Tag Archives: fellowship trained

KNEE PAIN? Get Back In The Game

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To the casual observer the sport of golf may seem a relaxing, calm respite from daily routine, however nothing is farther from the truth. Today in the U.S. there are over 25 million golfers and 15-20% of them will experience some form of golf injury. Of those, 80% will be from overuse and improper form. Worse, 50% of golf injuries will become chronic.

Low back pain is cited as the #1 complaint from golfers; however knee pain takes its toll on golfers as a very common ailment. This is hardly a surprise when you realize the sport requires excessive rotation of the knee as well as disproportionate force during your swing. When simply walking you are distributing your body weight evenly. In golf, the principal hazard to the knee is on the downswing when the forward knee experiences 4 ½ times your body weight and the opposite knee 3 ½ times. For example, a right handed golfer of 180 pounds will place 810 pounds of weight onto their left knee from a powerful downswing. This process repeated over 18 holes places a heavy burden on the knees, particularly the left knee.

One of the more common knee injuries we see in golfers is a meniscus tear. The meniscus is a shock absorber, with one located on either side of the knee to help evenly distribute weight across the knee. When a meniscus is torn, you may have pain, swelling, or stiffness, and may find yourself suddenly off balance from your knee “giving out”. Golf activity may exacerbate a pre-existing tear.

So, how can you prevent or limit injury to continue enjoying your game? Here are some tips:

  • If you haven’t golfed for an extended period of time, don’t jump back into the game. Ease in slowly.
  • Perform appropriate warm ups with stretching, including calves, to diminish risk of injury.
  • To stabilize your knees, keep your lower back and hip muscles strengthened with proper and regular exercises; see your physical therapist or golf coach for tips.
  • Increase your overall flexibility.
  • Use a ball retriever instead of bending at the knees to pick up your ball.
  • Decrease the frequency of your games when you have knee discomfort. If you typically golf 3 or 4 times a week, reduce that to once or twice. Rest between games. Repeating the same activity every day will intensify your condition.
  • A knee brace during play may help lessen discomfort.
  • Ice your knees for 10-15 minutes after 18 holes.
  • If you’ve had knee surgery, it is critical to follow your physical therapy protocol and receive clearance from your physician.

Jeffrey Silverstein, MD is a Fellowship Trained and Board Certified Orthopedic Surgeon with a specialty in hip and knee joint reconstruction. At Sarasota Orthopedic Associates our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.  Fore!

BACK TO LIFE: MANAGING YOUR HIP PAIN

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Hip pain is a very common complaint we hear from patients at Sarasota Orthopedic Associates. A decrease in mobility may make your daily activity problematic, depending on the severity. Did you know hip pain stems from many different causes?

We typically think of a broken hip as a condition suffered by the elderly, however hip fractures can occur in younger patients, particularly from a traumatic injury such as a serious fall, sports injury, or auto accident. These injuries may also involve labral tears, impingement, avascular necrosis (loss of blood to the bone), bursitis, and muscle tears.

The most common condition we see as a cause of hip pain is osteoarthritis (OA), also known as degenerative joint disease. This is the wear and tear of the joints occurring when the cartilage (or cushion) between joints breaks down. Characteristic indicators of OA might be pain, stiffness, swelling, and/or loss of mobility. Currently there is no cure for arthritis, however there are many ways to help manage it.

hip pain

Whether trauma or arthritis, at Sarasota Orthopedic Associates we begin with a comprehensive evaluation to ensure an accurate diagnosis. Typically we you will have a digital x-ray taken on-site in our office at your first appointment. Having on-site technology allows for a prompt diagnosis. Knowing the exact problem is essential to determining the best treatment options for you.

In the case of a less serious hip injury, Physical Therapy may be all that’s needed to extend your range of motion and manage your condition. PT and regular low impact exercise, such as bike riding or walking, may strengthen your muscles and help relieve discomfort in the joints. NSAIDs (nonsteroidal anti-inflammatory drug) or aspirin may be helpful, although should not be used on a long term basis. Other options include cortisone injections and PRP (platelet rich plasma) however, PRP is not a covered benefit of insurance and there is currently not enough scientific data to validate its effectiveness. It is important to know that nothing currently will regrow cartilage nor correct alignment.

hip injection

If measures to alleviate hip pain fail, you may want to explore a discussion with us about hip replacement surgery. You may be surprised to learn that hip replacement surgery can mean a relative quick recovery time. Everyone is unique so your timeline could be longer or shorter depending on individual circumstances. You will likely be in the hospital for about three days. A day or two after surgery you will start moving with assistance. Physical therapy will be fundamental to an optimal recovery. After 12 weeks, you may be able to resume normal activity under consent from your surgeon. In every case, it’s vitally important to discuss your situation with a skilled surgeon and listen closely to their advice.

