LOC Healthy Living Magazine

Volume 2 Issue 1 Healthy Living

Li ncoln Orthopaedic Center, P.C. Dedicated Surgical Expertise Midwest Physical Therapy & Sports Center

Specialists in sports injury rehabilitationBritnee Vavra, PTA Renee Tewes, PT, Owner Roxie Tesmer, PT Nicole Vyhnalek, PTA Dawn Bonness, MPT, CMLDT Jill Korta, MPT, ATC Kristi Roddel, PTA Karen Stille, PT, MA, CSCS Eric Schussler, MPT, ATC Adam Mailander, OT, CHT Darci Fanning, MPT, CSCS Shawntae Horst, DPT Kim Knopik, PT, MPA Moving You to Wellness

Pool Therapy available at Prairie Life and The Landing

4 Convenient Locations 6900 A Street, Ste 102 Expanded Hours 2801 Pine Lake Road Including same-day appts 5790 N. 33rd St. Circle Mon-Fri 7am-6pm Ashland - 15th & Silver 402-436-2535 Sat 7am-Noon (A St. Only) www.MidwestPhysicalTherapy.com Welcome Message from Lincoln Orthopaedic Center

We are pleased to bring you the second issue of Lincoln Orthopaedic Center - Healthy Living Magazine. It is our continued mission to help you, our patients and partners through education and expert Inside This Issue care, when needed. Inside this issue you will nd interesting and valuable articles about orthopaedic 4. Patient Story: procedures, MRI services and sports medicine. We Cindy Bassinger aim to motivate you with our patient story about joint Weight Loss and Joint replacement and weight loss. There are also safety tips Replacement Dr. Matt Reckmeyer, MD LOC President for you to peruse before your annual pumpkin carving. 5. Lincoln Orthopaedic Center, PC Receives MRI LOC continues to experience positive changes through the ever changing and Accreditation sometimes turbulent economy and medical industry. We were pleased to have Dr. Douglas Koch start a new outreach clinic at Saunders Medical Center in Wahoo. LOC 6. Hand Surgeons Warn of sports medicine continues to be well received in and around Lincoln. The most recent Pumpkin Carving Dangers sports programs we provide athletic trainers for include, Capital City Crush football team, David City Aquinas, Parkview Christian and York Public Schools. We are happy 8. I’ve Been Diagnosed with a to work with the Lincoln Saltdogs, Lincoln Stars, Concordia University, Doane College, Herniated Disc — What Do I Do Now? Wesleyan University and Lincoln Lutheran, Lincoln Christian, Seward Public Schools. In addition, we provide athletic trainers for Eastern Nebraska O cials Association, 10. Our Physicians Lincoln Rugby Club, High School Rugby Club, Junior Stars, Lincoln Ice Hockey Association, Lincoln Midget Football League and Lincoln Youth Softball Association. Our Locations 12. With the growth of our practice we have added new members to the LOC family 13. Dr. Doug Tewes of LOC including 1 nurse practitioner and 3 more athletic trainers. That puts us at 9 surgeons, Earns Sports Medicine 4 physician assistants, 1 nurse practitioner, 7 athletic trainers and 73 additional Board Certi cation support sta . We are very fortunate to have an exceptional group of people working at LOC. 14. Lincoln Orthopaedic Center Sports Medicine Program Last, but certainly not least, LOC wants to extend a big thank you to our advertisers. We could not achieve this publication without your continued support. Thank you! 16. Orthopedics 101 Stay Active,

Lincoln Orthopaedic Center’s Healthy Living Magazine is designed and published by Medical Custom Medical Design Group. To advertise Matt Reckmeyer, MD in an upcoming issue please contact us at: 800.246.1637 or www.CustomMedicalMagazine.com. This publication LOC President may not be reproduced in part or whole without the express written consent of Custom Medical Design Group. Custom Medical Design Group does not endorse the contents of this journal.

