Tag Archives: sports medicine

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.

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.

GOLF – Relaxation or Frustration?

golf-swing

For many people, the game of golf is a conundrum … a game of frustration and/or one of relaxation. It takes commitment, practice, and patience to make the game enjoyable. Unfortunately, all that practice may lead to stress on parts of the body, particularly the shoulder. Even professionals may experience a golf injury of this type. Injury may come for any number of factors including poor swing, incorrect set up/follow through, overly robust swing, improper grip, and overuse.

These repetitive factors may contribute to a common shoulder injury of tendinitis, bursitis, or even a tear in the rotator cuff. Pain may not be felt immediately during play, but rather the night after or when lifting arms overhead. Often times, the discomfort is felt just below the shoulder in the upper arm.

Fortunately there are simple methods to prevent a shoulder injury. Since most injuries are from overuse and improper form, the first and foremost prevention is to rest between playing.

  • If you are experiencing discomfort from a daily round of golf, limit yourself to every other day allowing your shoulder time to recover.
  • Support your muscles with eccentric (lengthening or the “negative”) motions to build strength on your “off” days.
  • Proper warm ups and stretches will help decrease injuries.
  • Learn proper mechanics to decrease the swing force on your shoulder (the most powerful generator of the swing comes from the hips so when mechanics are good this will decrease stress on the shoulders).
  • Enlist the assistance of a professional to correct your mechanics. The bonus? An improved game!

Assuming you’ve done all you can to prevent an injury yet you do sustain a shoulder injury, what’s the best course of treatment?

  • Rest, rest, rest; it’s extremely important to allow the shoulder sufficient time to heal prior to getting back on the course. Do NOT play when you are in pain or you will exacerbate the shoulder trauma.
  • Icing on and off for a day will help with swelling and may provide relief.
  • Anti-inflammatories, or NSAIDs, may ease the discomfort. These should be used only for a limited time.
  • If your discomfort continues longer than a week and/or persists at night, it’s time to consult a physician.

When pain persists for an extended period of time, an orthopedic sports medicine physician will be able determine the cause and amount of damage. Clinical examination, X-rays and/or an MRI will provide a closer look and valuable data on the best course of treatment. We may prescribe physical therapy or a cortisone injection. If surgery is required, surgical advancements have progressed allowing us to utilize minimally invasive techniques such as arthroscopy.

Julie Gladden Barré, MD is a Fellowship Trained/Board Certified Orthopedic Surgeon with a specialty in Sports Medicine at Sarasota Orthopedic Associates. Our commitment is to get patients back on their feet, back to work, back in the game, and back to life. Like us on Facebook here. Follow us on Twitter here.

UP CLOSE AND PERSONAL WITH JULIE GLADDEN BARRE, MD

We are so proud to introduce you to Orthopedic Surgeon, Julie Gladden Barre, MD.  Dr. Barre has a specialty in Sports Medicine and treats all ages from high school athletes to  couch potatoes to weekend warriors to professional athletes. You may find her professional bio on our website, however, we wanted to  spend a few minutes with Dr. Barre and get to know her on a more personal level.  Read about it here:

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What inspired you to become a physician?

Since I was very young I have always had compassion for those in need and this carried into my initial professional calling as a physical therapist. I loved helping people who had been through an injury or surgery and eventually when drawn into management, my love of patient care continued to lure me back to hands on treatment of those in need. I then decided to return to school and become a physician.

Why orthopedics?

With my unique background as a therapist I understood the process of those who were injured requiring surgery and the often grueling process required to get back to what brings someone joy in life. The human body and the increasing active lifestyle of people in today’s world is what has always fascinated me and propelled my love of Orthopedics.

What do you love most about your job?

I love meeting people every day and finding out about their lives and occupations. My job is so satisfying and I thoroughly enjoy being able to help get people back on their feet again as well as help them get back to their normal activities of daily living or get back on the field or golf course or tennis court.

What is your biggest challenge?

One of the hardest things to deal with in the field of medicine is when tragedy happens and seeing people go through physical and emotional pain. As a physician it is hard not to feel the pain that patients and their loved ones go through. I like to encourage my patients and establish a team approach so that I am with them every step of the process.

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

I can’t imagine not being a physician, however if I had to choose something it would be a chef. Everyone loves food and I thoroughly enjoy pleasing people through creativity in the kitchen.

Your proudest / happiest moment?

I think my proudest and happiest moment is when I had my son during the 4th year of my orthopedic residency. Residency is a grueling time in life and after going through a full 9 month pregnancy during residency, the morning my son was born was one of the most joyful times in my life.

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

Guatemala. I helped a medical team during a medical mission trip in college and I was so moved by the people in Central America and how grateful they were for the medical care they received.

Any hobbies? Activities?

Beach activities with family, cooking, travel, attending sporting events, exercise.

 What’s your next adventure?

I would love to take a trip to Europe with my family someday.

Your guilty pleasure food?

A really good coffee and French pastry.

