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FYI from OCI “Best Orthopedic Care” July/August/September 2016 2013, 2014, 2015, 2016

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FYI from OCI “Best Orthopedic Care” July/August/September 2016 2013, 2014, 2015, 2016 A quarterly publication from the Orthopedic Center of Illinois FYI from OCI “Best Orthopedic Care” July/August/September 2016 2013, 2014, 2015, 2016 Inside this issue: Meet Dr. Mulshine• The Benefits of Massage Continuing Education E xpansion Coming Soon! to The Oasis Short-Term Rehabilitation Center on the campus of lewis memorial christian village Relationships are just one thingto we build well. 3400 W. Washington Street • Springfield, IL 62711 • (217) 787-9600 www.LewisMemorialChristianVillage.org A Passion for Excellence 2 Springfield Office Ronald R. Romanelli, M.D. Dear Friends, Board Certified Orthopedic Surgeon School is out and the summer months are upon Rodney J. Herrin, M.D. us, meaning longer days, filled with more outdoor Board Certified activities for children and adults alike. More time Orthopedic Surgeon outside, often means more injuries. Our Fracture Karolyn M. Senica, M.D. and Injury Center is faster than the hospital Board Certified Orthopedic Surgeon emergency room for sports injuries, dislocations or broken bones. Each of our compassionate super Leo K. Ludwig, M.D. specialists strives to provide a superior level of Board Certified Orthopedic Surgeon quality medical services. Our highly trained and experienced orthopedic surgeons use the latest Timothy A. VanFleet, M.D. Board Certified and most minimally invasive procedures to repair Orthopedic Surgeon fractures and tears. When possible, we treat injuries with pain management and a physical therapy program. If surgery is required, Barry T. Mulshine, M.D. Board Certified we perform arthroscopic procedures as frequently as possible to minimize the Orthopedic Surgeon strain on your body as well as your recovery time. If you find yourself with an Joseph L. Williams, M.D. unfortunate injury this summer, put your trust in our board certified physicians to Board Certified get you back to your summer fun! Orthopedic Surgeon Christopher W. Maender, M.D. At OCI, we know that one way to insure our continued ability to provide the best Board Certified in patient care is to support the next generation of health care providers. Through Orthopedic Surgeon our Orthopedic Center of Illinois Foundation (OCIF) scholarship, we are able to D. Gordon Allan, M.D. encourage students who are passionate about health care and who might need Board Certified a little financial help to join the field and contribute in a meaningful way. This Orthopedic Surgeon year’s $5,000 scholarship recipient is 2016 Williamsville High School graduate, O.B. Idusuyi, M.D. Tucker Hirsch, son of Amelia and Trey Zibutis. Tucker plans to attend Washington Board Certified Orthopedic Surgeon University to study Pre-Medicine in the fall. Congratulations Tuckers, all of us at OCI look forward to your promising future. Ashkon Razavi, M.D. Board Eligable Orthopedic Surgeon This time of year also allows us to expand our focus from “strengthening” our patients to include “strengthening” the community through the non-profit John O. Watson, M.D. Board Certified network in central Illinois. Now in its thirteenth year, our charity golf outing Physiatrist supports an annual $20,000 grant to an area non-profit for programming focused on community health and education. To date, this event has put more than Frank J. Bender, M.D. Board Certified $220,000 back into our community. We are currently in the process of carefully Physiatrist reviewing the wonderful pool of grant applications to determine this year’s grant Matthew G. Michaels, M.D. recipient. Be sure to “like” us on Facebook to see which deserving organization is Board Certified chosen in mid July, and please visit www.ocif.net to find out how you can partner Physiatrist with us to continue to give back. Doug Eastham, P.A.-C Kim Lashway, P.A.-C We know you have a choice in your orthopedic care, Ask for OCI. Thank you, as Marty Wilson, P.A.-C always, for believing in our passion for excellence. Jacksonville Office Barry A. Werries, M.D. Have a safe, fun summer. Board Certified Orthopedic Surgeon St. Francis Hospital, Litchfield Tracy Painter, M.D. Board Certified Orthopedic Surgeon www.OrthoCenterIllinois.com 4 3 A Passion for Excellence Whether you are a serious athlete or a weekend Achilles tendinosis (sometimes referred to as warrior, injuries to the foot and ankle are common tendinitis) commonly occurs as an overuse with participation in many types of sports. Acute injury among athletes. This is typically caused injuries, such as ankle sprains or fractures will by prolonged running or jumping. Inflammation cause problems suddenly, but other overuse along the lining of the tendon will result in visible injuries such as tendinitis and stress fractures, can swelling of the tendon, pain, and sometimes a have a more gradual onset. This article will review scratching feeling with motion. Initially this will some of the more common sports-related foot present as pain after strenuous