Patient of the Month Ian Lawler

Posted May 21, 2020 by Orthopaedic Specialists

Meet this month’s patient of the month Ian Lawler!

Ian is originally from California and moved to Kentucky when he was 10 years old. He joined the military when he was 19 and in 2012 had to undergo quite a few surgeries. Since then, Ian has worked with Dr. Grossfeld to help treat his knee, shoulder, and soon his hip. “It’s awesome that she works so well with veterans and always seems eager to help. I’m really appreciative of her always being willing to answer questions.”

Ian owns and operates Somerset Martial Arts, an after school, summer camp, fitness and martial arts program in Somerset, Kentucky. In addition to coaching martial arts, Ian is currently preparing for the 10th Annual Refuge Strongman Classic on August 1st. Though he has never trained for the strong man competition before, it was the only fitness contest he could find between now and the CrossFit Open in October. Unfortunately due to COVID-19 all the competitions around have been cancelled. “I honestly don’t care how I perform, as Strongman is not my sport, but I am trying to be as prepared as possible.”

Ian is looking forward to participating in the CrossFit open in October for the 2021 season and is anticipated to be in the top 2% of the world this year. He is hoping to be the fittest in Kentucky. Barring any injury, Ian’s goal is to make it to the games in the summer of 2022 where he’ll be 32 years old and one of the oldest (if not the oldest) CrossFit Games rookie to date.

Ian started competing in fitness after being a professional MMA fighter.

“I still love fighting but the preparation for fights took so much away from my family while giving so little that I couldn’t justify it anymore. Fitness is something that helped me prepare for fights and I had always watched the CrossFit games. When I realized I still had the fire to compete, I decided CrossFit was it! In CrossFit it doesn’t matter who your manager is, what promoters you know, how many tickets can you sell, how big your social media following is, or what team you’re with. If you can make the time hacks, if you can lift the barbell, if you can beat the person next you, then no one gets to over look you. It doesn’t matter how marketable you are. In CrossFit you either can or cannot, which for me was much simpler and now I love it!!!”

When asked what keeps him motivated, Arthur responded, “I want to stand in the sunlight competing against the fittest on the planet, then look at my wife and my children, smile and say I made it against a lot of obstacles, against a lot of doubters, that my hard work and faith paid off! And of course remind them that they can achieve anything they put their everything into.”

When he’s not trying to become one of the fittest people on the planet, he enjoys spending time with his beautiful wife and children, training, and reading.

COVID-19 from an Orthopaedic Surgeon’s Point of View

Posted May 14, 2020 by Orthopaedic Specialists

Humans are creatures of habit, touch and interaction. This pandemic pulled the rug out from us in all of those areas. We are on the other hand a resilient species. That trait will allow us to overcome this pandemic.

Running an orthopaedic surgery practice amidst COVID-19 became a whole new world. Having essentially a similar routine for the last 23 years builds habits. Knowing that during the week I am starting my day with a workout at a gym, getting Adam ready, dropping him off at school, then off to the office to see patients and ending my workday day in the operating room, was set in stone. All that changed over night.

Touch was no longer allowed except with a gloved covered hand.

This touch needed to be restricted to very brief periods in order to stay six feet away from my patients. A lot of what I learn about someone’s injury or diagnosis comes from the physical exam which requires touch. The simple act of shaking a persons hand when greeting them in the exam room was stopped. I learn a lot from that initial skin to skin contact with a person. A sweaty hand means they are super nervous, a strong muscular hand with calluses lets me know their occupation vs a fragile hand with a slight grip. All of this insight, gone. The touch to their shoulder after telling them the treatment plan or a high five to a kid that just got their cast off was no longer proper either.

Every interaction was so different.

I read my patients faces as I discuss treatment plans and get their medical histories. With a mask on its hard to read expressions. Clues that maybe they didn’t understand what I just said or seeing what treatment plan they liked best, were no longer there. You can see some expression in peoples eyes and their foreheads but most of their facial expression is lost with a mask over their face. This made it challenging to “read” people.

Our patients craved in person interaction, especially the ones living alone. They just wanted to talk. I got to hear life stories, viewed pictures of pets and heard about grandchildren more than I had ever before in my career.

However, there were so many patients I saw at the height of the pandemic that were terrified and looked to me as a doctor, for answers regarding the coronavirus. I make decisions in my practice of orthopaedic surgery based on medical literature, 2 years of data, metrics and years of experience. Regarding covid-19, I had none of these resources and could not give science based answers. I had no data, no metrics, no science, no past experience to rely on for answers. The information was rapidly changing daily. My resources became physician lead Facebook pages, Medscape, the data being collected from John Hopkins website, the New York Times and the Wallstreet Journal. Not my typical go to sources for medical information.

As restrictions are easing and life is starting to have a hint of returning to a more normal routine, small things like touch and interaction become even sweeter.