www.ortholinc.com 3 Patient Story: Cindy Bassinger Weight Loss and Joint Replacement

indy Bassinger is a knee “I did not want to go the surgical route replacement patient from for weight loss. If it was meant to CUnadilla, Nebraska. But, she is come off it will, the natural way.” And, not only that, Cindy is a survivor. She that is exactly what happened. Cindy has taken back her life and shed 48 began walking around Unadilla. She pounds after her joint replacement was able to shed ten pounds prior to surgery. her knee replacement surgery. After her surgery in June 2011, she was Cindy spent many years taking care determined to lose more weight. She of her diabetic husband, all the while, was walking with only a cane at her two in pain. “I was 296 pounds at my week follow up, “Dr. Bigelow was very heaviest. It was hard to even get out pleased with the results from surgery of a chair”. Her husband passed from and that I was down 22 pounds.” At a massive heart attack in May 2008. her five week follow up appointment, Soon after, Cindy decided it was time Cindy was walking with no cane, while to make a major lifestyle change. “I many patients require one. know my family and most of all my grandchildren need me.” She had To date, Cindy has lost a total of 48 severe knee pain and was not happy pounds by continued walking and with the life she was living. watching what she eats. Cindy said, “I have a whole new outlook on life. The past ten years she sought outside I can go to car shows with my friends solutions for her aching joints. She and walk around all day with no pain. I started with a series of cortisone shots am more active with my grandchildren and sinvisc treatments. Eventually, and I am able to travel to Texas now to the less invasive treatments stopped see my daughter and her family.” working. Cindy made an appointment with Dr. Bigelow at Johnson County At the end of our conversation, Cindy Hospital in Tecumseh. At that time, floated out of the coffee shop as she Dr. Bigelow suggested she lose weight said, “I was able to prove to myself which will help her aching joints. That I could lose the weight and I am not was not a message that was easy to going to stop at 48 pounds. I feel great hear, but Dr. Bigelows advice coupled about myself.” Way to go Cindy!! ■ with the loss of her husband, prompted Cindy to begin her weight loss journey. For your appointment, please call 402-436-2000.

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Lincoln Orthopaedic Center, PC Receives Cathy Dorenbach MRI Accreditation Employee Beneﬁ t Specialist

agnetic resonance is an extremely useful diagnostic imaging tool, performed an estimated 28 million times annually in the United States. MRI enables interpreting physicians to visualize the structure and Midlands Financial Beneﬁ ts, Inc. M 7101 S 82nd Lincoln NE 68516 function of the body. Magnetic resonance is a complex imaging technique that (402) 434-8050 Fax (402) 434-8051 relies on the experience and training of both the physician and the technologist. www.midﬁ n.com

Lincoln Orthopaedic Center, PC (LOC) has been granted accreditation in the areas of musculoskeletal MRI from the Intersocietal Commission for the Accreditation of Magnetic Resonance Laboratories (ICAMRL).

LOC is one of the first 500 MRI Labs in the US, Canada and Puerto Rico to be so recognized for its commitment to high quality patient care and its provision We are proud to support of quality diagnostic testing. Participation in the accreditation process is Lincoln Orthopaedic Center voluntary. Those applying for accreditation are required to document detailed and wishWe are them proud continued to support success. information about all operational and technical components and submit Lincoln (800)Orthopaedic 421-1834 • www.callcopic.com Center protocols and case studies for review by a panel of experts. In this case, Dr. and wish them continued success. Regina Robinson-Noble, Dr. Douglas Tewes and Amanda Filipi R.T. comprise the Quality Assurance Committee for Lincoln Orthopaedic Center. ■

For more information about LOC and our MRI capabilities please call 402-436-2000 or go to www.ortholinc.com

(800) 421-1834 · www.callcopic.com

www.ortholinc.com 5 Hand Surgeons Warn of Pumpkin Carving Dangers Use caution during the Halloween season, and take steps to prevent hand injuries when carving.

very Halloween season we see four says Wint. “Even though the carving may be Use a Pumpkin Carving Kit or ve patients—both adults and going great, it only takes a second for an “Echildren—who come into our o ce injury to occur.” Special pumpkin carving kits are available in with severe injuries to their hands and ngers,” stores and include small serrated pumpkin says Je rey Wint, MD, an ASSH member from Leave the Carving to Adults saws that work better because they are less The Hand Center of Western Massachusetts, likely to get stuck in the thick pumpkin tissue. Spring eld, MA. “Treatment can often run Never let children do the carving. Wint “If they do get jammed and then wedged three to four months from the time of surgery suggests letting kids draw a pattern on the free, they are not sharp enough to cause a through rehabilitation.” pumpkin and have them be responsible deep, penetrating cut,” says Wint. for cleaning out the inside pulp and seeds. To prevent hand injuries, the ASSH suggests When the adults do start cutting, they should Help for a Pumpkin Carving Injury the following safety tips: always cut away from themselves and cut in small, controlled strokes. Should you cut your nger or hand, bleeding Carve at a Clean, Dry, Well-lit Area from minor cuts will often stop on their own Sharper is not Better by applying direct pressure to the wound Wash and thoroughly dry all of the tools that with a clean cloth. If continuous pressure you will use to carve the pumpkin: carving “A sharper knife is not necessarily better does not slow or stop the bleeding after 15 tools, knife, cutting surface, and your hands. because it often becomes wedged in the minutes, an emergency room visit may be Any moisture on your tools, hands, or table thicker part of the pumpkin, requiring force required. ■ can cause slipping that can lead to injuries. to remove it,” says Wint. “An injury can occur if your hand is in the wrong place when the Call for your appointment 402-436-2000. Always Have Adult Supervision knife nally dislodges from the thick skin of the pumpkin. Injuries are also sustained Copyright © American Society for Surgery of the “All too often we see adolescent patients when the knife slips and comes out the other Hand 2009. with injuries because adults feel the kids are side of the pumpkin where your hand may be responsible enough to be left on their own,” holding it steady.”

