Category Archives: Doc Blog

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

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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.

IS TECHNOLOGY DE-HUMANIZING US?

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No one can deny technology has made us smarter, more efficient, and even healthier.  Medical technology allows for early detection. The internet gives us instant access to news and information. But whatever happened to human contact?  We have become so wrapped up in the convenience of technology, we’ve lost the pleasure of interpersonal, social relationships. Our “plates” (don’t you hate that phrase?) are so full, we’re constantly seeking the fastest way to communicate and move along to our next task.

We are now more wired than ever. Researchers from the University of Glasgow found that half their study participants reported checking their email once an hour, while some individuals check up to 30 to 40 times an hour. An AOL study revealed that 59 percent of PDA users check every single time an email arrives and a whopping 83 percent check email every day while on vacation.

technology dehumanizing

Consider this:

  • Texting is now an art of abbreviations. Our spelling skills and grammar are going the way of the dinosaur.
  • Smart phones are now labeled “walking hazards”.
  • Our phones are next to our forks at the dinner table.
  • Many states have stopped teaching cursive, citing it as unnecessary. What happened to “thank you” notes to Grandma and Grandpa?
  • Have you been to a meeting with everyone looking at their phones? How does that make the speaker feel? Unimportant? Probably.
  • Next door neighbor children now play video games in their own homes rather than walk twenty feet outside and play with each other.
  • The population of Facebook is higher than that of China or India.
  • More people own a mobile device than a toothbrush. Read that again: scary, right?
  • Grandparents are the fastest growing demographic on Twitter, famous for its limitation of 140 characters per tweet.
  • We now have wearable technology on our wrists!

The statistics are scary. According to a recent study conducted by the Kaiser Family Foundation, children today spend up to 75 hours a week using technology gadgets. That’s 75 hours of time spent plugged into iPods, watching TV, using the Internet, and escaping into the world of video games.

Old fashioned criticisms? Maybe, but are we taking the easy way out and unplugging from human contact? Sherry Turkle, a media scholar who wrote “Alone Together” and “Reclaiming Conversation” claims that “the flight from conversation undermines our relationships, our creativity, and our productivity”.  She believes that the ability to text and email allow us to edit our personalities and control how we want to be perceived, rather than who we really are.  Take a few minutes and listen to her on TedTalks at https://www.ted.com/talks/sherry_turkle_alone_together?language=en#t-406314  

Human emotion is powerful and can’t be interpreted correctly through a text or email. Our body language, facial cues, and tone of voice all contribute to the conversation; when those elements are missing, it’s easy to be offended by a misunderstood remark or even a typo. Our smart phones are slowly driving us into isolation and while smiley faces on our phones are cute, they don’t convey the beauty of a smile or the sadness of real tears. Nothing replaces a mom’s hug, a shared memory, a family outing, reuniting with an old friend, touch and consolation when needed, or working out solutions in person via conversation.

Nearly two years ago, Scott Dockter, president and CEO of PBD Worldwide Fulfillment Services Inc., decided to take Casual Friday one step further, and created email-free Fridays, where employees are encouraged to talk offline to resolve issues, by picking up the phone or meeting face-to-face. As a result, he saw an 80 percent email drop-off in the first year and noticed a reduction of unnecessary reports sent and excessive cc’ing.

Here’s a challenge: Is it possible for us to go on an email/texting “diet”? Is it possible to feed our souls instead with human contact for an hour a day? Try it … you may be surprised how good it makes you feel. What are YOUR thoughts?

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DISTRACTED WALKING?

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“Dude. Engage!”

Distracted driving can cause crashes, injuries, and even death; it’s a prevalent public issue that the American Academy of Orthopaedic Surgeons (AAOS) continues to champion. But what about distracted walking? What are the consequences of pedestrians talking on the phone, texting, listening to music, or engaging deeply in conversation with the person next to them?

“Today, more and more people are falling down stairs, tripping over curbs and other streetscapes and, in many instances, stepping into traffic, causing cuts, bruises, sprains, and fractures,” said Alan Hilibrand, MD, chair of the AAOS Communications Cabinet. “In fact, the number of injuries to pedestrians using their phones has more than doubled since 2004, and surveys have shown that 60% of pedestrians are distracted by other activities while walking.”