The Orthopaedic Specialists are still open and here for you! We are safely administering injections and seeing to all of our patients needs. Dr. Stacie Grossfeld is also providing virtual orthopedic and sports medicine consults to patients who don’t wish to make the trip into the office. Most types of insurance are accepted. Set up is easy with the use of Zoom Video Conferencing and a smart device. To schedule an appointment, call our office at 502-212-2663!

Brain Exercises Recommended By The Experts

Posted May 7, 2020 by Orthopaedic Specialists

The brain is a muscle that contains trillions of neurons and manages bodily functions. Like all muscles, it requires some working out to remain healthy and fit. Most people don’t realize that their brain can atrophy, especially as they age. Healthy brain habits can delay muscle loss and degeneration by several years, if not indefinitely. The first step is to maintain a healthy diet and physical exercise schedule. If your body is fit, your brain will get all the nourishment it needs. Here are some forms of brain exercise that people can add to their healthy lifestyle.

Various Forms of Brain Exercise

1. Switch Hands

This is a simple, slightly bothersome task, but it can give your brain a big workout. When people use their non-dominant hand, their brain is forced to work harder and focus more. Even simple tasks like brushing your teeth can have an impact. It forces the non-dominant side of the brain to develop, so you’re building new connections and exploring new pathways.

2. Keep Your Eyes Closed

Perform regular chores with your eyes closed. Things like washing your hair, folding laundry, washing dishes, or even making a bed, can be done safely even if your eyes are closed. That forces your brain to focus and utilize different senses like touch or sound to complete the task. You use different pathways or neural connections, which sharpens your brain’s ability to process information.

3. Learn Something New

Learning something new always engages the brain in different ways. Every new skill forces the brain to make new connections or utilize its resources more efficiently. Learning something complex like music or a new language can engage different areas of your brain. Some of these regions are underutilized and could use some exercise.

4. Socialize More

Socialization is a complex task that requires a lot of focus and energy. The brain has to navigate different conversations, pay attention to others, and engage in various activities like consuming meals or watching entertainment. Research suggests that people who socialize more are less likely to develop degenerative mental diseases like Alzheimer’s. So, if you have just moved or don’t have any close friends, consider joining a club or community group to socialize more.

5. Participate in Activities That Utilize All Senses

Your senses feed a lot of information to your brain, so participating in actives that engage all of these senses can help. Traveling and exploring is a great way to engage all senses. You can look at new things, smell different fragrances, listen to a wide range of sources, and taste different cuisines.

Cooking is also a great activity as it engages all the senses. You see and feel all ingredients, taste to determine if the dish is turning out correctly, smell cooking aromas, and experience food through all those senses.

6. Meditate

People have been meditating for thousands of years and for good reason. It doesn’t just reduce stress- it forces your brain to work differently. Meditation helps improve focus, self-awareness, empathy, and mood. Plus, it can even improve your working memory capacity significantly. People who meditate regularly are sharper, more productive, and less likely to become frustrated. Meditation also forces individuals to focus inward and actively control the flow of thoughts.

These are just some of the many ways in which you can improve your brain’s function. Activities like playing chess, trying to solve puzzles, and painting can help engage different areas of your brain as well. People can play online brain games designed to improve function. Experts haven’t determined whether these games have any material impact, but they do keep the mind active through brain exercise.

Dr. Stacie Grossfeld and Orthopaedic Specialists are here to help. For an appointment with a board certified orthopedic surgeon and sports medicine doctor in Louisville, Kentucky, call 502-212-2663 today!

Patient of the Month Gerald Sebree

Posted April 23, 2020 by Orthopaedic Specialists

Meet this month’s patient of the month Gerald Sebree!

Gerald recently received treatment to help combat arthritis in both of his knees and as a result is no longer experiencing daily on going pain. “Coming to Dr. Grossfeld was the best thing I have ever done. I asked her about [various] treatment [options] and she was very up front with me. She said that although she had heard good results from her patients, to not expect an overnight cure. I said let’s do it, and have since been feeling great!”

After spending 8 years in the military, 40 years in manufacturing, and 12 managing a facility for individuals with special needs, Gerald now spends his time as a volunteer for Awake Ministries’s Serenity Center. Awake Ministries is a “non-profit organization that offers services, resources, and counseling programs that facilitate lasting recovery from the hurts, habits, and hang ups of life.”

Gerald has been a full time volunteer at the Serenity Center for 13 years. At the age of 81, he currently runs their food pantry, where he finds himself managing over 30 volunteers at any given time, and acts as a lay counselor as well. He started volunteering after losing two wives to illness; his first wife of 22 years to heart failure, and his second wife after 5 years to lung cancer. The center helps provide kids with lunches on the weekends via their backpack program and is an excellent resource to those struggling with addictions or in need of counseling.