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7 I’ve Been Diagnosed with a Herniated Disc — What Do I Do Now?

common cause of low back and leg pain is a ruptured or 1. Disc Degeneration: chemical changes associated with aging herniated disc. Symptoms may include dull or sharp pain, causes discs to weaken, but without a herniation. muscle spasm or cramping, sciatica, and leg weakness or loss A 2. Prolapse: the form or position of the disc changes with some of leg function. Sneezing, coughing, or bending usually intensi es the pain. Rarely bowel or bladder control is lost, and if this occurs, slight impingement into the spinal canal. Also called a bulge or seek medical attention at once. Sciatica is a symptom frequently protrusion. associated with a lumbar herniated disc. Pressure on one or several 3. Extrusion: the gel-like nucleus pulposus breaks through the tire- nerves that contribute to the sciatic nerve can cause pain, burning, like wall (annulus brosus) but remains within the disc. tingling, and numbness that extends from the buttock into the leg and sometimes into the foot. Usually one side (left or right) is a ected. 4. Sequestration or Sequestered Disc: the nucleus pulposus breaks through the annulus brosus and lies outside the disc in Anatomy - Normal Lumbar Disc the spinal canal (HNP). In between each of the ve lumbar vertebrae (bones) is a disc, a tough brous shock-absorbing pad. Each disc contains a tire-like outer band (called the annulus brosus) that encases a gel-like substance (called the nucleus pulposus). Nerve roots exit the spinal canal through small passageways between the vertebrae and discs. Pain and other symptoms can develop when the damaged disc pushes into the spinal canal or nerve roots. Disc herniation occurs when the annulus brous breaks open or cracks, allowing the nucleus pulposus to escape. This is called a Herniated Nucleus Pulposus (HNP) or herniated disc.

