Tag Archives: Orthopedic Doctors Sarasota

Meet Ashot Kotcharian, MD: Interventional Pain Management Physician

Kotcharian lab crop

This is a continuing series of interviews we do with our physicians here at SOA. Dr Ashot Kotcharian is a Board Certified/Fellowship Trained Physical Medicine & Rehabilitation Physician with a specialty in Interventional Spine and Sports Medicine. Dr Kotcharian has a strong background in interventional therapies for spine disease, complex pain syndromes, peripheral joint disease, and sports injuries. He served a most distinguished career in medicine as Assistant Professor of PM&R at Johns Hopkins University School of Medicine. Learn more about what motivates him and how he spends his time when not at work.

What inspired you to become a physician? What inspired me to become a physician is the legacy of my great grandfather. He was my namesake. Although I have no memory of him I grew up hearing so much about him. Before me he was the only physician in our family history. I grew up listening to stories of his work and all the good he did treating those who were ill.  I knew early on that just like my namesake I too wanted to have a career that can result in good to others and help those who are ill. One of my younger sisters was born with epilepsy and has a learning disability. As a young boy I witnessed how much my parents cared for her. From city to city, hospital-to-hospital, my parents searched for the best medical treatment available. Seeing her go from one hospital to another, I wondered why nobody could help her become better. I watched my parent’s worried faces and how hard they tried to get answers and care for my sister. Once they were able to get her the care she needed and the doctors were able to get her seizures under better control the relief and joy it brought was immeasurable. This is what I wanted to do with my life.  I wanted to be able to take away peoples pain, fear and confusion and give them hope and relief.

Why orthopedics? While on my journey through medical school and residency training what I found myself enjoying the most was anatomy and musculoskeletal medicine. I learned how crucial good understanding and knowledge of anatomy can be in diagnosing nerve injuries, ligament tears, or radiculopathies. I developed a greater interest in diagnosing and treating patients who presented with muscle and tendon injuries, repetitive stress injuries, as well as back and radicular pain to name a few.

What do you love most about your job? I love how in this field the convergence of good anatomical knowledge, physical exam skill, and history taking can often lead to diagnosis without a need for invasive tests.  I get a satisfaction out of being able to arrive at the solution simply from what the patient told me and what I find on my physical exam. I get a satisfaction from knowing that I was able to treat disabling pain be it from back, muscle or tendon injury, without the need of invasive surgery.

What is your biggest challenge? Helping my patients through difficult diagnoses where treatment options are few and without a “cure” can definitely be challenging.  I would also say that being able to convey the importance of daily exercise, stretching, as well as proper posture is another big one.  While I have a lot of skills and tools with which to help stop pain, its what the patient is able to do on their own at home and in their daily life that can really keep the pain from coming back. If I weren’t an orthopedic physician I’d be either a martial art instructor or a university professor. Although, to be honest, this is a difficult question, because I can’t see myself doing anything else. I truly love what I do and I am very passionate about it.

Your proudest moment? My proudest moment is completing my fellowship training.  As I looked back at my journey through medical school, residency, and fellowship I knew I was becoming the person I wanted to be and the person I wanted my sister and great-grandfather to be proud of.

Where is the most interesting place you’ve travelled?  Why? It would have to be Rome.  The layers and layers of ancient history, the architecture, the people, and the food were truly amazing.

Any hobbies?  Activities? One of my biggest passions outside of medicine is martial arts, exercise, and mindfulness meditation. I have been a student of martial art since I was just a kid. Most of my studying and training has been in Taekwondo and I have earned a rank of 2nd degree black belt. I have also studied some techniques of hapkido, karate, kungfu, and Brazilian jujutsu while attending a mixed martial arts school. What I love most about martial arts is the respect, the discipline, the mindfulness, and the physical exercise.

What’s your next adventure? I don’t really know. I am pretty happy exploring the Gulf Coast for now.

Your guilty pleasure food? Oh gosh, too many probably.  Hamburgers, Chinese food, fried chicken, pizza, oh now you’re making me hungry!

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Sarasota Orthopedic Associates has three locations and offers same day/next day appointments when needed.  For more information on Dr Kotcharian or any of our physicians click here.