The team of physicians at Sarasota Orthopedic Associates are experts in diagnosing and treating your condition. We have four convenient locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and are able to accommodate same day appointments when needed. Cal us at 941-951-2663 for an appointment or click HERE to view our website.

Sources: SOA website; WebMD; Arthritis Foundation; American Academy of Orthopedic Surgeons.

BAD TO THE BONE: Treating Knee Pain

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The knee is a very complex joint with many components making it vulnerable to a variety of injuries. When damaged, it can seriously impact your quality of life. Knee pain is one of the most common reasons people visit an orthopedic physician. Difficulty standing and walking can greatly diminish your sense of independence. The GOOD news is that most collective knee pain problems are treatable.

The CAUSES OF KNEE PAIN are many, including injury and disease. Injuries of the knee commonly seen tend to be damage to the anterior cruciate ligament, or ACL, and the meniscus. There are an estimated 2.5 million sports-related injuries a year just by adolescent athletes alone. A fracture is most often caused by trauma such as a car accident, a fall, or sports contact; the most common broken bone in the knee is the patella, more generally known as the kneecap.

Fast facts on knee injuries:

  • The highest knee injury rates occur in people between the ages of 15 to 24.
  • Sports participation is a high risk factor for knee injuries.
  • 60% of high school sports-related injuries occur in the knee.
  • Female basketball and soccer athletes are as much as 8 times more likely to suffer an ACL injury than a male.
  • Young athletes suffering an ACL injury will have an increased risk of arthritis as they age.

Orthotics-for-knee-pain

Avoiding knee injuries:

  • Warm up properly prior to exercising or participating in sports.
  • Wear proper footwear with a good fit.
  • Don’t increase sports or exercise workouts suddenly.
  • Wear knee guards in sports activities.
  • Maintain strong, flexible leg muscles.
  • Always, always, always … Use a seatbelt when driving.

The MOST WIDESPREAD DISEASE affecting the knee is arthritis, which is caused by the gradual wearing-away of cartilage. Primary symptoms are pain, swelling, and stiffness in the knee. Currently, there is no “cure” for arthritis, however there are options, both surgical and non-invasive. Depending on the amount of arthritic damage, treating knee pain may often be done without surgery. These options may include one or a combination of physical therapy, weight control, injections, medications, bracing, exercise, and strengthening. When considering knee replacement surgery, the physicians and physical therapists at Sarasota Orthopedic Associates have a wide array of experience and expertise.

Whatever the cause of your knee pain, from sports injury to trauma to arthritis, the 13 physicians at Sarasota Orthopedic Associates are here to help alleviate your discomfort. We have four convenient locations. Browse here to view our physicians and their specialties or call us at 941-951-2663 to make an appointment.

Sources: SOA.md website; MediLexicon International; arthritis.org; webMD

MAY IS NATIONAL ARTHRITIS MONTH: Getting the Upper Hand on Arthritis

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According to the Arthritis Foundation, 46 million Americans live with arthritis or chronic joint symptoms. Arthritis symptoms limit everyday activities such as dressing, bathing, and cooking for more than 7 million Americans. Half of those Americans with arthritis aren’t aware of options now available to help alleviate their symptoms.

The most common forms of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative joint condition in which the joint cartilage deteriorates resulting in pain and loss of movement when bone begins rubbing against bone. Your hands are constantly on the go. Everyday activities such as preparing a meal, woodworking, carrying grocery bags, or using your computer may damage your joints over time. Fortunately, joint protection techniques may help reduce pain, stress, and inflammation. These techniques may also help prevent further deformities and increase your independence in daily activities. There are many easy and inexpensive ways to protect your hands.

