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UP CLOSE AND PERSONAL

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Our newest physician, Dr Adam Mandel, is an Orthopedic Foot and Ankle Surgeon at Sarasota Orthopedic Associates. He took some time to sit with us and answer a few questions to get to know him on a more personal level. Take a look at our conversation:

What inspired you to become a physician?

I always was inspired to help people and strive to achieve health. Physicians help to not only cure disease but also to prevent it.  I enjoy educating people as well as continually educating myself.  Being a physician in an ever-changing world allows that.

Why orthopedics?

I was always mechanically inclined. In medicine there are procedural jobs such as orthopedics.  Being an athlete and mechanically inclined just matched me perfectly with orthopedics.

What do you love most about your job?

I enjoy the variety of cases that I do within my subspecialty. This includes trauma, sports cases, cartilage repair, tendon repairs, reconstructions, joint replacements.  I also enjoy constantly meeting new people and learning of their lives and help to ease and cure their pain or problems.  It gives me great personal satisfaction to be very gifted at what I do.

 What is your biggest challenge?

Electronic medical records, constant changing in laws, regulations, and compliance issues always challenge me. Being a physician isn’t always as glorious as it seems to be played out on television.

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

I’d be a bartender on a beach.

Your proudest moment?

Becoming a father to two amazing children.

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

Most interesting was to Italy. The people, culture, different way of life.  It was all amazing to me.  I kept thinking of nature versus nurture and what a different life I would have if I was born there instead of the United States.

Any hobbies? Activities?

Working out, running, paddle boarding, boating, wood-working.

What’s your next adventure?

Traveling. Definitely traveling.

Your guilty pleasure food?

I’m not a sweets kind of guy or dessert, but I love sushi.

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Dr Adam Mandel is a Fellowship Trained and Board Certified Foot and Ankle Physician. He sees patients in our Lakewood Ranch and Sarasota offices. We are able to offer same day / next day appointments at any of our three locations and appointments may be may online at www.SOA.md or by calling 941-951-2663.

 

When Should My Child See an Orthopedist?

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It can be hard to know whether a child needs orthopedic treatment or is just experiencing growth development. Symptoms can be signs of underlying causes. While many orthopedic problems that arise in childhood are temporary, it can be hard to know when your child may need additional care. Parents who notice persistent musculoskeletal problems may need to consider seeking pediatric orthopedic treatment. There are two primary orthopedic problems found in young children. These typically form when a child is first learning to walk and can lead to irregular walking habits.

Intoeing is identified as running or walking with the toes turned slightly inward as opposed to straight forward. The layman’s term for this condition is “pigeon-toed.” Intoeing typically corrects itself around the age of 8 in the majority of children, however, if it continues the child may need the assistance of a brace or other orthopedic treatment. Intoeing can be a symptom of metatarsus adductus (when a child’s foot is bent inward near the middle of the foot), tibial torsion (the inward twisting of shin bones), or femoral anteversion (an inward twisting of the thigh bone). Treatments include casts, braces, or surgery to reset bones.

Bowleggedness, or genu varum, is more commonly found in toddlers under the age of 2 and those suffering from childhood obesity. If a child has bowleggedness, there will be a noticeable gap between their legs when they place their feet together. As the child continues to grow, bowed legs typically straighten themselves out. However, if one leg is more bowed than the other or if the bowing is more severe than usual, the child may need orthopedic treatment. Furthermore, bowleggedness can be an indication of something more serious such as Blount’s disease or rickets. This is often identified via x-ray after the child is three years old. If left untreated, bowing may worsen or become permanent. Treatments include bracing, medication, or surgery depending on the underlying cause.

If parents notice these symptoms and they seem more severe than usual, it’s important to ask a pediatrician if seeing a specialist is necessary. At Sarasota Orthopedic Associates, we treat patients from pediatrics to adults. We have three convenient locations and are able to offer same day / next day appointments when needed. Our mission is to get patients back on their feet, back to work, back in the game, and back to life.

PREVENTING SPORTS INJURIES IN CHILDREN

Child-falling Injury on the soccer field

Youngsters are particularly prone to sports-related injuries, but there are steps coaches and parents can take to keep young athletes healthy and active.

Children love playing sports, whether on organized teams or in neighborhood pickup games. In fact, more than 46 million children participate in sports each year, with most reaping the benefits of physical activity and teamwork. But with so many youngsters participating in these activities, there will inevitably be some injuries. In fact, one in three children playing team sports faces an injury serious enough to be benched. But most injuries are preventable, and knowledge is key to prevention.

Benefits of Participating in Sports

sports

In addition to keeping kids in shape, sports also improve coordination, self-esteem, and discipline. Team sports also promote teamwork, a valuable skill not always learned in the classroom, and cooperation with others. And while losing isn’t easy, it’s important for kids to learn how to accept defeat and try again. Many children become close friends with their teammates and learn valuable social and communication skills.