Recently, AAOS expanded its injury-prevention efforts to include distracted walking. The “Digital Deadwalkers” radio and television public service announcements (PSAs) distributed in 2015 and 2016 humorously, but effectively, highlight what can happen when pedestrians focus on anything or anyone other than the task of safely getting where they need to go.

First, while 78% of U.S. adults believe that distracted walking is a “serious” issue; three-quarters of Americans say it’s “other people” who walk distracted. Only 29% of respondents admit that they, personally, have an issue. And the sense of “it’s not me, it’s you” cuts across a range of distracted walking behaviors:

  • Ninety percent say they see walkers talking on the phone (and 37% admit doing so themselves)
  • Eighty-eight percent engaging in conversation (vs. 75% themselves)
  • Eighty-eight percent listening to music (vs. 34% themselves)
  • Eighty-five percent using a smartphone (vs. 28% themselves)
  • Sixty-four percent generally “zoning out” (vs. 38% themselves)

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Despite the obvious risks associated with distracted walking, as many respondents believe it is “embarrassing (in a silly way)” as feel it is “dangerous” (46%). Furthermore, 31% say distracted walking is “something I’m likely to do” and 22% think distracted walking is “funny,” according to the study.

And distracted walking is resulting in injuries. Nearly 4 out of 10 Americans say they have personally witnessed a distracted walking incident, and just over a quarter (26%) say they have been in an incident themselves.

Information contained here is reprinted from AAOS (American Academy of Orthopaedic Surgeons).

To read the rest of the story go to:  http://www.orthoinfo.org/topic.cfm?topic=A00748 or if you’ve injured yourself in a “distracted” incident, go to our web site to learn more about Sarasota Orthopedic Associates and how we can help you.

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What’s on YOUR Bucket List?

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At this time of year we think about the year left behind, reflecting on our accomplishments and wondering about things we wish we had done.  Each new year prompts us to set new goals, but what about our “bucket list” … those wishes and dreams we wouldn’t normally be able to do, or even things we say “maybe someday I really will do that”?

We asked some of our SOA staff “what’s on YOUR bucket list?”; what is that one thing that would fulfill your dream? We had some interesting conversations.  The number one generic answer was the desire to travel and there were specific locations:  Alaska, Austria, Germany, Italy, Africa, and Paris.  Some were more detailed like seeing the Great Wall of China or the Grand Canyon.  There were interesting thoughts like “fill my passport” and “live on a cruise ship” and “the more places I see, the more places I want to go” and “see the Aurora Borealis” and “a road trip with no particular destination”.

my-bucket-list

See if you share in these other SOA staff responses:

  • Parachute
  • Hang gliding
  • Hot air balloon ride
  • Learn a musical instrument
  • Invent something
  • Reconnect with old friends from long ago
  • Parasail
  • Do more woodworking
  • Participate in live theatre on stage
  • Be able to carry a tune
  • Finish college
  • Have my own business
  • Backpack across Europe for a year and live among the locals
  • Culinary school
  • Learn a language
  • Retire
  • Be a firefighter
  • Go sport fishing
  • Reinvent myself
  • Be a mentor
  • Volunteer; pay it forward; do something without expecting something in return
  • Make photography more of a thing rather than a hobby

So how about joining the conversation? What would be appealing to you? What would make your life more interesting?  How will YOU change the world? What’s on YOUR bucket list? Share your dreams with us. Better yet, get out there and DO it!

DID YOU SAY SPORTS INFECTIONS?

MRSA

Most athletes expect injuries and not an infection to be the thing that would most likely make them miss some time. Viral, fungal, and bacterial infections can not only take a person out of the game, but can be serious enough to require hospitalization. Recent outbreaks of Staph infections at schools and even ones affecting professional teams (e.g. Tampa Bay Buccaneers) have shed light on the issue, but many athletes are still unaware of the potential for infection in locker rooms, outdoor sporting activities, and even among family. Here are some commons infections that can afflict athletes.