In his spare, time, Gerald plays at least 36 holes of golf a week!

5 Common Cycling Injuries

Posted April 16, 2020 by Orthopaedic Specialists

Cycling is a great activity for staying fit and exploring new places. Like any sport, there are some common injuries that can occur in cycling. Some of these injuries occur due to overuse, and some result from acute trauma. Here are 5 common cycling injuries:

Knee Pain

Knee pain can occur while cycling due to a variety of things. If your knee pain is located on the front of your knee, that typically indicates that your saddle height is too low. When the back of your knee is hurting, it may be the case that your saddle height is too high. If your knee hurts on the inside or outside, it might be the position of your feet on the pedal that is the root cause. Left unattended to over time, some of these pains could develop into patellar tendonitis. This means the tendon below your kneecap is overworked due to improper. Small tweaks to saddle height and cleat positioning can really help eliminate overuse injuries in your knees. As with any overuse injury, resting, icing, and taking anti-inflammatories is always a good idea too. Pushing through the pain can lead to longer healing processes and a more serious injury.

Achilles Tendonitis

Some cyclists develop inflammation in the tendon behind the ankle, the Achilles tendon. This can be caused by an improper fit to your bike or improperly positioned cleats. If your seat is too high, your toe may be pointed down while you ride, which causes a lot of stress on the calf muscles and the Achilles tendon. Just like with knee pain, rest, ice, and anti-inflammatories can help.

Back Pain

Back pain, often starting in the lower back, is a common overuse injury for cyclists. Long rides in unstable positions can lead to back pain. It’s important to make sure your form and bike fit are correct to avoid chronic back pain from cycling. A strong core helps too- stronger muscles around your pelvis help you stay stable on the bike.

Neck Pain

If the way you lean over your bike while riding is improper, you may develop neck pain. A reach that is too long can cause aching in the shoulders and neck. Adjusting your seat stem length, seat setback, handlebar drop, and handlebar width are all possible ways you can reduce neck pain.

Impact Injuries

Sometimes, it isn’t your form that causes you pain over the long term. When you are speeding along on your bike, you can obtain injuries from crashes. One of the most common forms of injury from a crash is a clavicle break. Your reaction upon falling from your bike may be to extend your arm before impact, which can lead to a clavicle break. Your head is at risk too. Even with a helmet, which significantly reduces negative outcomes from head impacts, you can develop a concussion from blunt force.

One last common impact injury is road rash. This occurs when you slide on the ground after falling and your skin is grazed. The seriousness of your road rash can vary in severity, depending on the factors involved in a crash.

For any impact injury, it’s important to take the time to evaluate how your body feels and seek medical attention if necessary. This can be as simple as keeping road rash wounds cleaned and covered or as significant as an emergency room visit for a broken collarbone or wrist.

Cycling injuries aren’t always avoidable. When you find yourself in need of assistance for a nagging injury, Dr. Stacie Grossfeld and Orthopaedic Specialists are here to help. For an appointment with a board certified orthopedic surgeon and sports medicine doctor in Louisville, Kentucky, call 502-212-2663 today!

Telehealth from an Orthopaedic Surgeon’s Point of View

Posted April 9, 2020 by Orthopaedic Specialists

10 Things We Have Learned While Providing Telehealth Appointments

1. Patients are so thankful that we are providing a way from them to have their orthopedic issues addressed.

2. We have been graciously invited into their homes via FaceTime or other conference platforms.

3. You can actually do a lot of an orthopedic exam without ever putting your hands on a patient. You have to be clever about helping the patient do the exam with you. For example: the patients palpate specific areas on their knee where you would normally palpate to look for a specific pathology.

4. Most patients no matter their age are pretty handy with FaceTime.

5. We’ve been able to review patients’ x-rays from various sources by them allowing us to look at their films from their phone or computer.

6. Patients have allowed us to streamline this process, when they call to make an appointment we are gathering key data and giving them information on how to set up their phones, iPads, or laptops for the telehealth visit.

7. Not everybody knows where the volume button is located on their smart device.

8. We are learning the names and even getting to visit with some of their pets.

9. Sometimes patients forget that we will need to examine the body part that is below the web cam level. There’s been a couple times when we had to go off camera so they could get appropriately dressed.

10. The bottom line is patients are extremely appreciative of this service in these unprecedented times.

Dr. Stacie Grossfeld is now providing virtual orthopedic and sports medicine consults to patients who don’t wish to make the trip into the office. Most types of insurance are accepted and set up is easy with the use of Zoom Video Conferencing and a smart device. To schedule an appointment, call our office at 502-212-2663!