Here are a few tips to keep your hands healthy:

 Give your Hands a Break

  • If you have pain during an activity, stop the activity. Pain is one of the best ways your body has of letting you know you are causing tissue damage, so listen to and respect your pain.
  • If writing is painful, try using a thick, rubber grip pen with a gel tip or roller ball to decrease the amount of pressure.
  • Remember to stretch and take breaks every 15 minutes during repetitive or prolonged activities such as needlework, painting, sewing, knitting and crocheting, hammering, and filing.
  • Use enlarged grips on every day equipment or tools to reduce strain on your joints; e.g. potato peelers, gardening tools, tooth brushes, hair brushes, or build up the handles with foam.
  • Keep scissors and knives sharp to minimize effort.
  • Always use two hands when lifting heavy objects. A gallon of milk weighs about 8 pounds, and lifting it with only your fingertips places excessive stress on your joints.

Don’t Use your Hand as a Tool

  • Don’t tear your mail open – use a letter opener to open mail.
  • Use utility scissors in the kitchen – do not rip open bags.
  • Always use the right tool for the job – use pliers for tight pinching and a small hammer for pounding.
  • Use a staple remover instead of your fingers and thumb.

Use Adaptive Equipment to Decrease Stress on your Joints

  • Use foam to enlarge small diameter objects such as paring knives, cutlery, toothbrushes, paint brushes, pens, and pencils.
  • Purchase lightweight kitchen, gardening, and workshop tools with built-up handles.
  • Perform a search on the Internet for “adaptive equipment” to see what products are available.

When Symptoms Become Severe

If you have already tried these techniques but are still experiencing symptoms, it might be time to consider a consult with an orthopedic specialist.  Gregory Farino, MD, a Board Certified/Fellowship Trained hand and wrist specialist at Sarasota Orthopedic Associates, can help you with providing an accurate diagnosis as well as treatment options.

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In the initial stages of arthritis, conservative management provided by a hand therapist may be all you need. Hand therapists can fabricate splints to support and protect the joints, recommend home exercises to improve strength in the small muscles of the hand, and educate you on pain management techniques.

If the arthritic process or your pain and stiffness is more severe, treatments like oral and topical medications or a cortisone shot may help relieve pain and improve mobility and strength. If conservative measures are not successful, surgery may be recommended. Joint replacement or joint fusion surgery has been consistently successful for both osteoarthritis and rheumatoid arthritis.

The hand and wrist team at Sarasota Orthopedic Associates is here to help you manage hand arthritis and stay as active as possible. We have four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and offer same day appointments when necessary. Call us at 941-951-2663 for an appointment or visit our website at www.SOA.md for more information.

Note: Article written by Gregory Farino, MD, a Fellowship Trained and Board Certified Orthopedic Surgeon with a specialty in hand and wrist and Sangeetha Bulusu, OT, CHT, CLT (Occupational Therapist, Certified Hand Therapist, Certified Lymphedema Therapist). Both are available to see patients at Sarasota Orthopedic Associates.

Time Out with Johnny Gibbs, MD

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Our weekly blogs have given us fascinating insight to the more personal side of our SOA physicians. This week we sat down with Johnny Gibbs, MD, a Fellowship Trained, Board Certified Sports Medicine Physician, and learned a bit more about what makes him tick.

What inspired you to become a physician?

I originally started my career as a physical therapist, and learning more about disease processes, I developed a strong interest in medicine.  During my first year as a physical therapist, a young patient of mine, Claire, passed away from what seemed to be medical complications of her disease.  She was a young woman, in her thirties, a single mother, and wonderful person.  I will never forget how helpless I felt over her passing and as a result, was compelled to pursue medicine to help improve patient outcomes.

Why orthopedics?

My original interest in sports medicine and rehabilitation was sparked when I was a patient myself during high school.  That, along with a background in physical therapy, made it an obvious decision for me.

What do you love most about your job?

I love that I’m able to give people their active life back and alleviate their pain.   And, of course, I love the detail and intricacy of operating!

Gibbs with girl in cast   Gibbs surgery

What is your biggest challenge?

Trying to meet patient expectations while dealing with the constantly evolving challenges of the healthcare environment is an enormous task. At times our hands may appear to be temporarily tied as a result of changes in healthcare and insurance. I want patients to know I am their advocate.