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Meet Dr Raye: Interventional Pain Management Physician

Raye lab cropped

We sat down with Sarasota Orthopedic Associates physician, Dr Justin Raye to learn what motivated him to pursue the medical profession and how he helps his patients non-surgically.

What inspired you to become a physician?

I always had an interest for human physiology as well as health/fitness, which led me to pursue a major in Physiology and Kinesiology at the University of Florida. As an undergraduate I volunteered in multiple different health/medical related fields in order to experience each possible career first hand. I became confident I wanted to become a physician after working closely with physicians within the Orthopedics and Sports Medicine Institute at UF. I felt I was able to align my interests for athletics and human physiology while having the opportunity to closely interact and affect the lives of those within my community.

My father suffered from heart disease and had to undergo multiple cardiac procedures under the care of multiple different medical teams. When I was in high school he underwent his second open-heart surgery at Shands Hospital in Gainesville Florida. I was able to observe the interaction between multiple physicians as they helped care for my dad with the common goal for him to have the most successful outcome. Everyone was very professional and caring as they put in long hours yet always took the time to make sure my family was thoroughly informed. I knew from that experience that one day I wanted to put in the hard work so I would have the chance to be a part of a team in order to help others live their best quality of life with their family by their side.

My mom is a nurse and has always been a positive influence as I expressed interest in a medical career. She has always been someone in my family to talk to with a common interest of medicine.

Why orthopedics?

The musculoskeletal system and the biomechanics regarding movement of the human body have always been strong interests of mine throughout my medical education. I enjoy interacting with others while applying my knowledge in order to help my patients improve their pain in order to improve their overall quality of life.

What do you love most about your job?

I enjoy affecting someone’s life in a positive way whether it’s by performing a procedure to decrease their pain or by taking the time to listen to and educate them on something that will impact their health. I can’t express how much I enjoy hearing that someone is getting better or moving back to some of the activities they love because their pain is improved.

What is your biggest challenge?

I enjoy listening to my patients and clearly explaining to them their problem while at the same time making sure they understand all planned treatments.  I wish I could take even more time with each patient. I definitely do my best to answer all questions because it is important to me for my patients to be well informed regarding their care.

If you weren’t an orthopedic physician, what would you be doing?

If I weren’t an orthopedic physician I’d be a professional soccer player in Barcelona (HaHa). Realistically though, I would have probably further explored my undergraduate major of exercise physiology and looked into teaching at the college level or becoming a strength and conditioning coach for a university or professional athletic team.

Your proudest moment?

Graduating medical school. The hard work and sacrifices along the way make an accomplishment that much better when you finally achieve it.  I would never change a thing and ask myself, how can use my knowledge to improve the lives of others.

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

I recently travelled to St Lucia for a week to relax and take in the culture/beauty of the island. We were able to spend several hours on the beach but also had the opportunity to hike the Gros Piton Mountain, go snorkeling in the coral reefs, and sailing at sunset.  We are already planning our next vacation- Spain or a short Euro trip!

Any hobbies?  Activities?

I really enjoy playing and watching just about any sport. I grew up playing soccer and always enjoy a game of pick up basketball. I plan to get more involved with golf. I am a big Florida Gator fan and try to get to Gainesville for football games as much as I can.  I enjoy being outside whether it’s boating, fishing, paddle boarding or just spending time with family and friends.

What’s your next adventure?

I am always looking for a new place to explore and trying new things. My sister recently told us that Barcelona has been one of her favorite places that she travelled which is high on our list. I am open to all suggestions.

Your guilty pleasure food?

Pizza for sure. I also enjoy a good burger and BBQ ribs.

Dr Raye is an Interventional Pain Management Physician at Sarasota Orthopedic Associates and his treatment focus includes, but is not limited to, back/neck pain, sciatica, spinal compression fractures, headaches, and chronic regional pain syndrome. His therapies include RFA, SCS, and regenerative therapy among many other non-surgical treatments. SOA has three locations and accommodates patients on a same day/next day basis when needed.