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Staph Infections

Perhaps the most dreaded and serious of them all are the Staph bacterial infections. Most recently, there has been a surge in community-acquired MRSA infections (a resistant strain) that often affects those with poor hygiene, who live in crowded situations, and have had recent trauma to the skin. They are particularly common in wrestlers, football players, and anywhere there is shared use of contaminated equipment. A recent study showed that there was a 22% prevalence of Staph in locker room whirlpools in college training rooms. It will often present as a red, painful bump but can also develop into abscesses and further soft-tissue infection. Prevention is key with frequent hand washing being the most important prophylaxis. How it presents determines how it is treated. Fluid collections should be drained and all patients should be placed on antibiotics that target the resistant form. Returning to play, per various groups’ guidelines, should only be considered after treatment for 72 hours, no new lesions for 48 hours, and no drainage being present.

Infectious Mononucleosis (IM)

Also known as “kissing disease”, IM is a common viral infection that affects teenagers and young adults, and is often caused from sharing water bottles. Patients will experience a sore throat, body aches/pains, fatigue, fevers, and possibly a rash, and it may take upwards of a month for symptoms to present themselves after one is exposed. The most concerning feature associated with IM is spleen enlargement. When an athlete’s spleen is enlarged, especially contact athletes, this puts them at risk for having the spleen rupture, and, while although rare, can be potentially fatal. IM symptoms usually disappear after 3-4 weeks but may take longer till an athlete is ready to return to sports. Controversy exists with regards to when a contact athlete with IM is safe to return to sports, but most studies show that is probably safe after 4-6 weeks for them to return to play.

Fungal Infections

Caused by direct skin-to-skin contact, fungal infections are quite prevalent and can affect all parts of the body. “Athlete’s foot”, “jock itch”, “ringworm” all fall into this category. While they don’t usually cause too much in the way of significant health issues, they can cause athletes to miss quite of bit of practice and competition time. Most commonly, treatment is in the form of topical creams/ointments, but for more serious cases oral treatment may be needed. Current guidelines recommend 72 hours of topical treatment for non-scalp infections and having a protective dressing over all lesions for return to play.

Summary

While infections are an often overlooked cause of athletes and patients missing time from their sports or activities, they can be just as frustrating as an injury with regards to time off, treatment, and recovery. Sarasota Orthopedic Associates is driven to helping get their patients back in the game, no matter the cause.

Trevor Born, MD – Dr Born is a Sports Medicine physician at Sarasota Orthopedic Associates specializing in upper and lower extremity conditions. SOA has three convenience locations in Sarasota, Lakewood Ranch, and Venice and offers same day appointments when needed.

TENNIS ANYONE?

tennis racket and ball

Tennis is one of the more popular sports on the Gulf Coast of Florida. Year round competition at all levels can unfortunately lead to various “overuse” injuries, and some athletes may even sustain acute traumatic injuries which may force them to miss time. An overview of common injuries as well as ways of preventing and treating them may help to keep a tennis player on the court.

Tennis Elbow

Perhaps the most dreaded of all the overuse conditions is “Tennis Elbow,” or lateral epicondylitis. A degenerative process affecting the tendons on the lateral aspect of the elbow, which help to bend the wrist backwards, it is commonly seen in tennis players given that these muscles help resist impact when the racquet strikes the ball. Combined with their importance in gripping the handle, these muscles/tendons are prone to overuse if not properly prepared. Strengthening, a regular warm-up routine, and paying attention to grip size can help minimize the risk of developing the condition. Treatment often includes rest, therapy, braces, medications, and injections. While most cases improve with these conservative measures, occasionally surgery is needed.

Shoulder Injuries

The shoulder, like the elbow, is also predisposed to overuse injuries in tennis players. The serve is a complex motion that not only requires a balance of muscle coordination around the shoulder, but good core and lower extremity flexibility and strength to minimize risk of injury. The rotator cuff muscles can often become fatigued or weak, which can throw off the balance, and irritate surrounding tissues. The tendons and surrounding bursa can become inflamed, which may affect one even off the court. Again, conservative treatment is often all that is needed, not only focusing on the shoulder, but providing a total body program to minimize the stress on the shoulder during strokes. If symptoms persist, then further imaging and possible surgery may be needed, especially if a rotator cuff tear is present.