Sporting Hazards

cheerleader knee injury

For most youngsters, the benefits of sports far outweigh the risks, but children are still growing, and injuries can impact them more than they would an adult. Muscles, tendons, ligaments, and bones are rather susceptible to injury, and sudden trauma like twists, falls, or collisions can lead to more than just a bruised knee; sports medicine physicians often see injuries like strains and sprains, broken bones, and growth plate injuries that affect bone growth. Overuse can also cause injuries when kids practice too long or too hard without adequate rest in between exercise sessions.

Preventing Sports Injuries

There are a number of steps parents and coaches can take to ensure kids remain safe on the field or court. The first is proper age-appropriate physical conditioning and training to ensure children are in good shape before joining the team. This conditioning should also incorporate  stretching techniques and adequate warm-up exercises for their particular sport. Protective gear is also a must, and kids should be given a lesson in how to properly use or adjust helmets, padding, mouthpieces, protective eyewear, and other safety equipment.

Too often young athletes are playing only one sport all year long without the potential for rest or recovery. Sports medicine specialists now understand that this is not a healthy strategy. In fact, young athletes who play or perform a single sport greater than eight months out of the year are at a significantly increased risk of experiencing an injury compared to the other youths who participate in different sports. Playing only one sport may overload developing structures causing overuse injuries.

Creating a Supportive Atmosphere

Children can also feel pressure to win, so it’s vital to their emotional health that parents and coaches foster a supportive atmosphere, emphasizing teamwork and sportsmanship over winning. When children are properly cared for physically and emotionally by their coaches, they’re a lot less likely to face severe injury and stress.

If your child has been experiencing pain during sports or other concerning symptoms, call Sarasota Orthopedic Associates at 941-951-2663 to schedule an appointment. You may also schedule an appointment through our website. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

DON’T LET BACK PAIN RUIN YOUR GOLF GAME

golf feet

While an estimated 75% of people will experience some form of back pain at some point in their life, that number is even higher among golfers. Pro golfers and weekend warriors are both subject to the pain. There are ways to avoid back pain, and, non-invasive treatments if it does happen to you.

Some of the more common causes of back pain in golfers are rotational stress from an improper swing, overextension, pivoting/twisting of the hips, and muscle spasms from overuse. Those with prior history of back injury or pain are at higher risk of re-injury. Deficits of hip range of motion as well as lumbar extension are also common in golfers with back pain. Research studies that have looked at differences seen in golfers with back pain versus pain-free golfers have shown statistically significant differences in techniques. Specifically what was observed is greater spine flexion when addressing the ball and less trunk rotation compared to pain free golfers who had twice as much trunk flexion velocity. That greater spine flexion versus trunk rotation increases risk of back injury.

There are simple solutions to avoid back pain in golfers:

  • Proper stretching and warm up prior to play
  • Strengthening back and shoulder muscles on days not in play
  • Knowledgeable coach/trainer to correct your swing
  • Correct fitting footwear
  • Cut back on number of days per week
  • Avoid playing a full round after a long hiatus from playing

At home remedies for reducing discomfort include icing, rest, or NSAIDS.

If your pain is not resolved after a few days, it may be time to see an Interventional Pain Management Physician for a non-surgical or minimally invasive solution. Some of the methods might include:

    • Injections. This may include injection of an anesthetic, a steroid, or both.
    • Radiofrequency ablation. This is used as an option to stop back pain that has become chronic and is no longer responding to injections.
    • SCS (spinal cord stimulation). Another option to stop chronic pain especially back pain that comes with severe pain in the legs.

At Sarasota Orthopedic Associates, we have three locations and offer same day appointments.  Ashot Kotcharian, MD is a PM&R physician with a specialty in  Interventional Spine & Sports Medicine. With proper attention and treatment for the discomfort, you can get back in the game with minimal down time. Fore!

BUILD YOUR GAME FROM THE GROUND UP

golf stance

A powerful, and effective golf swing starts with a stable foundation. From a solid foundation the entire swing can be leveraged and a low handicap status can be achieved. The important but often overlooked foundation, are pain free and well-functioning feet and ankles. While there is a lot of discussion about back, hip and knee injuries in golf, most golf instructors will tell you that the power of a swing is created “from the ground up”.

Injuries to the great toe

At the end of follow through, the great toe of the dominant foot experiences an increase in pressure. This can cause a jamming of the toe into the top of the shoebox. With repetition, the area under the toenail can become injured causing blood to form or the nail to lift from the nail bed. These types of injuries should not be taken lightly. Even though the toe is a small portion of the body, if not treated injuries to this area can cause significant pain, infection and loss of function. Wearing proper fitting shoes and adjustments in the golf swing to prevent the irritation of the nail is necessary to eliminate recurrence.

Ankle Instability

Stability is an important factor in performance in both accuracy and distance, and is also a contributor to the amount of power generated. The lower body needs to be the stable foundation for the upper body during the rotation required for the backswing and the trail foot is expected to remain relatively stable during this rotation. The lateral, or outside of the ankle is a common site of injury for golfers and other athletes alike. Repetitive strain will cause laxity of the lateral ankle ligaments and predispose that ankle to easier spraining. Sprains of the ligaments can lead to weakness and a lack of stability in the golf swing and while walking on the uneven terrain of a golf course.

