the comment section below.

Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.  A healthy diet is essential to your bone health. If you’d like to view information about Sarasota Orthopedic Associates, our facility, our locations, or our physicians, please CLICK HERE.

PRP – What is it and how can it help me?

prp

Platelet rich Plasma (PRP), a minimally invasive treatment for Tendinitis and Arthritis, is an enriched blood product composed primarily of platelets — a type of cell found in the blood. PRP is an emerging clinical tool for use in a wide variety of medical applications. With PRP, a blood sample is collected and then blood plasma is concentrated with higher than normal amounts of platelets, which most famously play a role in blood clotting, but have also been discovered to release a multitude of protein growth factors involved in many other biological responses involved in healing and tissue repair. The theory behind PRP is that by introducing platelets in large quantities to an injury site, the excess of growth factors might stimulate inflammation and heal long-term injuries contributing to chronic pain. PRP was first utilized during an open heart procedure in 1987, and has since found application in a wide variety of medical specialties. The growing medical application of PRP is a direct result of an increased understanding of platelets and their physiological role in healing processes.

PRP-Feat

Musculoskeletal injuries are one of the most common causes of chronic pain and disability in the world, and PRP has been shown to be particularly suited their treatment. Tendons in particular are vulnerable to injury as they anchor muscle to bone and are responsible for handling large amounts of force. They also heal very slowly, as the fibrous tissue contains very little vascular supply with which to receive blood and healing mediators such as platelets.  PRP has more recently been reported to be helpful in the treatment of chronic pain due to osteoarthritis, bursitis, and plantar fasciitis. Clinical studies continue to accumulate data on the potential benefits of PRP therapy. Some of the best documented musculoskeletal conditions that have been effectively treated with PRP therapy include:

  • Epicondylitis (Tennis Elbow/Golfer Elbow)
  • Tendinopathy/tendonitis (Achilles/Patellar/Rotator Cuff)
  • Osteoarthritis

Dr. Nomen Azeem, Interventional Pain and Sports Medicine Physician at Sarasota Orthopedic Associates, has done extensive research in the use of PRP for painful musculoskeletal conditions and has had numerous patients benefit from this progressive treatment.  He reports, “Many patients become frustrated having tried anti-inflammatories, physical therapy, and even steroid injections without long lasting relief of their pain. I am excited to be able to offer a minimally invasive treatment option for such patients, allowing them to experience long term pain relief.” For more details, please visit our website HERE.

 

A NEW TREATMENT FOR CHRONIC KNEE PAIN

knee pain

Chronic knee pain is a very common complaint in the United States. The typical conservative treatments for knee pain are physical therapy and over-the-counter pain medicines. The next step in treatment may call for injections, with steroids or visco-supplementation such as Synvisc/Euflexa treatment, along with prescription pain medications. Beyond that, knee replacement surgery has been a common solution to chronic knee pain due to osteoarthritis.

Dr. Nomen Azeem, an Interventional Pain and Sports Medicine Physician at Sarasota Orthopedic Associates, offers a new solution called knee radiofrequency ablation (Knee RFA) for his patients who suffer from chronic knee pain. This procedure can help patients delay or even avoid surgery, and may also provide pain relief to patients who have already had knee replacement surgery.

Knee RFA is an outpatient procedure carried out in two steps. In the first procedure, which is diagnostic, a medication is injected into the nerves around the knee, called the genicular nerves. This medication serves to temporarily block the pain signals.

If a patient gets pain relief from the diagnostic procedure, the doctor will move forward with the second step, which is the actual knee radiofrequency ablation. In this procedure, a specialized needle is used to apply heat directly to the genicular nerves of the knee. After a genicular nerve is heated in this way, it is unable to continue sending pain signals to the brain. The pain relief from this procedure may last six months or more. While this is a new type of procedure, radiofrequency energy has been used in medical procedures for over 75 years and is very safe.

Dr. Nomen Azeem, of Sarasota Orthopedic Associates, is excited to offer this treatment and says, “The genicular nerve block and radiofrequency ablation of the knee has been a great option for several of our patients who suffer from chronic knee pain.”

A recent patient who is happy with the results achieved just one week after his procedure said, “I’ve had pain since my knee replacement. Nothing provided me with any pain relief, aside from drugs. This procedure has provided 95 percent pain relief so far. It has definitely helped my quality of life.”

For more information on Dr Nomen Azeem, please click HERE. To explore the full web site please click HERE.