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Lower Extremity Injuries

The legs are just as important as one’s arms on the tennis court. Rapid changes of direction, sudden stopping and acceleration, and jumping are often needed during a match. Muscle strains, knee and ankle sprains, and stress injuries can occur during these movements. Strains, such as “pulling” a hamstring or calf muscle, can often be prevented by adequate stretching prior to playing. An awkward step or twisting episode may result in a sprain. Ankle sprains almost always improve with conservative measures, but recurrent sprains may result in continued instability and require surgery. Knee sprain treatment depends on what is injured. While certain ligament and tendon issues around the knee can heal with non-operative treatment, meniscal and ACL tears often need surgery, but this is determined on a patient-to-patient basis.  Quickly increasing the amount of tennis one is playing may predispose them to a stress fracture, either in the lower leg or foot. These require rest and off-loading of the limb, possibly with the assistance of crutches. Lastly, proper footwear is vital to the health of the lower extremities and minimizing the risks of these conditions.

Summary

Understanding the spectrum of conditions that can affect tennis players is often a good first step into learning ways to avoid them. Every patient/athlete is unique and working with them through their condition in a customized approach will best enable them to get back in the game.

Trevor Born, MD  is a Sports Medicine Physician at Sarasota Orthopedic Associates treating upper and lower extremities with non-surgical treatment as well as minimally invasive options. Click HERE for more information.

 

SHOULD MY CHILD PLAY THE SAME SPORT ALL YEAR LONG?

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Ahhh!!! Florida, with its beautiful warm sunny days and virtually endless opportunities for sporting events, is a hotbed for the development of youth sports.  Here in the Sarasota/Bradenton area, there are numerous opportunities for the young athlete to participate in sports year round.  Too often, however, young athletes are playing only one sport all year long without the potential for rest or recovery.

Unfortunately, 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.  In a recent sports medicine article, youth athletes who focus on a specific specialization of sport program are twice as likely to get injured compared to their friends who participated in self-directed unstructured free play.

There are a few theories as to why this may occur. Playing only one sport may overload developing structures causing overuse injuries.  Additionally, proper development of other diverse muscle skills which occur during regular free play or from participating in array of different sports may not occur when a child only plays one sport.

Based on these theories, it is recommended that young athletes be given time away from their specific sport so that they can participate in free unstructured play with their peers.  Parents and educators should provide opportunities for free play as well so that our young athletes can improve their motor development in general during the growing years which can reduce injury rates and encourage life-long activity free of injury.

Paul H. Lento, MDDr Lento is Fellowship Trained and Triple Board Certified in Physical Medicine.  He is a nationally recognized Sports Physician having served as team physician for major sporting events such as Winter Olympics and major city marathons. Locally he is team physician for Lakewood Ranch High and Booker High Schools. He holds the distinction being named a Castle Connelly Top Doc and sees patients at Sarasota Orthopedic Associates.  Learn more HERE.

YOU’RE GOING TO STICK A CAMERA IN WHERE? The Basics of Ankle Arthroscopy

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You have probably heard of, or know someone who has had, a knee or shoulder arthroscopy or “scope.” What you may not know is that we can also perform arthroscopy of the ankle. This can be a quite useful procedure for some common ailments of the ankle. This is frequently performed as an outpatient procedure with a few small incisions.

During ankle arthroscopy a small incision about ¼” long is made over the front of the ankle. This small incision allows us to place the camera into the ankle joint and see the cartilage covering the tibia, talus and fibula (the bones that make up the ankle joint). We then make a second 1 /4“ incision that allow us to insert a second tool such as a probe or motorized shaver that we can use to assess and clean up damaged tissue. Being able to visualize the ankle joint from the inside out allows us to treat some conditions with much smaller incisions than would be possible otherwise.

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We commonly clean up damaged cartilage or inflammation of the lining of the joint through the ankle scope. We can also perform procedures such as micro-fracture or grafting which can help stimulate healing of damaged cartilage. Recently, we have been using ankle arthroscopy to prepare the ankle joint for fusion by scraping out any remaining cartilage. This has been incredibly helpful because it allows us to perform an ankle fusion procedure through 4 or 5 small incisions instead of 1 or 2 quite large incisions. This has resulted in lower levels of pain and fewer issues with wound healing.