Golfing is a highly coordinated sport that, by its nature, is associated with risk of repetitive motion injuries. Being intentional about maintaining good foot form and taking care of a stable foundation can keep golfers free of injury and enjoy years on the course.

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Dr Jemaar Graham is a Board Certified Foot and Ankle Podiatrist at Sarasota Orthopedic Associates treating all related problems related to the foot and ankle with both surgical and conservative modalities. He joins the mission of SOA to get his patients back on their feet, back to work, back in the game, and back to life.

THE DOCTOR IS IN: Separating Facts from Fiction of Knee Replacement

Knee-Pain

Knee replacements have come a long way over the years, and along with improvements are misconceptions. Modern medicine is now able to reduce your post-surgical “down time” and in many cases, avoid surgery altogether. Let’s take a look at some of those myths.

Myth: You have to have knee surgery.

Truth: No one should tell you that you have to have surgery. YOU, the patient, determine when the time is right. Your orthopedic surgeon can show you the progression of your condition and discuss your discomfort level, however you are the one who makes the final decision.  Many times knee discomfort may be managed conservatively with options such as NSAIDS, physical therapy, strengthening, injections, or PRP (platelet rich plasma).

Myth: Advertising shows people running and jumping after knee surgery.

Truth: Don’t fall prey to marketing.  Everyone is unique and outcomes are different based on your individual situation.  Returning to golf and tennis are reasonable expectations after knee replacement for many patients.  Dropping 10 pounds prior to surgery and following your physical therapy instructions will make a difference in recovery.

Myth: My knee should feel like it did when I was 17.

Truth: All surgeries require a period of adjustment in recovery. If you’re 60 years old, expecting your knee to behave as it did when you were a teen is not realistic. Since everyone is different, your recovery will depend on you. Most patients are happy how their knee feels after replacement and would recommend replacement.

Myth: I heard a lecture that knee replacements don’t work and I should have regenerative therapy instead.

Truth: According to the American Academy of Orthopedic Surgeons, over 90% of people having a knee replacement experienced reduced pain and are able to return to their normal activities they previously gave up. While PRP and Stem Cell Therapies are options, they aren’t the “golden ticket” you may hear in lectures peddling the fountain of youth. These may be helpful for some, but they do not “cure” arthritis and are not presently covered under insurance. Remember, everyone is different and what works for some, won’t work for others.

Bottom line: Know your orthopedic surgeon and ask questions. Based on my condition, how much improvement should I expect? What are the risks/complications? When can I go back to work? May I drive? The more you know, the lower your anxiety level and the better your ability to make decisions. ###

Steven Page, MD is a Fellowship Trained / Board Certified Orthopedic Surgeon with a specialty in Sports Medicine. He specializes in surgical and non-surgical treatment of knees and shoulders. Sarasota Orthopedic Associates offers same day/next day appointments in all three locations. Visit www.SOA.md or call 941-951-2663 for more information.

THE DOCTOR IS IN: Getting to Know Dr Graham

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Dr Jemaar Graham is a Board Certified Podiatrist and trained to treat all problems related to the foot and ankle with both conservative and traditional modalities. He is a native of Lakeland, FL and joined SOA in May. We’re pleased to welcome him to our family and asked him to give us some insight into what motivates him.

What inspired you to become a physician? I’ve wanted to be a physician since early childhood. I accompanied my mother as she was seen by a podiatrist while I was in elementary school. After the nurses that worked there gave me a tour of the clinic, I knew it was what I wanted to do. In the following years I shadowed other Podiatrists, and studied bio-physics and knew Podiatry was a great fit for me.

Why orthopedics? I enjoy working with my hands and have an interest spatial reasoning. In many ways orthopedics is like being a carpenter. Thinking in three dimensions, solving problems and putting broken pieces back together again was much more attractive to me than other medical specialties.

What do you love most about your job? Seeing the relief on patient’s faces after treatment. There’s a sense of hope and restoration that comes from patients when overcoming something that was ailing them; it’s an honor to contribute to that.

What is your biggest challenge? Insurance companies and costs. There are many ways we as physicians could better treat patients if costs and payments were such an inhibiting factor.

If I weren’t an orthopedic physician I’d be a: Radiologist…maybe. Imaging and interpretation are a fascinating part of patient care. I think I would grow bored though

Your proudest moment? Seeing my daughter thrive and do well in anything she sets her mind to.

Where is the most interesting place you’ve travelled? Why? Ghana. It was a blessing and honor to see the country of ancestors that is still filled with so much love and contentment.

Any hobbies? Activities? Photography

What’s your next adventure? Becoming a father of two daughters

Your guilty pleasure food? New York style cheesecake or red velvet Learn more about Dr Graham here. You may also make an appointment through our website or by calling 941-951-2663. Sarasota Orthopedic Associates has three locations and offers same day/next day appointments when needed.

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Meet Ashot Kotcharian, MD: Interventional Pain Management Physician

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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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