Many factors increase the risk for disc herniation: (l) Lifestyle choices such as tobacco use, lack of regular exercise, and inadequate nutrition substantially contribute to poor disc health. (2) As the body ages, natural biochemical changes cause discs to gradually dry out a ecting disc strength and resiliency. (3) Poor posture combined with the habitual use of incorrect body mechanics stresses the lumbar spine and a ects its normal ability to carry the bulk of the body's weight. Combine these factors with the a ects from daily wear and tear, injury, incorrect lifting, or twisting and it is easy to understand why a disc may herniate. For example, lifting something incorrectly can cause disc pressure to rise to several hundred pounds per square inch! A herniation may develop suddenly or gradually over weeks or months. The four stages to a herniated disc include: Ligaments of the Spinal Column (left lateral view) 8 Locating the Cause of Pain discuss this option and ask about potential side e ects before beginning this treatment. Interestingly, not every herniated disc causes symptoms. Some people discover they have a bulging or herniated disc after an x-ray Additionally, we may recommend physical therapy. His orders for an unrelated reason. Most of the time the symptoms prompt are transmitted to the physical therapist by prescription. Physical the patient to seek medical care. The visit with Dr. Castro usually therapy includes a combination of non-surgical treatments to includes a physical and neurological exam; review of medical history, decrease pain and increase exibility. Ice and heat therapy, gentle symptom evaluation and the history of treatments and medication massage, stretching, and pelvic traction are some examples. the patient has tried. An x-ray may be needed to rule out other causes In four to six weeks, the majority of patients nd their symptoms of back pain such as osteoarthritis or spondylolisthesis. A MRI scan are relieved without surgery! Be optimistic about your treatment' or CT veri es the extent and location of disc damage. Sometimes a plan and remember that less than 5% of all back problems require myelogram is necessary. surgery! Non-Surgical Treatment Surgical Treatment Most patients with a lumbar herniated disc do not need surgery! Initially, we may recommend some bed rest, cold therapy, and Spine surgery is considered if non-surgical treatment does not relieve medications. Bed rest takes the pressure o nerves in the low back. symptoms. Constant pain, leg weakness, or loss of function requires During the rst 24 to 48 hours cold therapy helps to reduce swelling, further evaluation. Rarely, does a lumbar herniated disc cause bowel/ muscle spasm, and pain by reducing blood ow. Never apply cold bladder incontinence or groin/genital numbness, which requires or ice directly to skin; instead wrap the ice pack or cold product in a immediate medical attention. If surgery is recommended, always ask towel and apply for no longer than 15 minutes. the purpose of the operation and what results you can expect. To relieve nerve pressure and leg pain, surgery usually involves a partial Medications may include an anti-in ammatory to reduce swelling, a disc removal or discectomy. In addition, we may need to access the muscle relaxant to calm spasm, and a pain-killer (narcotic) to alleviate herniated disc by removing a small portion of the bone covering intense but short-lived pain (acute pain). Mild to moderate pain may the nerve. This procedure is called a laminotomy. Fortunately, these be treated with non-steroidal anti-in ammatory drugs (NSAIDs). procedures can often be done utilizing minimally invasive techniques. These work by relieving both swelling and pain. Discuss NSAID use Minimally invasive surgery does not require large incisions, but with your physician rst. instead uses small cuts and tiny specialized instruments and devices such as a microscope and endoscope during the operation. Usually, after the rst 48 hours, heat therapy can be applied. Heat increases blood ow to warm and relax soft tissues. Increased blood Prevention ow helps to ush away irritating toxins that may accumulate in tissues as a result of muscle spasm and disc injury. Never apply heat Aging is inevitable, but lifestyle changes can help prevent lumbar directly to skin; instead, wrap the heat source in a thick towel for no disc disease. Risk factors include poor posture and body mechanics, longer than 20 minutes. weak abdominal muscles, smoking, and obesity. Start now to adopt habits that will help preserve your spine for the future. ■ If leg pain is severe, or leg weakness is developing, we may prescribe an epidural injection. An epidural is an injection of anti-in ammatory Call LOC for your appointment 402-436-2000. medication into the space near the a ected nerves. You should Thank You to Our Sponsors

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9 Meet Our Physicians

Matthew C. Reckmeyer, M.D. Douglas P. Tewes, M.D. Robert A. Vande Guchte, M.D. Joint Replacement Sports Medicine Spinal Disorders and Reconstruction Arthroscopic Surgery Arthroscopic Surgery Trauma Surgery Sports Medicine Knee and Shoulder Disc Arthroplasty Hip Resurfacing Reconstruction

Nicholas K. Gove, M.D. Bruce Miller, M.D. John C. Yeakley, M.D. Hand and Microsurgery Orthopaedic Surgeon General Orthopaedics Wrist and Elbow Joint Replacement Reconstruction Arthroscopic Surgery Meet Our Physicians

Keith W. Lawson, M.D. Douglas A. Koch, M.D. Scott D. Bigelow, M.D. Joint Replacement Joint Replacement Joint Replacement Arthroscopic Surgery Arthroscopic Surgery Arthroscopic Surgery General Orthopaedics Sports Medicine Sports Medicine Sports Medicine Anterior Approach Anterior Approach to Hip Replacement to Hip Replacement

Dedicated Surgical Expertise Outreach Clinic Locations Dr. Doug Tewes of LOC Earns Sports Wahoo Medicine Board Certiﬁ cation

Auburn Outreach Clinic Nemaha County Hospital 2022 13th Street Auburn, NE 68305 Phone: (402) 274-4366

Beatrice Outreach Clinic 103 S. 9th Street Beatrice, NE 68310 Nebraska City Wahoo Outreach Clinic Phone: (402) 228-5969 Outreach Clinic Saunders Medical Center 1760 Country Road J David City Outreach Clinic St. Mary’s Hospital 1314 3rd Avenue Wahoo, NE 68066 Butler County Health Care Center Nebraska City, NE 68410 Phone: (402) 443-4191 Outpatient Department Phone: (402) 873-3321 372 South 9th Street David City, NE 68632 York General Specialty Clinic Phone: (402) 367-1265 Seward Outreach Clinic York County Hospital Memorial Hospital 2222 N. Lincoln Avenue Henderson Health Care Services 300 N. Columbia Avenue York, NE 68467 Phone: (402) 362-0420 1621 Front Street Seward, NE 68434 Henderson, NE 68371 Phone: (402) 643-2971 Phone: (402) 723-4512 For more information email: Tecumseh Outreach Clinic [email protected] Marysville Outreach Clinic Johnson County Hospital Community Memorial Healthcare Specialty Clinic 708 N. 18th Street 202 High Street Marysville, KS 66508 Tecumseh, NE 68450 Phone: (785) 562-2314 Phone: (402) 335-6372