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If you have been having problems with your ankle, whether it is new or quite old, come see me at Sarasota Orthopedic Associates. We have many options both surgical and nonsurgical for getting you back on your feet… back to work… back in the game… back to life.

For an appointment with Dr. Eric James, orthopedic foot and ankle surgeon, call 941-951-2663.

For more detailed information on foot and ankle arthroscopy, check out this excellent article at the American Orthopedic Foot and Ankle Society website.

http://www.aofas.org/footcaremd/treatments/Pages/Ankle-Arthroscopy.aspx

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OFF BALANCE? IT’S MORE SERIOUS THAN YOU THINK

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Studies have shown that 40% of us will have a balance issue at some point in our lives. Some of these issues will be the catalyst for us to see our physician. A balance disorder is a condition making one feel unsteady or dizzy. Any number of things may cause a balance disorder including:

  • Ear infection
  • Head injury
  • Medication
  • Low blood pressure
  • Eye/Vision problems
  • Arthritis
  • Inner ear condition
  • Brain disorder
  • Weak muscles or bones
  • Aging

Proper balance is important to daily living.  A good sense of balance helps us bend over without falling, rise from a chair without tumbling, turn without tipping over, and walk without stumbling. Balance is critical to maintain our independence and enjoy our daily life. Good balance functions as a result of many systems in our body working in harmony. The eyes, ears (vestibular system), and sense of surroundings, when working properly together, help us to stay upright. These tell the brain how to work with our musculoskeletal system and maintain balance.

The CDC (Center for Disease Control) says one-third of adults over 65 fall each year and among those even older, falls are the leading cause of injury related deaths. As we age, our sense of balance can deteriorate, however, there are some simple things we can do to slow the process.

balance with chair

  • Keep moving. One of our physicians’ favorite phrase is “motion is lotion”. Exercise is, indeed, our best defense against many conditions.
  • Build balance. Try standing on one leg for 30 seconds, increasing your time each day. Stay close to a counter or table for support.
  • Biking helps bone density and strengthens your muscles to help avoid falls.
  • Proper stretching of your calves will build strength and stability in legs and feet.
  • If you’re able, plank exercises help build your core.

With any exercise program or even increasing your daily activity, it’s advisable to consult your physician first and discuss any limitations you might have. At Sarasota Orthopedic Associates, we take care of your bones, joints, tendons, and muscles. Click HERE to learn more about us.

THANKSGIVING – A REFLECTION

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The Thanksgiving holiday has come to mean so many things:  family, food, football.  Most of all it’s a day to reflect on our gratitude for those in our lives who bring us joy and the opportunities we are afforded throughout our lives.

“A thankful heart is not only the greatest virtue, but the parent of all other virtues.” Cicero

As you celebrate the day and give thanks for whatever is dear to you …  family near and far, your work or the enjoyment of retirement, the support of friends, the gift of freedom, abundance of nourishment, your journey through life … reflect on the goodness.  Here is some Thanksgiving trivia to help you appreciate the journey of the Thanksgiving holiday:

  • Most people think the holiday started in 1621. In reality, it was the result of a good harvest and the “day” was a three day celebration. The Indians brought five deer as a gift for the Pilgrims and venison was served along with corn, barley, and chicken. Not a turkey or potato was in sight.
  • The tradition technically started in 1789 when President George Washington proclaimed a day in November an “official” Thanksgiving but was not celebrated every year.
  • Thanksgiving wasn’t celebrated nationwide until the 19th century.
  • Sarah Hale, a writer, petitioned to make Thanksgiving an annual national holiday, creating recipes for turkey, stuffing, and pumpkin pie for the occasion.
  • During the Civil War, President Abraham Lincoln proclaimed the final Thursday of November as the national holiday.
  • During the Great Depression, President Roosevelt moved the date one week earlier to encourage retail purchasing for the holidays and boost the economy.
  • In 1941, it was moved back to the traditional fourth Thursday of November.
  • The annual Presidential Pardoning of the Turkey began in 1989 and has continued each year since.

SOA is thankful every day for each and every one of you … our patients, our friends, our families, our vendors, our referring primary care physicians, our staff, and our charitable partnerships.  Sarasota Orthopedic Associates wishes you a holiday filled with reflection, health, joy, and thankfulness.

Thankful