If I weren’t an orthopedic physician I’d be a __________________.

That’s easy … If I weren’t an orthopedic physician I’d be a football coach.

Your proudest moment?

Even easier answer … Becoming a father to my children.

Where is the most interesting place you’ve travelled? Why?

Bamberg, Germany, a small picturesque town famous for its smoked beer. Why? It’s delicious!

Any hobbies? Activities?

I love sports, watching ESPN, exercising, golfing, and spending time outdoors with my children.

What’s your next adventure?

My wife and I are going on a European river cruise to celebrate her graduation from dermatolopathology training.

Your guilty pleasure food?

Chocolate chip cookies and preferably Otis Spunkmeyer.

NOTE:  Dr Gibbs is a board certified, fellowship trained orthopedic surgeon at Sarasota Orthopedic Associates with a specialty in sports medicine.  You may read his professional bio by visiting our website or clicking here. SOA has 13 physicians in four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and offers same day appointments when needed.

Powerful TLC for Your Feet and Ankles

Eric James, MD is a Fellowship Trained orthopedic foot and ankle surgeon at Sarasota Orthopedic Associates. He specializes in foot and ankle advanced techniques and reconstruction of complex foot deformities. Dr James shares with us the importance of not neglecting our feet … they need a workout as much as the rest of our body!

happy foot

Stretch, Stretch, Stretch

Many common conditions affecting the foot and ankle can be attributed to, or worsened by, having a tight calf muscle. A large percentage of people have overly tight calf muscles and could benefit from a daily stretching routine. I prefer the runner’s stretch where the leg being stretched is straight behind you with the heel on the ground. This is done for varying periods of time, but I generally encourage a long, deep stretch.

calf stretch

Use the Little Muscles

The small muscles in our feet are often neglected and as they weaken, so does our foot’s ability to maintain correct alignment. Keep your feet strong by using them frequently. I recommend using the toes to pick up and grab objects off the floor. Spare sock on the ground? Grab it with your toes and avoid having to bend over while providing a work out for your feet.

Wear the Right Shoes

Finding the right pair of shoes can be challenging but makes a big difference in your foot health. Make sure you plan to try on shoes later in the day when your foot has done any swelling so you don’t end up buying shoes that are too small. Wear activity appropriate shoes. Try to limit high heel wear and shoes that are too small or pointy in the toe box. These shoes can lead to numerous problems like foot pain, bunions, hammertoes and neuromas.

Check Your Feet

It is a good idea to do a check on your feet daily when you shower or bathe. Check for any skin irritation, blistering, or other abnormalities. This is particular important if you have diabetes or neuropathy (loss or abnormal sensation) in the feet.

Our feet and ankles are very important and we need to keep them healthy! Let us know if we can help in maintaining your foot and ankle health!

NOTE: Eric James, MD is one of 13 physicians at Sarasota Orthopedic Associates treating conditions of the joints, spine, and muscles. We offer same day appointments when needed. Call 941-951-2663 for an appointment at any of our four locations: Sarasota, Lakewood Ranch, Venice, or Bradenton.

Thumbs Up for Dr Gregory Farino

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This interview marks the halfway point in chatting with our physicians at Sarasota Orthopedic Associates. Dr Gregory Farino, a Fellowship Trained and Board Certified orthopedic surgeon, has a specialty in hand and wrist conditions. Take a look at what inspires Dr Farino and what he does in an occasional spare moment:

What inspired you to become a physician?

I wanted to do something in the sciences where I could be useful and helpful to others. Initially during college, I was going to be a teacher but after spending some time with a few different MDs, decided to pursue medicine.

Why orthopedics?

As a medical student, I thought I would pursue primary care but after rotating through, sensed it wasn’t the right fit for me. I decided to try orthopedics in my 4th year of med school. I did a rotation at Einstein hospital in Philadelphia and worked with a great group of guys. They let me do an entire surgery and I was hooked. I decided to apply for an orthopedic residency.

What do you love most about your job?

Obviously the job is challenging in many ways but I enjoy knowing that the things I do and decisions I make translate into another person feeling better and functioning better. It is satisfying to know all of the time and effort I spent in training allows me to do something useful, not just for myself, but for everyone I see.

