Tag Archives: musculoskeletal

A PHYSIATRIST: Taking a Look at the Big Picture

physiatrist

Physical Medicine and Rehabilitation (PM&R) physicians known as physiatrists (fizz-EYE-ah-trist) are medical doctors who have graduated from medical school and have completed 4 years of residency training. The specialty is a very small one beginning with WWII when many military personnel returned home with various disabilities from the war.  Over time the specialty has grown and now board certified physiatrists care for those with amputations, stroke, spinal cord injury, and traumatic brain injury, including concussions.

In addition to these conditions, physiatrists may also have sub-specialty certification in the management of sports medicine injuries.   While they complement orthopedic surgeons in their care, they do not perform surgery, preferring to treat the injured athlete utilizing the most effective research-based non-surgical care.  In addition physiatrists do not limit their care to only one area of the musculoskeletal system but instead focus on the interaction of how one link in the kinetic chain may affect the rest of the problem (i.e., “the shin bone’s connected to the knee bone” philosophy).  For instance an overhead athlete such as a tennis player with recurrent shoulder pain may have inflexibility to their hamstrings or weakness of the hip muscles as the underlying issue.  Similarly, a runner with knee pain may have difficulty with absorbing shock due to ankle and calf mobility issues.

While an athlete’s history and examination will often determine the cause of an athletes’ condition, a physiatrist will often utilize musculoskeletal ultrasound (US) to examine the injured area.  Musculoskeletal US, much like that used to examine a pregnant woman, is able to use sound waves to determine if any ligaments, muscles, or tendons have been sprained or torn.  Unlike MRI, claustrophobia is not a problem using US and the patient can actively move the injured tissue to give a dynamic picture to the physiatrist.  This allows the physiatrist a glimpse as to what is happening at the tissue level. In this way they are better able to give an athlete a more accurate diagnosis as well as guide appropriate therapy.

Sarasota Orthopedic Associates believe in treating the whole person so you can get back on your feet, back to work, back in the game, and back to life.  We have three convenient locations and are able to accommodate same/next day appointments.

Paul Lento, MD is a Fellowship Trained / Triple Board Certified PM&R physician with a subspecialty in sports medicine. He specializes in the non-surgical treatment of various musculoskeletal conditions to determine if the problem is mechanical, inflammatory, or degenerative.

Top Doc       blue shirt cropped

Like us on Facebook HERE / Follow us on Twitter HERE / Follow us on Instagram HERE

THE SUPER SEVEN

superfoods

Our previous blog post talked about foods and drinks to NOT put into your body. Now let’s talk about the 7 foods that are nutritious AND taste good to help preserve your musculoskeletal system.

  1. Salmon is often referred to as a “super food”, packing a punch of protein, minerals, and vitamins like B12. Most important: salmon is rich in omega-3 fatty acids.
  2. Greek yogurt is thicker than regular yogurt because the liquid is drained giving it a creamy texture. It contains probiotic cultures and is lower in lactose than regular yogurt. Greek yogurt is an excellent source of calcium, zinc, and B12. Stir some blueberries or strawberries into a cup of plain Greek yogurt and you have a great kick start to your day.
  3. Sweet potatoes are another “super food” and extremely versatile. Plain or fancy with stuffing or toppings, they are high in fiber and potassium. They are also known to maintain a healthy blood pressure. A sweet potato contains more nutrients and less calories than a white potato.
  4. While dairy products are essential to a child’s growth, it can be a source of discomfort for some adults. Dairy products are rich in calcium and vitamin D, along with other nutrients, to help keep bones and teeth strong. For those on a diet, you may opt for a fat free version and there are lactose free brands for those with a low tolerance. Both still have the calcium that is provided in regular milk.
  5. When your mom told you to eat your veggies, she was on to something. Leafy greens should be your “go-to” vegetable whenever possible. Greens like broccoli, kale, cabbage, spinach, romaine lettuce, and arugula contain essential vitamins like A (for the immune system), C (for tissue repair), and K (for blood coagulation). Nuts may also lower your blood sugar. The best nuts for your health are almonds, pistachios, walnuts, and cashews, however, go easy since a large handful may contain as many as 200 calories.
  6. Another great source of fiber and vitamin B can be found in beans. They may also help lower cholesterol and blood sugar. The best beans with benefits are chickpeas, lentils, peas, kidney and black beans.
  7. Figs, dried or fresh, are rich in fiber and give you a feeling of fullness. They are also high in calcium to help promote bone health.