LOC Outreach Locations

6900 A Street • Lincoln, Nebraska 68510 • Phone: (402) 436-2000 • Fax: (402) 436-2085 Dr. Doug Tewes of LOC Earns Sports Medicine Board Certiﬁ cation

incoln Orthopaedic Center congratulates Dr. Doug Tewes Lfor being awarded his Sports Medicine Board Certi cation in February. Dr. Tewes is the only orthopaedic surgeon in the Lincoln area with this Sports Medicine Board Certi cation.

In addition to passing the exam prescribed by the American Board of Orthopaedic Surgery. Dr. Tewes was required to submit a list of sports medicine operations performed in a 12 month period. This list included more than 115 cases with at least 75 including arthroscopy. Ten additional cases involved patients with non-operative treatments which required Dr. Tewes to manage their Orthopaedic Surgery at the University of Kentucky. During sports injury or condition for at least four weeks. this time he was awarded the American Orthopaedic Association National Travel Award Fellowship for his research Doug Wyatt, LOC Surgery Center Director stated, “Dr. on knee ligaments. Tewes’ commitment to clinical excellence is further demonstrated by his attainment of the Sports Medicine Lincoln Orthopaedic Center provides sports medicine for Board Certi cation. With Dr. Tewes’ leadership, the Lincoln athletes at all levels; Lincoln Midget Football League, Lincoln Orthopaedic Center Sports Medicine Outreach Program Junior and High School Hockey Leagues, Lincoln Lutheran, continues to distinguish itself as the leader in providing Lincoln Christian, Seward Public Schools, Capital City Crush superior medical coverage for area athletes.” Football Team, Wesleyan, Concordia, Doane, Lincoln Stars and Lincoln Saltdogs. His dedication to sports medicine began while at the University of Kentucky where he became actively involved For more information about Lincoln Orthopaedic Center with their basketball program. His sports medicine expertise or how to become a part of our Sports Medicine is further highlighted by his award-winning research and Program please call 402-436-2900 or go to his work with the Minnesota Vikings, Minnesota Timber www.ortholinc.com. ■ Wolves, and the University of Minnesota football team.

Dr. Tewes has been a physician with Lincoln Orthopaedic Center, P.C. since 1993. A native of Seward, Nebraska, he graduated from the University of Nebraska Medical Center in Omaha. He completed his residency in

6900 A Street • Lincoln, Nebraska 68510 • Phone: (402) 436-2000 • Fax: (402) 436-2085 13 Lincoln Orthopaedic Center Sports Medicine Program By Sandi Witkowicz © Copyright 2011 Women’s Edition, Inc. Reprinted with the express written permission of Women’s Edition Inc.