activities, and may and ankle problems typically seen in our clinic. then progress to pain with everyday activities and even at rest. Achilles Tendinosis The Achilles tendon is the largest, strongest tendon Non-operative treatment is successful in 70-75% in the body. It connects two large muscles in the of patients and is directed at relieving symptoms. calf, the gastrocnemius and the soleus, to the back It is important to correct any training errors and of the heel, so that when these muscles contract alignment problems. Physical therapy to improve the ankle plantar flexes, or pushes downward. flexibility and strength may be beneficial. This is necessary to generate the push-off power needed for running and jumping. Because of the In acute tendinopathy controlling inflammation high stresses transmitted through this tendon, is recommended. Modified rest, cross-training, and its rather unprotected location behind the and icing the affected area is important. Anti- ankle, the Achilles tendon is somewhat prone to inflammatory medications may have a role for injury in athletes. acute tendinitis, but are less helpful for chronic www.OrthoCenterIllinois.com Would you like to join our mailing list? Do so by visiting our website and scrolling to the bottom of the page: www.OrthoCenterIllinois.com 4 tendinopathy. There is controversy regarding more active patients. Non-operative treatment the effectiveness and safety of various types of consisting of casting and crutches for 6 weeks injections. Studies investigating injections of had pretty good results, but with a higher rate of cortisone, sclerosing agents, and platelet-rich repeat ruptures compared to surgical repair. Newer plasma (PRP) have not demonstrated convincing non-operative protocols involving early motion benefits. and earlier weight-bearing have – somewhat counterintuitively – yielded better outcomes. For the approximately 25% of patients that continue In fact, some studies have shown very similar to have pain despite conservative treatment surgery outcomes compared with surgical treatment, may be considered. In most cases the tendon without the risk of wound-healing problems. can be debrided through a small incision or even percutaneously. This involves removing adhesions For more athletic patients desiring surgical and scarring around the tendon, jumpstarting treatment, there are newer less invasive techniques the blood supply to the weakened area. This is that reduce the risk of wound problems, and successful 75-100% of the time. If there is an area allow for earlier weight-bearing than traditional of significant damage to the tendon, more invasive open surgical repair. Sutures can be placed into surgery may be needed to reconstruct the damaged the tendon through puncture holes in the skin tissue. and brought together using a special instrument inserted through a small incision over the torn Achilles Tendon Rupture tendon. The sutures can either be tied together to A complete tear of the Achilles tendon can occur if repair the tendon, or can be attached directly to the the calf muscles quickly contract while the ankle is heel bone with bone anchors. being forced into dorsiflexion. This is most common in middle aged men, the so-called “weekend The key to obtaining good outcomes with Achilles warriors.” Sometimes this can occur when trying tendon ruptures is prompt diagnosis, and quickly to jump, or during a slip or stumble. Sometimes an initiating treatment, be it operative or non- audible crack or pop can be heard. The pain is usually operative. more severe in the calf than by the ankle. Patients will often report that they thought someone had Stress Fractures kicked or struck them in the calf. Initially, walking In the same way that tendinitis is often an overuse is difficult and painful, although the pain does injury of a tendon, a stress fracture is an overuse gradually improve with time. injury of a bone. Since the bone is a living tissue, it continuously responds to the stresses that are It is very important that treatment begin applied to it during activities. In response to immediately after an Achilles rupture, so early repeated stress, such as from exercise, the bone evaluation by an orthopedic surgeon is critical. will gradually get stronger. Unfortunately, bone Patients that wait 4-6 weeks to seek treatment cannot strengthen itself very quickly – this is a because they self-diagnosed an ankle sprain will gradual process. If someone begins a new exercise have poorer outcomes. Acutely, the diagnosis can program or rather suddenly increases the length or usually be made without an MRI except in some duration of workouts, this repetitive trauma could equivocal cases. cause a localized weakening of a particular bone. Common locations for stress fractures are the 2nd The proper treatment for acute tendon ruptures metatarsal, 5th metatarsal, tibia, and the navicular. is somewhat controversial. Traditionally, non- operative treatment was recommended for ruptures The first sign of a stress fracture is pain and swelling in older and less active patients, and open surgical during or after exercise.
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