So there you have it. Add these “Super 7” to your regular diet and you’re on your way to a healthy eating habit. When you do have pain or injury to your musculoskeletal system, Sarasota Orthopedic Associates can be your “go-to” place for help. We have 3 convenient locations and offer same or next day appointments when needed.

Like us on Facebook here. Follow us on Twitter here.  Follow us on Instagram here.

MRI and X-Rays: Myths and Truth

MRI-Knee-Example  Xray-Left-Knee

First of all, what is the difference between an MRI (Magnetic Resonance Image) and an X-ray (electro-magnetic wave of high energy with very short wavelength)?  The above image on the left is an MRI of a left knee.  The image on the right is an x-ray of a left knee. While they are both diagnostic imaging devices and equally important tools (in some circumstances) for your physician, there are important differences. X-rays are mainly used for evaluating detailed images of bones and sometimes diseased tissue. An MRI is better suited for evaluating soft tissue like tendons, ligaments, muscles, organs, etc. The MRI shows a series of “slices”, allowing abnormalities to be seen from varying angles.

X-Rays

Most X-rays are now digital, like the ones we use at SOA, a safer and more effective technology than the older “films”. The digital aspect also allows easy transport of the images onto a CD for sharing between physicians when needed. The digital x-ray results are immediately available to your physician at your appointment.

Dispelling a myth: Naysayers may have you believe that X-rays aren’t safe because of radiation. Fact is, we are surrounded by radiation on a daily basis and this is known as “background” radiation. The earth itself emits radiation and certain parts of the country, like Colorado, have higher radiation levels than areas near the coast at sea level. Frequent airline flyers receive more radiation than those who don’t fly. Surprisingly, the highest source of radiation is in our homes!

So how does that relate to when we need an x-ray at your orthopedic visit? A typical adult will receive a total dosage of 620 “millirem” each year from background, diet, industrial, and medical radiation with 50% coming from “background” radiation. Put that into perspective with a single hand or foot x-ray at 0.5, a very small amount. In fact, our food contains radiation and we ingest about 30 “millirem” a year just in our diets! Even a can of soda emits radiation.  An interesting website will evaluate your estimated annual radiation at https://www.nrc.gov/about-nrc/radiation/around-us/calculator.html

MRI

At Sarasota Orthopedic Associates, we may utilize an MRI to provide a more comprehensive diagnostic evaluation of the soft tissue structures which are not seen on an x-ray. An MRI may identify a condition much faster than traditional methods, and allow you to receive more expeditious treatment. Our MRI services are readily available to our patients, however many physicians refer to us for scans other than orthopedic conditions because of our state-of-the-art technology. Our Signa HD 1.5 scanner is breakthrough technology with lightning speed and breathtaking image quality. We turn around studies in 24 hours and are many times able to schedule patients on a same day basis.

One of the more fascinating technologies is an extremity MRI, specifically for hand, wrist, elbow, knee, or foot. It’s a compact MRI device allowing the patient to rest outside the scanner, eliminating the magnetic “noise” close to your head! You may even read or nap during the exam. That extremity MRI is available for our patients as well as those referred from other offices.

At Sarasota Orthopedic Associates, our mission is to get our patients back on their feet, back to work, back in the game, and back to life. Check out our website at www.SOA.md or call us at 941-951-2663 for more information. You may also schedule an appointment at the home page of our website.

Sources: SOA.md website; ICRP; ASRT; USNRC

What’s So Special About PHYSICAL THERAPY?

 

pt-month

October is NATIONAL PHYSICAL THERAPY MONTH and it’s a time when we honor the special people on our PT team. Where do we begin?

First, let’s look at the definition of Physical Therapy: the treatment of disease, injury, or deformity using various methods of massage, manipulation, temperature, and/or exercise.

pt-hot-pack     hand-therapy-northern-beaches-sydney    pt-exercise    pt-elec-stim

Ok, well that’s sounds simple enough, doesn’t it? Maybe not … let’s take a look at how long it takes to become a Physical Therapist. It’s a path of SEVEN YEARS minimum. Typically a bachelor degree is required with a concentration in biology, anatomy, kinesiology, or a similar study in the sciences. Then, after an impressive GPA achievement, a high GRE score, an interview process, and referral recommendations, the candidate is accepted into a physical therapy program of studies for three years. There are even specialties within the field; a few are geriatric, sports rehab, hand, industrial, aquatic (check out our aquatic therapy pool), and vestibular. By now, you probably understand it’s not a simple path to this career, although it’s a rewarding one.