f your student athlete has ever taken The new Sports Medicine Outreach becomes familiar with the athlete’s a nasty fall or su ered a bump on Program was established by BryanLGH ability to deal with pain and treatment Ithe head, you know how important Medical Center with the support of LOC processes so they can get back to it is to have quali ed injury evaluation in an e ort to reach out to area high playing their sport. Since the trainer available. Lincoln Orthopaedic Center school sports programs to provide a serves as a liaison among parents, (LOC) has long-recognized this need, full-time certi ed athletic trainer to be athletes, coaches, and physicians, the and has been involved in sports at the high school every school day and lines of communication remain open. medicine for many years in Lincoln and to cover home varsity events, Corey says. Everyone wants the athlete to have a the surrounding areas. Lincoln Christian, Lincoln Lutheran, and speedy return to play, yet to be safe Seward High Schools are part of the while doing so, Corey points out. LOC is comprised of a team of physicians program. who specialize in varied types of Depending on the size of the school, orthopaedic care, including general The Sports Medicine Outreach the program provides one trainer per orthopaedics, joint replacement, and Program also extends to local sports school, or in some instances, one trainer arthroscopic and spinal surgeries. Five organizations, including Lincoln Midget for two schools. of the nine LOC physicians specialize in Football and Lancaster Youth Softball. sports medicine. These include Douglas The program has been shown to Scott Ernstmeyer, executive director of P. Tewes, MD, whose foremost specialty reduce the number of ambulance calls, Lincoln Lutheran, says, “A school our size is sports medicine. A complete list of according to Corey. During previous would nd it di cult to fund and nance LOC physicians and their specialties is years, there were four to ve ambulance an athletic training department. We available at www.ortholinc.com. calls per Sunday during a typical league certainly have kids that get injured and play period of eleven Sundays. Last year kids that need support and attention. Dr. Tewes serves as medical director with the trainers in attendance, the This program is really invaluable in that of BryanLGH Medical Center’s Sports number of ambulance calls was reduced it provides medical expertise once an Medicine Outreach Program. LOC’s to four or ve for all eleven Sundays, he injury need is recognized. The whole Corey Courtney, ACT, LAT, provides and adds. referral process gets athletes connected oversees the athletic trainer service with the treatment resources they need.” for the program, and is also the head The trainer’s job is to be on the scene athletic trainer for the Lincoln Stars to provide basic rst aid, CPR, and life Scott continues, “We’ve had an ongoing hockey team. support if needed, explains Corey. The partnership with LOC for many years. We trainer completes injury evaluations value the longevity of that relationship, Corey, who works with Dr. Tewes as well and provides education about injuries and we value the breadth of services as all of the physicians at LOC, proudly for athletes, parents, and coaches. that are now also available through the states that while the Sports Medicine “Being at the school every day helps the partnership with BryanLGH.” Outreach Program is a newer, need- trainer get to know individual athletes based program, LOC has long-provided The Sports Medicine Outreach Program on a personal level. The goal is for the provides a great opportunity for the team physicians to many area programs. trainer to become part of that school’s It has covered the Lincoln Stars hockey community to have a combination of community, which encompasses the expertise from LOC and the resources team and the Lincoln Saltdogs baseball sta , parents, and athletes,” he adds. team, for example, since their inaugural and support of the hospital, adds Dr. seasons in 1996 and 2001, respectively. The trainer can learn rsthand about the Tewes. “Neither one of us could do it athlete and his or her injury. The trainer without the other’s participation.”

14 One of the most important aspects of trainer involvement at high schools and community sports events is the recognition, education, and exercise of concussion protocols, Corey says. The Sports Medicine Outreach Program features the use and expertise of Im-Pact concussion software.

At the beginning of the school year or a sports season, athletes take a baseline test. If sometime within the season an athlete is suspected of having had a concussion, the trainers utilize ImPact to follow up individually and work through the symptoms to assist the athlete so they can return to playing their sport. LOC has been using ImPact software for nearly 10 years. Dr. Tewes is licensed and accredited through ImPact to read the tests.

LB260 is a new state law designed to protect athletes from concussions. It will take e ect July 1, 2012. With ImPact, LOC has been implementing and practicing the protocols that will become mandated by the new law for many years, Corey says.

“Assessing a concussion is important because if the brain cells are not functioning normally, the cells are at risk of dying. If those cells die, the athlete will lose functional brain tissue,” explains Dr. Tewes. “Most kids don’t really know what symptoms of a concussion to report. When they do report symptoms, the majority of parents and coaches don’t know Kiss Your what symptoms to take seriously. ImPact makes a huge di erence in our ability to assess brain activity.” Bunion Pain

JoAnne Bartek has years of experience of working through Goodbye. sports injuries treated by Dr. Tewes. “Unfortunately, we’ve had more than our share of injuries, and we’ve never considered Since it is vital to your mobility, any issue with your big toe can make jogging, walking, or simply standing a calling anyone else. He was always very sensitive to the fact painful chore. One of the most common problems of that our daughters were Division I volleyball players. He was the big toe is a bunion, which is deﬁned as an excess so concerned that their college sports were never on the line.” or misalignment of the bone at the big toe joint. Bunions are often quite painful, limiting your activity. If LOC will again this year o er the Saturday Morning Sports nonsurgical treatment has not relieved your pain, or if Clinic from 8 a.m. to 10:30 a.m. from Saturday, August 27th you have a severe bunion, you may want to consider through Saturday, October 29th The clinic is open to any surgery. Your doctor may choose from several Wright athlete who may need an injury evaluation or treatment products to correct your bunions. after a weekend varsity event. No appointment or referral is necessary. Bunion surgery can both reduce pain and improve the appearance of your feet. To learn more about For more information about the BryanLGH Medical Wright’s bunion solutions, call 1-800-238-7117. Center’s Sports Medicine Outreach Program or LOC’s Saturday Morning Sports Clinic, contact Corey Courtney at 402-499-4834. The LOC o ce and surgery center are located at 6900 A Street. For more information about LOC, a list of all LOC surgeons, and their specialties, call 402-436-2000 or visit www.ortholinc.com. ■