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TEXT NECK? What You Need To Know …

texting adults

Those who experience pervasive, uncomfortable symptoms such as neck and shoulder pain, headaches, and numbness and tingling in the arms and hands might be surprised to learn that smartphone use could be the culprit. “Text neck” is caused by poor posture while using handheld devices. The average head weighs about 10 pounds, which puts substantial weight on a neck bent at 60 degrees to read a smartphone screen. While this condition is an epidemic, it’s also preventable. Untreated, this may cause damage to the neck or spine. Here’s what smartphone users need to know about avoiding text neck.

Adjust Posture

The correct way to look at a phone to avoid straining your neck is to hold it at eye level. Your head should be held upright with ears directly above your shoulders. While on a phone call or streaming media, using headphones can help encourage better posture.

Switch to the Desktop

Save long articles to read later at the monitor, where positioning makes users less likely to compromise posture. Instead of checking and replying to emails on the phone, set aside time every day to do so at the desk rather than bending your neck uncomfortably.

Take a Break

It’s called text neck for a reason. Rather than relying on texting alone, reduce symptoms by picking up the phone and calling the recipient for more lengthy conversations. While taking a break, stretch your neck and shoulder muscles to provide relief. Set an alarm on the phone to encourage hourly breaks.

Use Voice Dictation

Take advantage of this smartphone function to dictate messages while holding your head upright. This will help reduce the amount of time spent looking at the screen.

If you’re struggling with symptoms of text neck you may want to consult with one of our physicians at Sarasota Orthopedic Associates. We offer diagnosis and non-invasive treatment of issues that affect the musculoskeletal system. We offer same-day appointments when needed at our three convenient locations.  The mission of SOA is to get our patients back on their feet, back to work, back in the game, and back to life.

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TENNIS ELBOW? IT’S NOT WHAT YOU THINK!

elbow-pain

Many people will come to our Sarasota Orthopedic Associates sports clinic with complaints of pain on either side of their elbow which has been present for months and is aggravated by gripping things or shaking hands. While often referred to as Golfer’s or Tennis elbow, this painful tendon condition usually occurs not from playing golf or tennis, but from repeatedly gripping or lifting objects improperly. Unfortunately, the condition can become severe enough where the tendons on either side of the elbow will become swollen, degenerated, and possibly torn causing persistent pain.

Despite being referred to as lateral or medial epicondylitis by the medical community, this condition is known not to be an inflammatory condition.  Because of this, typical anti-inflammatory medications like Ibuprofen or Naprosyn often will not help. While steroid  or “cortisone” injections can be tried and may give temporary relief, studies have shown that the condition often returns weeks to months later causing further delay in healing.

The good news is that this condition can be treated non-surgically. Medical studies have revealed that a dedicated specific exercise program that concentrates on eccentric (lengthen) strengthening of the elbow and wrist tendons often will successfully cure the problem. Even when rehabilitation fails, other procedures less invasive than having surgery can often be performed which can significantly improve pain in 90% of the cases.

So whether you are struggling with chronic elbow pain from playing doubles tennis or from lifting luggage at the airport, the physicians at Sarasota Orthopedic Associates can evaluate your elbow problem, correctly diagnose the cause of the pain, and suggest a specific treatment regimen which will get you back on the road to recovery.

Paul Lento, MD is Fellowship Trained and Triple Board Certified in Physical Medicine and Rehabilitation. He is a distinguished Sports Physician having served as team physician for major sporting events such as the Winter Olympics and major city marathons. Locally, Dr Lento is Team Physician at Lakewood Ranch and Booker High Schools. He is also a Castle Connolly Top Doc, a national recognition of the best physicians in healthcare. Dr. Lento sees patients at Sarasota Orthopedic Associates, voted the #1 choice for Orthopedic Care in Sarasota and Manatee .

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THE ULTIMATE GUIDE TO CARPAL TUNNEL SYNDROME

cello player

Until about 75 years ago carpal tunnel syndrome, or CTS, was thought to be caused by the compression of structures in the frontal portion of the neck or from a network of nerves from the spinal cord, over the first rib, and into the armpit.  Today we recognize this condition of CTS as a compression of the median nerve travelling through the wrist. The carpal tunnel is a tiny passageway on the palm side of the wrist.