What is your biggest challenge?

Dealing with imperfection. I don’t handle failure well at all. I expect 100% success with what I do. Logically, I know it’s not possible but I expect it anyway. That creates unhappiness for me when things turn out less than my expectation.

If I weren’t an orthopedic physician I’d be a ____________.

I’m not sure. Maybe a college professor in history.

Your proudest moment?

I have to say my proudest moment was probably the day I matched in orthopedics at Penn State. It was my first choice and the culmination of 8 years of really hard work.

Where is the most interesting place you’ve travelled? Why?

Sicily. It has everything: food, wine, beautiful vistas (the sea, mountains, an active volcano), fascinating history and great people.

Any hobbies? Activities?

I like to read mostly ancient Greek history and early American history. I am teaching myself to play the guitar and ukulele.

What’s your next adventure?

I usually have a trip planned but don’t at this time. I would love to go back to Italy.

Your guilty pleasure food?

It’s a tie: pizza and French fries.

 NOTE:  Dr Farino, MD is one of 13 physicians at Sarasota Orthopedic Associates. He is Fellowship Trained and Board Certified with a hand/wrist specialty. You may read his medical biography and CV by clicking here. SOA offers four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton), and provides same day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

INSPIRATION JUST AHEAD — Meet Dr Kim Furman

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The fifth in our series of getting to know our SOA physicians on a personal level features Dr Kim Furman, Fellowship Trained and Board Re-Certified Orthopedic physician.  Dr Furman specializes in hip and knee joint replacements, and there’s an inspirational side of him you may not know.  Read about it here:

What inspired you to become a physician?

Great question but difficult to answer.  Since age 9 while growing up in Brooklyn, I wanted to go into medicine. Perhaps I was influenced by my next door neighbor, who was general physician, as well as my childhood pediatrician, who made house calls, when I was sick.  Surprisingly, my parents never directed me to the medical field but fully supported my decision.

Why orthopedics?

Several factors influenced my decision for Orthopedics.

As a kid, I was always working with my Dad in his basement workshop, building and repairing all sorts of stuff.  I was mechanically inclined and loved working with my hands.

For 7 years, while in college and medical school, I was an operating room technician at Columbia Presbyterian Medical Center. I had the opportunity to work with all the surgical specialties.  I was fascinated by reconstructive plastic surgery and this became my initial focus.  During that time I suffered a traumatic knee injury.  A close friend of my family was an orthopedic surgeon.  He took care of my knee injury and had a significant impact on redirecting my focus to orthopedics.

While continuing work at Columbia Presbyterian, I rotated through orthopedics.  It was at that point that my decision for orthopedics was solidified.  I loved all the neat tools that were used.  Working on fixing fractures was just like woodworking I did as a kid and continue to do now.

Unfortunately, I suffered numerous complications from my knee injury and seven surgical procedures later resulted in significant knee arthritis.  My personal experience with my injury, multiple surgeries, and arthritis has given me an inside view of the problems of my patients.  I can empathize easily with them.

What do you love most about your job?       SOAStudio-170

The gratification I get from returning a patient to a pain free life style.

What is your biggest challenge?

The ever changing medical environment (insurance, government intrusion) that has taken away the true art of medicine and has made it a business.

If I weren’t an orthopedic physician I’d be an ________________.

Anthropologist/archaeologist

Your proudest moment? 

The birth of my 2 children.

Where is the most interesting place you’ve travelled?  Why?

China, because of the incredible history and culture developments.

Any hobbies?  Activities?

Woodworking, gardening, fishing and traveling.   I was an avid softball, tennis, and paddleball player before my knee arthritis limited those activities.

What’s your next adventure?

A trip to the Antarctic.

Your guilty pleasure food?

Pepperoni pizza

NOTE:  Dr Kim Furman is  a Fellowship Trained and Board Re-Certified Orthopedic Surgeon. He specializes in the treatment of arthritic knees and hips and has been with Sarasota Orthopedic Associates for 30 years. You may read his medical CV by clicking HERE.  SOA treats both adults and children in four locations (Sarasota, Lakewood Ranch, Venice, and Bradenton) and offers same day appointments when needed. For more about SOA, click HERE, or call 941-951-2663 for an appointment.