t’s a beautiful summer day, and you are watching your young or the occasional lapse in grip strength that you feel. If you are older athletic daughter play in a softball game. The game is an exciting than 20, your hips have changed and may give you occasional pain. Ione with a tied score. There is a big hit to deep left center. Your Is your lower back twitchy and achy? daughter runs it down, dives, and tries to catch it with both hands. Crack. You are afraid to look. As she is screaming in pain, you are If you are noticing hip or knee pain, di culty reaching for items, or thinking “Oh no, it’s her collar bone!” The chatting fans fall silent, other age-related pains, you may be searching for a doctor. and everyone is watching as she struggles to sit up. You and your Do you know where to turn for accurate medical information to daughter are going to need a good orthopedic doctor. achieve a more functional lifestyle? Your best choice may be a Perhaps you are past the time when your kids were susceptible to doctor who specializes in orthopedics. sports injuries, and that scenario is from times gone by. Maybe now What exactly is an orthopedic doctor? An orthopedist is a doctor the focus of your pain is the knee that clicks as you climb the stairs who focuses on injuries or deformities of the musculoskeletal

16 system such as the shoulders, knees, hips, or wrists. You may have Patients who are su ering from painful conditions are looking experienced an injury from a friendly game of tennis or football, for relief from the pain. Orthopedic doctors will prescribe or maybe you are just collecting new and varied pains as you are medications to address the underlying problem related to your aging. injury. Your doctor’s goal is to correct the problem that is causing pain and restore your quality of life. Orthopedists treat all age groups. There are specialists within the eld who focus on patients with arthritis, degenerative conditions, There are many medications that can control your pain, with osteoporosis, tumors, knee or hip replacements, juvenile arthritis, some being more comprehensive and expensive than others. Be and sports injuries and infections. An orthopedic doctor has years familiar with the risks and side e ects of whatever medications of specialized education after medical school, and usually has a you are using. specialty within that big umbrella of “musculoskeletal.” You may need an orthopedist for your arthritic knee or hip, spinal pain, or Acetaminophen (Tylenol is one brand) controls pain, but has no shoulder or elbow pain. If it is important to you to keep active and anti-in ammatory e ects. Many times there is no in ammation healthy as you age, a consultation with an orthopedic doctor can with these types of injuries, so Tylenol should reduce your pain help you reach those goals. quickly. Like any drug, however, too much is not better. There are serious side e ects associated with using too much Tylenol. Although most visits to the orthopedic doctor are because of Carefully read the directions on the box, and do not mix Tylenol broken bones, an orthopedic doctor can give you some guidance with other prescription drugs like Percocet or Darvocet. on treating your aches and pains. Do you have pain in your wrists or ngers? If you are a tennis player or a golfer, you may experience Nonsteroidal anti-in ammatory drugs such as Advil, Motrin, pain in your wrists, elbows, hips, or knees. Our constant use of and Aleve are helpful for acute pain or occasional are-ups. keyboards, remotes, phones, and other technology has created These medications help control pain from tendonitis, tennis all types of physical maladies, from trigger nger to carpal tunnel elbow, arthritis, and bursitis, for example. The excess use of anti- and tendonitis. Our bodies are on the move continually, and in ammatories can cause stomach problems. Be sure to discuss sometimes a slight jolt or turn, slip or fall, or sports injury sends us the use of these painkillers with your orthopedic doctor. to a doctor who can diagnose and treat our speci c injury. Your physician may write you a prescription for Celebrex, which Like our young softball player, chances are good that you or controls chronic pain in patients su ering from osteoarthritis. someone you know is among the seven million Americans who There are also other prescription drugs that help control pain and visit a doctor every year for bone breaks or joint pain. Medical in ammation from painful arthritis. Be aware that these drugs experts predict that most of us will experience two fractures over can be addictive when used for longer than the recommended the course of our lifetime. time period or more often than prescribed. Your doctor may recommend other pain management techniques such as massage, An orthopedic doctor will guide a patient to the right choices meditation, yoga, myofascial release, or physical therapy to tone about treatment, surgery, physical therapy, and any follow-up and tighten the a ected area. care that may prevent further injuries. Your primary care physician can recommend local orthopedic specialists in your area, and Another option for controlling chronic pain or are-ups may be you can use the Internet to research the doctor or o ce where oral corticosteroids such as Medrol or Prednisone, or cortisone you will be seen. Ask co-workers or family members if they have shots. Your orthopedic doctor may o er cortisone injections as suggestions of doctors that they have found to be helpful. one option for pain management. Your doctor will advise you on how often these injections can be given. The injections help If you are facing a particularly tricky surgery, don’t be afraid to ask manage the pain and in ammation, which cause the pain. the doctor how familiar he/she is with the procedure. Have a list of questions about your injury or pain, and ask speci cally about Cortisone shots are injected into the soft tissue joints. potential treatments, suggested surgeries, the cost and recovery Usually these shots control the pain for four to six time, and what outcomes you can expect after treatment. months, and are given up to three times per year. If your pain is severe and is Before performing surgery, your orthopedist may want to explore compromising your ability other treatments such as physical therapy, re-educating or toning to function, your your a ected muscles, and pain medications such as an anti- in ammatory or steroid to control the in amed area.