Dr Barre is aligned with the mission of Sarasota Orthopedic Associates to get her patients back on their feet, back to work, back in the game, and back to life.  SOA has three locations and offers same day or next appointments when needed. Check the website at www.SOA.md or call 941-951-BONE (2663) for more information.

Meet Steven Page, MD – Sports Medicine Physician

Throughout last year we profiled all our physicians here at Sarasota Orthopedic Associates in a series of interviews. We were pleased to have Steven Page, MD join our SOA group late last year as  Board Certified Orthopedic Surgeon and Sports Medicine Physician.  This week, we posed those same questions to him so you might get to know him better.

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Dr Page, what inspired you to become a physician?

When I was in high school, I injured my ankle playing soccer. I went to see an orthopedic sports medicine doctor. He took great care of me and led me through a rehabilitation program that got me back to playing quickly so I didn’t have to miss the season.   I loved playing and being around sports.  I knew then I wanted to be a sports medicine doctor so I could take of people the way he took care of me.

Why orthopedics?

I really like that we can actually fix problems and get people back to doing the things they like to do.

What do you love most about your job?

I love that my patients are really motivated to get back to what they enjoy. When patients are engaged in their own care, we work together like a team to accomplish their goals.

What is your biggest challenge?

Finding a way to spend as much a time as I can with every patient while not making the next patient I see have to wait.

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

A veterinarian. I have two boxers and I absolutely love animals.

Your proudest moment?

A college football player that I did a knee surgery on during my fellowship is still playing in the NFL over 10 years later today. I am proud that I had a small part in enabling his success.

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

My favorite place visited is Maui, Hawaii. You can be on top of a volcano that looks like a Martian landscape in the morning and scuba diving with sea turtles in the afternoon.

Any hobbies? Activities?

I love to play sports and enjoy skiing and scuba diving. I get injured a little easier now as I get older so it helps me relate to my patients.

What’s your next adventure?

Becoming a father. I trained for years to be a surgeon, but I am totally unprepared for this.

Your guilty pleasure food?

French fries and macaroni and cheese. And I don’t feel guilty about it all!

Tablet with the text Sports medicine on the display

Whether you are a weekend warrior, professional athlete, or just a regular couch potato who overused those muscles and bones,  Dr Page sees patients of all  walks of life and all ages from pediatric to geriatric. If you’d like an evaluation, call 941-951-2663 or schedule an appointment with us online through our web page at www.SOA.md.   We have three locations and offer same day appointments. To keep up to date on everything at Sarasota Orthopedic Associates “like” us on Facebook HERE, or, follow us on Twitter HERE.

SHOULDER INJURIES IN GOLF

golfer-in-pain

Shoulder injuries are common in golfers. Stresses on the shoulder are different from other sports because each shoulder is in opposition when swinging the club. The forward shoulder stretches across the body with the trailing shoulder raised and rotated. This leads to different complications in each shoulder.

In addition, the rotator cuff muscles are placed under stress as they are a major force in providing power and control of the swing. The leading, non-dominant shoulder is most commonly injured. It is placed into an extreme position during the backswing causing impingement, or, pinching of the rotator cuff. This condition causes inflammation and rotator cuff tears. The placement may also put stress on the shoulder joint and cause tears of the labrum (a stabilizing structure in the shoulder).

golf-shoulder-pain-injury

Pain may be felt in the shoulder or upper arm at various phases of the golf swing, or following play, often when the arms are overhead or at night. Injuries to the shoulder may be sustained from a poor golf swing, a mis-hit, or from overuse. Golfers can develop tendinitis and tears in the rotator cuff from a combination of poor mechanics and the repetitive motion of the golf swing.

Prevention

While many golf injuries occur due to a combination of overuse and poor technique, a lack of conditioning and flexibility also contribute to injuries and pain. Tips:

  • Rest between playing to prevent overuse injury.
  • When in discomfort, decrease the amount of time you play.
  • Shorten your back swing and turn more through the hips & waist.
  • Refine your swing to decrease force on the shoulder joint; pro lessons will help.
  • Exercise when not on the course to improve flexibility.
  • Warm up with brief cardio and stretching to decrease injury.

Treatment

  • Shoulder pain should be treated initially with rest or decreased playing time.
  • It’s best to completely avoid playing until pain is resolved.
  • Nonsteroidal anti-inflammatory drugs may be helpful over a brief timeframe.
  • Icing over 24-48 hours may support relief.
  • Range of motion exercises should improve flexibility.
  • If pain persists beyond 7-10 days, consult your physician.

A sports medicine physician can examine the shoulder and obtain x-rays or an MRI to determine the cause of injury. Most injuries are treated with rest, anti-inflammatories, and/or physical therapy. Bursitis and tendinitis may be treated with a cortisone injection. For pain that continues despite a thorough treatment program, surgery is an option to consider. Recent advances in arthroscopic surgery allow repair of most injuries through minimally invasive techniques, enabling quick return to your game and minimizing downtime.

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Steven Page, MD is an Orthopedic Surgeon with a specialty in Sports Medicine at Sarasota Orthopedic Associates. He is Fellowship Trained and Board Certified. Dr Page serves as a Team Physician for the Mustang football team at Lakewood Ranch High School. 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 an appointment go to our website at www.SOA.md or call 941-951-2663.