pt-pool

A Physical Therapist is an expert in the treatment of neuro-musculoskeletal disorders and pain relief. More important, they are educators in helping you understand your body and how to avoid injury after the healing process. Typically at a first appointment, your PT may perform a number of things including an assessment evaluation, discussion of your issue, take a medical history, check your ROM (range of motion), balance, and muscle strength. In therapy they may use modalities such as heat/ice, ultrasound, massage, electronic stimulation, and/or hands-on treatment. You’ll be given a series of exercises with instructions to perform at home that will help you heal and strengthen.

Pain Concept.

The number of visits needed will vary upon your condition. The most important and critical instruction to remember is that YOU are the key to YOUR  recovery. You play an important role in this process. Compliance with your home exercises and following the number of recommended visits to your Physical Therapy appointments will benefit your healing and speed your recovery.

So now you know why we love our Physical Therapy staff. We are grateful to them for all they do to keep us healthy and strong!  The commitment of Sarasota Orthopedic Associates is to get our patients back on their feet, back to work, back in the game, and back to life.  For more information or an appointment, go to our website at www.SOA.md or call us at 941-951-2663.  We have four convenient locations and offer same day appointments when needed.

FUN FOOD & FITNESS QUIZ – TEST YOUR KNOWLEDGE

fitness-aging[1]

Nowadays we’re more prone than ever to think about our health and ways to stay fit. With so much information and “mis”-information out there in cyberspace to “digest”, it’s not easy making wise choices”. It’s difficult to separate myth from fact. Take our quick quiz and see how much you know. Then check your answers below.

  1. You stuffed yourself by binging on fatty foods at a party. What’s the best way to counter your overeating: Take a walk for 30-45 minutes OR Fast for the next 12 hours.
  2. Which burns more calories: swimming OR jogging?
  3. Cycling OR Aerobic Dancing?
  4. At PF Chang’s Restaurant which is the lowest in calories: Crisp Salad, or an Egg Roll?
  5. Which burns more calories: Boxing OR Jumping Rope?
  6. Which has more calories: a Starbucks Grande Caramel Frappuccino OR an Applebee’s Grilled Oriental Chicken Salad?
  7. What is the strongest muscle in the human body?
  8. Which contains more lycopene: a cup of watermelon or a tomato?
  9. What is the longest bone in the human body?
  10. Which burns more calories: cardio OR strength training?
  11. BONUS QUESTION – True or False? Crunches are the best way to lose belly fat.

apple

ANSWERS:

  1. If you said take a walk, then pat yourself on the back. Fasting throws your metabolism out of whack while walking burns off a few calories, increases blood flow, and relieves stress.
  2. Swimming wins this one with approximately 580 calories burned vs 390 from jogging. Plus it’s more fun!
  3. The winner here is cycling but not by much. An hour of cycling burns approximately 480 calories vs. 440 from aerobic dancing, plus you get some fresh air. Which brings up another point … indoor cycling and outdoor burn equal calories so either way, you’re shedding those calories.
  4. You may be pleasantly surprised to know that the egg roll has 180 calories with 6 fat grams while the salad contains 270 calories and 22 fat gram. Sometimes the tastier choice actually IS better for you!
  5. Boxing takes the bigger punch on this one with 720 calories. Jumping rope is good aerobic exercise as well with 670 calories burned.
  6. You’ll be glad to know that while the Frappuccino is full of sugar, it has far less calories and fat than the salad which weighs in at a whopping 1,290 calories. There are far better salad choices out there, so think before ordering!
  7. This is a tricky one and there may be a couple of “correct” answers. There are different ways to measure strength: dynamic, elastic, and endurance. To complicate things even more, there are 3 types of muscles: cardiac, smooth, and skeletal. Most will say the strongest is the masseter, or jaw muscles, because it is based on weight and ability to force as much as 200 pounds on the molars. For more on this subject, check out this link: https://www.loc.gov/rr/scitech/mysteries/muscles.html
  8. In a one cup comparison, watermelon edges out tomatoes by a slim margin. Lycopene is a free-radical antioxidant able to fight some cancers. You can also get a healthy dosage of lycopene in pink grapefruit, red peppers, mangos, and carrots. Think “red” although some other non-red foods like asparagus contain lycopene.
  9. The femur, or thighbone, wins this one and comprises about one quarter of the height of an adult. Runner up is the tibia, or shinbone. The smallest? It’s the stapes, or stirrup, located in the ear.
  10. Both are important. Cardio will burn more calories, but won’t do much for your muscles. With strength training for every three pounds of muscle you gain, you may burn an extra 120 calories a day without even trying. The best solution? Do both!
  11. The most popular abdominal exercise in existence is not the best way to trim your midsection. They will tone a small portion of your abs, however your shoulders and butt need to move as well to be effective. Your waistline will sculpt faster by doing planks. If you do decide to do crunches, make sure you’re doing them correctly or you could put your spine into a painful situation.