The cause of CTS continues to be a subject of debate. Typically, the common age range of patients with CTS is between 45 and 60 years of age.  CTS is less common in people under 30 years of age.  Untreated, CTS can lead to lack of coordination between the fingers and thumb along with weakness in the hand.

What are the most common symptoms in patients with Carpal Tunnel Syndrome?

  • Hands get numb, fall asleep
  • Loss of grip, dropping items
  • Tingling
  • Feeling of tightness or swelling

When might an individual most notice these symptoms?

  • Driving, painting, knitting, typing, writing
  • Waking during the middle of sleep with wrist pain, usually the dominant hand
  • Temperature changes, sensitivity to cold

How is CTS diagnosed?

A physician can typically diagnose CTS with a patient history, physical exam (usually focusing on the median nerve running from the forearm into the hand), x-ray, and possibly a nerve conduction study.

What are some home remedy treatments for relieving CTS?

  • Night wrist splints
  • Gentle shaking of the hand/wrist
  • Immerse the hand in warm water and gently flex

If home remedies do not provide relief, it may be time to see an orthopedic physician who specializes in treatment of the hand and wrist.  Hand therapy may be recommended with a Certified Hand Therapist. An anti-inflammatory (NSAID) may provide some relief.  Cortisone injections may provide a temporary reprieve of discomfort.  If conservative methods do not provide relief, minimally invasive surgery to remove a band of tissue in the wrist should provide relief.

CTS is a common condition treated at Sarasota Orthopedic Associates by our orthopedic specialists and hand therapists.  SOA offers same/next day appointments when needed at each of our three locations. The commitment of SOA is to get our patients back on their feet, back to work, back in the game, and back to life.

Source:  MedScape 3/22/16, CTS Quiz;  WebMD; Cleveland Clinic; AAOOS

THE GIFT OF GETTING BACK TO LIFE

Maggie W

Sarasota Orthopedic Associate’s Occupational Therapy Department continues celebrating National OT Month. To commemorate we are sharing a case study of one of our Occupational Therapy Star graduates.

Matthew exemplifies how Occupational Therapy can help patients get “back on your feet, back to work, back in the game, and back to life”, the SOA mission statement. Matthew is a 28 year old male who was injured at work as an Ocean Rescue Lifeguard. An injury to his cervical spine was a result from practicing dolphin dives as part of a work training exercise.  He experienced temporary paralysis in all four  extremities from his spinal cord compression and  underwent emergency surgery to fuse his neck from C3 to C5.

Matthew was then referred  for inpatient therapy immediately following his surgery to begin his long rehabilitation. Once stabilized, he was discharged home and referred to outpatient Occupational and Physical Therapy.  On his first visit at SOA, he presented as a very motivated, hopeful young man despite his multiple deficits.  His cervical spine was stabilized in a neck brace, and he was able to walk with a rolling walker.  He required assistance to stabilize his balance while his upper extremities were assessed.

The OT/PT team found Matthew to have limited range of motion of his arms, significant weakness, both gross motor and fine motor coordination deficits, and sensory deficits. Initially, Matthew was able to do his own basic self-care with extra time, utilizing adaptive equipment, like a reacher/grabber, shower chair, and grab bars. Basic functions of cutting food and driving were not possible and he was lucky enough to reside with his parents as he recovered.

After careful assessment of his strengths and deficits, his Occupational Therapist derived a plan of care to return him to independent living. Through Mathew’s diligence with his home exercise program and his motivation and positive outlook, he is now walking on his own and performing all of his self-care with improved efficiency.  His goal is to return to work, be able to paddle his rescue board out a quarter mile to a predestined location, dive down 20 feet, grab a handful of sand, and emerge a new, stronger man. Matthew wants to be ready to pursue his passion… rescuing others in need.  “I want to get back to doing what I love.”

Occupational Therapy and Physical Therapy is available at all three locations. If you would like an appointment please go to our website at www.SOA.md to schedule online, or call us at 941.951.BONE. We are able to accommodate same day appointments when needed.

