Our dedicated surgery team at the groundbreaking of the new surgery center Determination magazine volume 9 2018/2019 “Quality Care from People Who Care” Free Copy www.missoulaboneandjoint.com Please Take Phone (406)721-4436 Satellite Clinics Quality Patient Care Closer to Home POLSON Polson Foot & Ankle Specialty Clinic Plains Dr. Glenn Jarrett 2nd & 4th Friday of the month PLAINS Missoula Orthopedic Clinic Dr. Jeff LaPorte Stevensville Every Tuesday Hamilton STEVENSVILLE Foot & Ankle Specialty Clinic MISSOULA Dr. Brent Roster 2360 Mullan Road, Suite C 1st Friday of the month Missoula, Montana 59808 (406) 721-4436 x 2 1-866-721-4436 Toll Free HAMILTON (406) 721-6053 Fax Hand & Wrist Specialty Clinic To schedule an appointment Dr. Charlie Sullivan call our Missoula clinic at (406) 721-4436 x2 3rd Thursday of the month or visit www.missoulaboneandjoint.com and • Spine & General Orthopedics Clinic Dr. Michael Woods 1st Friday of the month | www.missoulaboneandjoint.com | ONE LOCATION – MANY SERVICES ORTHOPEDIC CLINIC ORTHOPEDIC URGENT CARE PHYSICAL THERAPY SURGERY CENTER (ASC) Monday-Thursday 8:30am-5:30pm Walk-in CLINIC Monday-Thursday 7:00am-7:00pm Monday-Friday 6:00am-5:00pm Friday 8:30am-5:00pm Monday-Thursday 8:30am-7:00pm Friday 7:00am-6:00pm 2360 Mullan Road, Suite B 2360 Mullan Road, Suite C Friday 8:30am-5:00pm 2360 Mullan Road, Suite D (406) 542-9695 Missoula, Montana 59808 Saturday 9:00am-2:00pm (406) 542-4702 (406) 542-9703 Fax (406) 721-4436 2360 Mullan Road, Suite C (406) 541-8240 Fax 1-866-721-4436 Toll Free (406) 721-4436 (406) 721-6053 Fax Urgent Care Direct (406) 829-5581 In This Issue... Dear Friends, 2 MBJ Satellite Clinics Quality care from people who care is the core of Missoula Bone & Joint. 4 Running Gait Analysis We truly care about our patients and the community we all live in. We 6 Effectively Treating strive to accommodate your orthopedic needs in a timely manner. Our Urgent Care walk-in clinic has been successful in helping people with Patellofemoral Joint Pain acute orthopedic injuries for initial evaluation and to start an appropri- 7 What is ACI? ate treatment plan. 8 Sacroiliac (SI) Joint Pain Our surgeons replaced their surgical tools with shovels for a ground Get to Know Your Doc! 10 breaking ceremony of the new Surgery Center in June 2018. The site Dr. Rob Amrine of the new and improved surgery center is the vacant grassy lot between 11 Urgent Care at MBJ our clinic and Mullan Road. The surgery center will continue to pro- 12 MBJ Physicians & Physician Assistants vide services and care for our day surgery patients having surgery to the 14 MBJ Services shoulder, knee, hip, hand, wrist, foot and ankle. Outpatient total joint 15 A Different Approach for replacement procedures and outpatient spine procedures will be added to our services as the new facility will have the capability of extending Total Hip Joint Replacement Surgery a patient stay up to 23 hours. If your doctor anticipates you needing 17 DXA Bone Density Scans more than 23 hours of specialized care after surgery, your surgery will be 18 Get to Know Your Doc! scheduled at one of the local hospitals. Dr. Brent Roster We will continue quality care for patients with bone and joint injuries 19 Total Ankle Replacement – TAR and conditions, as we have done for over 60 years. Our new state of 20 Breathing Matters the art facility will allow us to expand our services and still continue to 22 Proper Cast Care provide compassionate, cost effective care to a wide variety of patients. 23 Body Composition Scans Missoula Bone & Joint magazine is See you in the beautiful Montana outdoors, designed and published by Custom Medical Design Group, Inc. To advertise Michael Woods, M.D. in an upcoming issue please contact us at 800.246.1637 or visit us online at 2018/2019 President, Missoula Bone & Joint www.CustomMedicalMagazine.com. This publication may not be reproduced in part or whole without the express written “Quality Care from People Who Care” consent of Custom Medical Design Group, Inc. | www.missoulaboneandjoint.com | 3 Running Gait Analysis Kristina Pattison, DPT, OCS, CSCS Missoula Bone & Joint Physical Therapist Kristina on Holland Peak in the Bob Marshall Wilderness Have you ever thought about how you run and develop a corrective program to improve your running how your body moves with each foot strike? Kristina performance and reduce your risk for injury. Pattison is passionate about helping runners to move Running and walking is a repetitive action. Many stronger and faster and avoid injury. Running Gait injuries are often caused, at least in part, by poor Analysis is the best way to develop a program specific biomechanics. The following are a list of common for you. Kristina says "maintaining full joint range of overuse injuries associated with poor gait biomechanics. motion and functional stability required for running • shin splints takes a small investment of time that pays off with reduced risk for injury and improved performance." • plantar fascitis Gait is the way in which we move our