17 What are the most common reasons that patients seek out an orthopedic surgeon? Broken bones and sports injuries are the rst reasons. Shoulder injuries, broken wrists or arms, and torn ACLs—these are all commonly seen in an orthopedist’s o ce.

There is a list of orthopedic problems, including nagging aches and pains, that can interrupt your daily quality of life. If you are of “Boomer” age, chances are good that you are living with one or all of these: “frozen” shoulder; a torn or injured rotator cu ; arthritis in the knees, wrists, and neck; and/or painful hips or heel spurs that don’t allow you to move the way you used to or impair walking altogether. Boomers, as a whole, don’t want to live with pain that limits their active lifestyle, whether they participate in sports or just enjoy their interactions with their grandkids. doctor may put you on narcotics for a short period of time. Post-surgery care is another step in helping you return to full Because pain is really a message that something is wrong, it is function. After your surgical procedure, you will be meeting one- always wise to have it evaluated. The small, nagging voice alerting on-one with a physical therapist. A physical therapist can treat you to a little pain may all of a sudden turn into a frenetic scream— not only the a ected area, but your body as a whole. Remember usually just as you are planning to do something very important the song “…the ankle bone is connected to the shin bone…”? (go on a trip, go to a wedding, start a new job, etc.). The ability to return to a pain-free lifestyle with restored function depends largely on the hard work you do after surgery. What are If the pain cannot be controlled and your condition is not you going to do to strengthen and tone the area, and to make sure improving with exercises, physical therapy, or other techniques, that all of your parts feel better once you are put back together surgery may be your next best option. Your family doctor can again? recommend several orthopedic surgeons in your area. Orthopedic surgeons specialize in the treatment and healing of certain areas Surgeries that require some rehabilitation are spinal fusion, of the body such as the knees, wrists, hands, hips, and spine. What carpal tunnel or trigger nger, total hip or knee replacement, are some of the most common orthopedic problems that require ankle reconstruction, rotator cu repairs, ACL surgery, and surgery? meniscectomies. The length of rehabilitation, usually six to 12 weeks, will be determined by your physical therapist. The therapist Children su er broken bones and injuries, but usually heal quickly evaluates you and designs a program that helps you strengthen since their bones are more exible. What about adults? If you have the healing area. He or she will work with your orthopedic surgeon a conversation with anyone over age 40, you may be sharing stories regarding pain management. During this time, you will be about the new pains that seem to crop up overnight—signaling expected to do some homework and practice at-home exercises that our bodies are aging a bit. But these are also warnings that and stretches that will prevent further injury or surgery. we may need to change techniques, improve our posture, breathe a little deeper, and rest a little more. It is true that at age 45 or 55, Don’t let a painful condition interfere with your daily life. you are not going to move as easily or as quickly as you did when A consultation with an orthopedic doctor can restore your you were 20. excitement for life, increase your comfort, and put you on the road to more mobility. ■ You may have decided that it is time to replace some of your old and worn out joints, especially if you are over age 50. Knee Call for your appointment 402-436-2000 replacements have tripled in the 45- to 65-year-old age group, Sources for this story included: www.webmd.com, numbering about 630,000 per year. Hip replacements hover at www.orthopedics.about.com, and about 300,000 per year. www.orthopedicinstituteSF.com.

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