Vivian

Article submitted by Vivian Robinson, OT, CHT at SOA.

A REASON TO CELEBRATE

OT

April is National Occupational Therapy Month … that may not mean much to you now, but very likely it will someday in your future. This year’s theme is living life to its fullest! An Occupational Therapist can help with common upper extremity and hand conditions like arthritis, tendonitis, or repetitive strain which could limit you from doing the activities you enjoy.

So what does an Occupational Therapist do?

After assessing your condition in collaboration with your orthopedic physician, we establish a treatment plan to improve flexibility and strength, recommend and fabricate an orthosis to support the joints of the wrist, hand, or fingers to reduce pain/swelling during activities, and educate you on joint protection techniques to reduce wear and tear of the joints during daily activities.

An Occupational Therapist may also help with rehabilitation after traumatic injuries such as fractures and tendon/nerve injuries. Most important, they provide customized, one-on-one care to help you achieve the best outcome.

What training is required to become an Occupational Therapist? More than you think.  While master’s and doctoral degree programs are common, some colleges also offer combined bachelor and master’s degrees in occupational therapy. There is a focus on general anatomy, the nervous system, physiology, movement, activity, and trends in rehabilitation techniques. A certification process must also be completed before receiving state licensure.

AOTA (American Occupational Therapy Association) describes an OT visit as:

  • Individualized evaluation where patient goals are determined by patient and therapist
  • Customized intervention to improve ability to return to daily activity
  • Outcome evaluation to ensure goals are met, or, changes are made to the plan

If you have a physical condition keeping you from living life to its fullest, the Occupational Therapists at Sarasota Orthopedic Associates can help. For an appointment, call 941.951.BONE or schedule through our website at www.SOA.md. We have locations in Sarasota, Lakewood Ranch, and Venice. Our mission is to get you back on your feet, back to work, back in the game, and back to life.

WHAT SHOULD I EXPECT WHEN I HAVE AN MRI?

O-Scan-In-Use     GE-Signa-HDe-1_5T-MRI

Magnetic resonance imaging, also known as an MRI scan, uses radio waves and magnets along with a computer to create detailed two-dimensional or three-dimensional images of organs and tissues. Radio signals given off by the body are digitally processed to produce images based on both the body’s anatomy and its chemical composition. There is no radiation involved in the MRI exam. Patients who know what to expect tend to have less anxiety about this painless, non-invasive test.

Preparing for an MRI

Most MRI scans do not require dietary restrictions before the test. Leave jewelry at home since it will have to be removed for the test. You will be asked to place your belongings in a locker and change into a gown. Once you are in the exam room, the technologist will confirm your identification and exam orders. An MRI exam is probably one of the easiest and most comfortable medical exams you may ever experience.

During the Test

For some patients, your doctor will order an injection of contrast dye through an IV, which will be inserted just before the scan. This simply makes details of the MRI more clear. You will be asked to lie on a cushioned table that will automatically move into the magnet after you’ve been comfortably positioned. During the test, the technologist will be in another room with a glass window and can be contacted by you through a microphone or a buzzer that you will hold.

While it’s important to lie still during the procedure, the scan itself is painless. Banging, thumping, or tapping noises may be heard, so we provide non-magnetic headphones for you to listen to your choice of music during the test. The entire MRI takes between 15 and 60 minutes to complete depending on the size and number of body parts to be scanned. We also offer Extremity MRI for hand, wrist, foot, or knee scans; this technology places only that specific body part to be inserted into the machine, rather than a full scan. When the screening is over, you may resume normal activities, including working and driving, right away.

Patients experiencing pain or musculoskeletal issues can schedule an appointment with Sarasota Orthopedic Associates at any of our three locations by calling 941-951-2663 or going to our website here. In addition to MRI and other imaging tests, we offer specialized care for chronic and acute conditions of the foot, ankle, hip, knee, shoulder, spine, elbow, hand, and wrist.

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COULD PRP HELP YOUR ORTHOPEDIC INJURY?

prp

PRP, or platelet rich plasma, is not a new technology, but is much talked about currently. Plasma is a component of the blood that assists with clotting to promote growth of new, healthy cells. The theory of PRP is to merge this technology with the body’s natural ability to heal itself.