whole body • Illiotibial band syndrome (runners knee) from one point to another. Therefore, Gait Analysis • Patella tendonitis (jumpers knee) involves walking or running on a treadmill under the • Patellofemoral knee pain watchful eye of Kristina. A video recorder will also be • Achilles tendonitis utilized to capture your walking and running style. She will analyze the way you move, closely observing your • Lower Back Pain feet, ankles, knees and hips. Kristina can then show Biomechanical problems are usually caused you what is happening to your joints at the different by muscular imbalances - tight muscles working phases in your walking and running motion using slow against weak muscles. Sometimes they can be caused motion video and freeze frame. Kristina can identify by structural problems, for example leg length areas of weakness and poor biomechanics and then discrepancies resulting in hip hiking. 4 | www.missoulaboneandjoint.com | Examples of biomechanical abnormalities include: • Overpronation A Professional Limited Liability Partnership • Oversupination • Increased Q angle A full service law firm built upon a strong tradition of • Hip hiking - lifting the hip on one side providing exceptional legal • Limited ankle dorsiflexion representation to business and • Pelvic Tilt individuals across Montana. Kristina Pattison is an ultra-distance mountain runner, doctor of physical 350 Ryman Street therapy, board certified clinical specialist in orthopedics and certified strength Missoula, MT and conditioning specialist in Missoula, Montana. (406) 523-2500 Keep your stride strong and your running swift! Call today to schedule www.garlington.com your appointment with Kristina at Missoula Bone & Joint Physical Therapy (406) 542-4702. Attorneys at Law Since 1870 Hyaluronic Acid Injections for Knee Joint Osteoarthritis Hyaluronic acid (HA) can be injected in to the knee joint to work right at the source of your pain. In healthy knees, HA is a thick, slippery fluid that helps cushion, lubricate and protect the joint tissue. The injected HA helps protect your existing cartilage and can provide pain relief for 6-12 months. Speak to your orthopedic provider to learn what is best for your condition. | www.missoulaboneandjoint.com | 5 Effectively Treating Patellofemoral Joint Pain Patellofemoral joint pain (PFJP) is familiar to • Training errors may be the most prevalent cause of PFJP. individuals of all ages and activity levels. Named for Increasing activity or exercise intensity or duration too the joint formed by the patella (knee cap) and the rapidly results in tissue breakdown. trochlear groove of the femur (thigh bone), PFJP may • History of prior injury contributes to the health and be referred to as runner’s knee, anterior knee pain, or function of our joints. Prior fractures, orthopedic chondromalacia. Patellofemoral joint pain accounts surgeries, and trauma predispose the knee joint to 1 for 25% of all knee disorders and 42% of all running degenerative changes. injuries2. The difficulty in treating PFJP lies in the numerous causes and complex structures involved. • Body mass index (BMI) and social factors must not be overlooked when treating PFJP. BMI is the ratio of height Symptoms are usually located beneath the patella, in the to weight. Simply put, the higher your BMI, the greater patella tendon (below the patella), or along the medial- the impact load through the patellofemoral joint. lateral sides of the patella. Symptoms may include crepitus (clicking, cracking), swelling, tender-ness to touch, Treatment: and pain with squatting, descending stairs, running, or Physical therapy alone will not cure patellofemoral joint prolonged sitting. pain. The correct physical therapy intervention over a period Possible Causes: • Poor joint kinematics or poor tracking of the patella over the trochlear groove of the patella combined with excessive or repeated joint loading may cause PFJP. • Poor strength and stabilization in the supporting musculature results in increased compression and-or 3 torsional forces through the patellofemoral joint. John Fiore, PT Holly Warner, DPT Jesse Dupre, DPT Kate Hughes, DPT SERVING ACTIVE MISSOULIANS FOR 22 YEARS SPECIALIZING IN: • Joint Pain & Overuse Injuries for Athletes of All Ages • Running & Athletic Injury Experts • On Site High Speed 2D Video Running Gait Analysis • Pre & Post-Operative Rehabilitation • Back & Neck Pain Treatment • Work-Related Injury and Work Hardening • Functional Capacity Evaluation • Core & Functional Strengthening for Athletes • Manual Therapy & Dry Needling • Biomechanical Movement Evaluation • Total Joint Replacement Rehabilitation 1705 Bow St. • Missoula, MT 59801 549-5283 • Early & Late Appointments Available See us at www.sapphirept.com 6 | www.missoulaboneandjoint.com | What is ACI? By Dr. Michael Wright Missoula Bone & Joint Orthopedic Physician Specializes in Sports Medicine and General Orthopedics Autogenous Chondrocyte Implantation (ACI) is a procedure used to treat painful cartilage defects, primarily in the knee.