So how did you do with your answers? At Sarasota Orthopedic Associates, we treat conditions of the musculoskeletal system with skilled physicians at each of our four locations. If you have chronically sore muscles, aching joints, or suffer from pain, call us at 941-951-2663 (BONE) or check our website www.SOA.md by clicking HERE. You may also obtain an appointment with us via our website BUTTON “request an appointment” which directly reaches our skilled scheduling team.

CHECK THESE ORTHOPEDIC “A to Z’s” … How many do you know?

hand xray

At times, orthopedic terms can sound like a foreign language. We thought it would be fun to compile a list of one orthopedic term for each letter of the alphabet. Take a look and see if you’ve heard of these:

  • Arthroscopy – a minimally invasive surgical procedure on a joint where an exam and/or treatment is performed through a tiny incision.
  • Bursa – a fluid filled sac providing a cushion between bone and tendons or muscles.
  • Cubital Tunnel Syndrome – pressure on the ulnar nerve (better known as your funny bone), one of the main nerves of the hand.
  • DOMS – Delayed Onset Muscle Soreness, or pain and stiffness felt several hours after strenuous exercising.
  • Eccentric – the motion of a muscle as it is lengthening; the opposite of concentric, or shortening.
  • Fascia – a sheet of connective tissue below the skin that separates muscles or organs.
  • Gout – most commonly affected at the big toe, inflammatory arthritis caused by elevated uric acid in the blood; more prevalent in men.
  • Heterotopic Ossification – the presence of bone in soft tissue where it would not normally exist.
  • Impingement Syndrome – when the tendons of the rotator cuff muscles become irritated, resulting in pain, weakness, and loss of shoulder movement.
  • Jones Fracture – occurs in the small area of the small toe that is prone to healing challenges due to less blood flow.
  • Kyphosis – abnormally convex curvature of the spine.
  • Lordosis – the inward curvature of the spine.
  • Meniscus – tissue that serves to disperse friction in the knee joint when moving.
  • Neuropathy – disease or dysfunction of nerves (sensory, motor or autonomic) causing numbness or weakness.
  • Osteoarthritis – the most common form of arthritis occurring when the protective cartilage wears down.
  • Plantar Fasciitis – a disorder of the heel and bottom of the foot causing pain, usually upon taking first steps of the day or after a rest.
  • Q -?
  • Referred Pain – pain perceived in a location different from that of the pathology.
  • Strain vs Sprain – partial tear of a muscle vs partial or complete tear of a ligament.
  • Tendinitis vs Tendinosis – “itis” occurs when the body detects an injury and responds with increased blood flow to the tendon; “osis” is a degenerative injury with repetitive stress over time.
  • Ultrasound – sound waves with ultra- high frequencies above the limit of hearing, allowing resolution of small internal details in tissue.
  • Viscosupplementation – a procedure where a fluid, hyaluronate, is injected into the joint to provide relief and movement.
  • W Sitting (pediatric) – a sitting position discouraged in children causing abnormal stress on hips and knees during growth.
  • X-rays – electromagnetic waves that are able pass through a part of the body to show internal composition, shown as a photographic or digital image.
  • Y – ?
  • Zika – a once rare mosquito born disease; though not orthopedic, the bite can cause joint pain; currently ranking high in the news as it spreads into several countries including USA.

So, how many did you already know? Do you have an orthopedic related term for the missing letters ”Q” or “Y”?

Sarasota Orthopedic Associates offers same day appointments at our three locations of Sarasota, Lakewood Ranch, and Venice.  Our 13 physicians are committed to get you back on your feet, back to work, back in the game, and back to life.