PRP has a number of applications; some are:

  • Faster healing for tendon injuries such as tennis elbow, runner’s knee, and tendinitis
  • Treating acute sports injuries like sprains and strains
  • Facilitating recovery after surgery to speed healing
  • Pain relief for those with osteoarthritis and other inflammatory conditions

What Might Patients Expect during a PRP procedure?

This simple treatment is performed in clinic on an outpatient basis and takes less than one hour from start to finish. A small amount of blood is drawn from the patient’s arm and put into a centrifuge machine. This centrifuge rapidly spins to separate the blood into layers of PRP and red blood cells. The PRP layer is then injected into the affected injury under a local anesthetic or topical numbing agent on the skin. Often times Ultrasound Imaging is used to target the specific treatment area.

Are There Any Side Effects?

While PRP has been used successfully for many years, it is still considered in the experimental stages. Since the patient’s own blood is used, PRP is a safe procedure. Minor side effects of the treatment might include discomfort or swelling at the injection site. This is alleviated with ice and elevation. Physical Therapy may also be recommended to optimize the effects of PRP.

If you would like more information about PRP or would like to schedule an appointment, give us a call at 941.951.2663. You may also find information on our website here. The experienced physicians at Sarasota Orthopedic Associates have been treating patients in Sarasota, Manatee, and Charlotte Counties since 1978 and offer same/next day appointments in three locations.

DO YOU HAVE RUNNER’S KNEE?

RUNNERS

Avid runners can experience pain for a number of reasons, from simple trauma (banging the leg against something) to muscle spasms (usually the result of improper stretching). When running and jogging are consistently painful, however, the problem could be runner’s knee. Exercise enthusiasts should always pay attention to pain and respond accordingly. Before panicking over persistent knee pain, however, it’s important to understand what runner’s knee is and how to recognize it.

Recognizing Runner’s Knee

Patellofemoral pain syndrome (PFPS), the medical term for runner’s knee, is a persistent irritation localized at the juncture of the patella and femur—the “top” side of the kneecap. It’s commonly associated with running and jogging, hence its lay name. PFPS is characterized by a dull knee pain that sufferers describe as “behind” or “around” the top of the kneecap.

Exercise and activity can aggravate runner’s knee injuries, particularly when the direction is downhill such as descending stairs or running on a decline. Squatting and sitting for long periods can also be problematic for people dealing with PFPS. There is likely also knee pain associated with resisting leg extensions. The kneecap itself may be adversely sensitive to pressure.

PFPS vs. Patellar Tendonitis

As noted above, PFPS produces pain localized on the upper side of the kneecap. If the pain manifests “inside” or “below” the kneecap, the condition in question is more likely patellar tendonitis—an inflammation of the tendon connecting the patella to the shin muscle. Patellar tendonitis results from a different kind of injury than does PFPS, though the only sure way to get a diagnosis is by meeting with a certified doctor, preferably an orthopedist.

Misconceptions About PFPS

PFPS can strike anyone who actively and/or aggressively uses the legs and knees for work or recreation. While less common among active children, there is a higher tendency for this kind of knee pain among women runners. The reasons for this correlation remain unclear; however, recent research has disproven the so-called “Q-angle” theory that the wider hips of female physiology render women more susceptible to runner’s knee.

In the last decade, science focused on PFPS has discovered that the knee actually moves differently during runs or squats than it seems to the person exercising. Although it feels like the kneecap “tracks” outward when running or squatting, it’s actually the femur that is rotating above and around the patella. This fact explains why PFPS sufferers generally also have weakened hip abductor and external rotator muscles. In fact, the most successful physical therapy regimens for runner’s knee all involve strengthening these muscles to help stabilize knee movement and reduce irritation.

Sarasota Orthopedic Associates offers customized pain management treatment plans for runners and athletes throughout the Gulf Coast of Florida. Fill out our contact form to schedule your appointment today.

With three convenient locations we are able to offer same/next day appointments when needed.  Like us on Facebook here. Follow us on Twitter here.