What’s That Sound? SNAP, CRACKLE, POP

knuckle cracking

It’s a question most orthopedic surgeons get asked on a daily basis: “My joint pops…is that normal?” Like most things in life, if it’s not broke (or hurting), don’t fix it. An acute injury resulting in an audible “pop” is different from a situation such as a hip “popping” for years. Popping, cracking, or crunching of joints is quite common and often nothing to be too concerned with, especially if it is not causing discomfort or affecting one’s activities. Here are some need to know tidbits on joint popping and cracking.

What Causes This?

  • Numerous theories and causes exist including ligament stretching, tendons snapping, nerves subluxing, or bubbles forming within the joint. A recent study investigated the bubble theory using MRI videos to propose the mechanism by which “cracking” your knuckles results in a negative-pressure event which draws synovial fluid into the joint, thus leading to the subsequent pop. Why does it feel good to crack a knuckle? Thoughts are that the pressure phenomenon within/around the joints stimulates certain receptors which allows for muscles to relax. Another theory suggests natural painkillers (endorphins) are released with such activity, which may explain why it can be a difficult habit to break.
  • Other things must also be taken into account when discussing the cause of noise around a joint, such as prior injuries, surgeries, hardware/implants around the joint, and other accompanying symptoms. It is quite common for someone who injures their ACL to feel or hear a “pop” from the ligament rupturing. This must be taken in a different context from the chronic, painless popping that someone may experience around their knee cap from soft-tissue issues.
  • Lastly, arthritis can commonly be accompanied with crunching or cracking sensations and as long as it is not resulting in increasing pain or swelling, it is something that can be observed. Some older style knee/hip implants may result in noises (e.g. squeaking), and if you were experiencing this, it would likely be best to visit with your orthopedic surgeon to check the status of things and make sure the components were not wearing out in an abnormal fashion.

Should I Be Concerned?

In general, if the popping/cracking around a joint is not causing pain or swelling to occur or interfering with your function or activities, there shouldn’t be much concern. Studies have looked at whether or not cracking your knuckles would lead to arthritis, and to date, no such correlation has been shown. That said, it is generally recommended that one not perform such activities too frequently or on purpose as there have been reports of joints/knuckles becoming loose from habitual cracking. In addition, habitual knuckle crackers have been shown to develop hand swelling (not from arthritis) and decreased grip strength which can lead to decreased manual function. Nodules can also form from such activity, and this may cause cosmetic concerns for certain patients.

Common Areas to Experience It

Any joint can develop it, but perhaps the most common areas to experience it are in the hands, knees, spine, and shoulders.

  • As already mentioned, knuckle cracking is a common occurrence.
  • With regards to the knee, the anterior aspect often experiences popping/crunching from the patellofemoral joint (knee cap). This can be from mild softening of the joint, but most of the time it is from soft-tissues in the area (e.g. plica, fat pad) that simply release themselves during motion.
  • Similar to the knuckles in the hand, the facet joints and other muscles/ligaments around the spine are prone to popping.
  • The spine is a complex unit with numerous muscles, joints, discs, and ligaments contributing to its stability. Chiropractors make a living out of therapeutically popping, cracking, and aligning patients’ backs, so why would you get too concerned with your back popping if you’re not having any discomfort with it?
  • Lastly, the AC joint of the shoulder almost always develops arthritis, but rarely causes too much pain or functional limitation. Popping over this portion of the shoulder with no other symptoms is quite common. On the contrary, patients with symptomatic instability or arthritis in the shoulder joint proper will almost always have pain or issues with their function accompanying this, and would thus be treated differently to the above mentioned scenarios.

Summary

Painless popping around joints is an issue that one should hardly ever get too concerned with. If popping occurred from an acute injury or there were other symptoms being experienced in addition to it, then a visit with your orthopedic surgeon would be recommended at that point. Otherwise, keep up what you are doing and don’t let some painless noise around a joint stress you out.

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Trevor Born, MD is an orthopedic surgeon with a specialty in sports medicine. At Sarasota Orthopedic Associates our commitment is to get our patients back on their feet, back to work, back in the game, and back to life. We have four convenient locations and offer same day appointments when needed. Visit our website at www.SOA.md or call us at 941-951-2663 for an appointment. Appointments may also be made via our website.

 

BAD TO THE BONE: Treating Knee Pain

knee-pain-faded

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

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

Fast facts on knee injuries:

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

Orthotics-for-knee-pain

Avoiding knee injuries:

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

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

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

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

Time Out with Johnny Gibbs, MD

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

What inspired you to become a physician?

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

Why orthopedics?

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

What do you love most about your job?

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

Gibbs with girl in cast   Gibbs surgery

What is your biggest challenge?

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

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

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

Your proudest moment?

Even easier answer … Becoming a father to my children.

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

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

Any hobbies? Activities?

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

What’s your next adventure?

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

Your guilty pleasure food?

Chocolate chip cookies and preferably Otis Spunkmeyer.

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