Everything You Ever Wanted to Know About a Frozen Shoulder (Adhesive Capsulitis)

Posted March 23, 2020 by Orthopaedic Specialists

It is not a shoulder that has frostbite…
A frozen shoulder is also known as adhesive capsulitis. It is a condition that most commonly affects women (70 % of women vs 30% of men).
Diabetics are also commonly affected. If you are a diabetic you have a 20-30% chance of developing a frozen shoulder. Diabetics also tend to have more severe cases of frozen shoulders than the general population.
There is typically no injury that causes this condition.
People will notice that they are slowly losing range of motion of the shoulder or the shoulder becomes more and more painful.
Treatment starts with a cortisone injection in conjunction with physical therapy. The cortisone will help to reduce the inflammation and pain . The PT is to stretch out the tight structures in the shoulder joint.
If PT and the cortisone shot fail then the next step is surgical intervention.
A closed manipulation is typically the first surgical step. This is completed in a surgical center. A nerve block (this typically will last for 18 hours) is placed to reduce post-operative pain and light anesthesia is administrated. The surgeon places the shoulder through different planes of motion to break up the scar tissue and release the adhesions. After this procedure, the patient will see a physical therapist the day of in order to further manipulate the shoulder and arm while the nerve block is protecting against pain. I typically recommend PT 4-5 times for the first 3 weeks after this initial manipulation.
If a closed manipulation fails then arthroscopic lysis of adhesions is needed. This is a true surgical procedure where we release the capsule around the shoulder joint and reset the areas of fibrosis (scar tissue).

For more information on treating a frozen shoulder (aka Adhesive Capsulitis), contact Stacie Grossfeld and the Orthopaedic Specialists at 502-212-2663.

5 Things to Know About Carpal Tunnel Syndrome Treatment From an Orthopedic Surgeon

Posted March 16, 2020 by Orthopaedic Specialists

Carpal Tunnel Syndrome (CT) is caused by median nerve compression in the wrist. It’s a painful, lingering injury that is very common. Some common symptoms from Carpal Tunnel are numbness and tingling involving the thumb and index finger, worsening numbness with wrist flexion, and shooting pain up the forearm. Fortunately, there are several ways to treat symptoms of CT. Here are 5 things you should know about carpal tunnel.

1. Supplements and Drugs

There are a few treatments that are often used in conjunction to treat mild to moderate CT. Vitamin B6 is often used as a first treatment for Carpal Tunnel symptoms. There is some mixed evidence that B6 might help reduce pain from CT. Another natural symptom-reliever is turmeric, which may reduce inflammation. You can add small doses to your diet or you can consume turmeric supplements. Similarly, oral NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen aspirin, and naproxen sodium can be taken to relieve symptoms and reduce swelling. However, you should consult a doctor before taking B6, turmeric, or NSAIDs to make sure you are not consuming quantities that are too high and might lead to adverse side effects.

One other potential drug treatment for CT symptoms is cortisone injections. These injections typically have about a 45% success rate in providing short-term relief, and are a good option if other treatments have failed.

2. Night Brace

Wrist splints can help avoid further stress to a CT injury. Wearing a splint keeps the wrist in a neutral position. This is especially important at night because you are most likely to bend your wrist while sleeping.

3. Modified Work Stations

One important way you can prevent or mitigate CT is by modifying your workplace layout. If your job requires a lot of wrist positions that add stress to your wrists, you may be able to make some adjustments that can help. Ensuring keyboards are lower than desks, using a touch pad instead of a mouse, and taking regular breaks can all help.

4. Physical Therapy and Stretches

Some hand therapy treatments may also help alleviate symptoms of CT, in general and after surgery. When used in combination with other treatments, specific stretches and exercises can help reduce mild to moderate CT symptoms. Stretches may help reduce pressure in the median nerve of the carpal tunnel, and improve circulation.

Check out our video showing you some stretches to help with Carpal Tunnel!

5. Carpal Tunnel Surgery

If none of the treatment options above have worked, an EMG/NCS (electromyogram and nerve conduction study) may be conducted. An EMG/NCS is a diagnostic test that helps doctors determine a patient’s nerve and muscle condition and informs treatment options like surgery.

CT surgery is an outpatient procedure that usually only takes 5-10 minutes and typically uses local anesthetic. A surgeon cuts the transverse carpal ligament and enlarges the carpal tunnel in the wrist to relieve compression of the median nerve.

After CT surgery, patients usually wear a splint for one or two weeks before a follow-up appointment to remove the splint. After splint removal, a physical therapy program can help improve wrist and hand mobility and movement. Full recovery takes around 6 weeks. Over the course of recovery and beyond, it’s normal for there to be some pain and numbness in the fingers and wrist. However, you should always consult with your surgeon to assess your recovery.

If you have Carpal Tunnel or you have any questions about treating Carpal Tunnel, you may want to consult with a professional for advice and treatment. Call Dr. Grossfeld’s office at 502-212-2663 for more information and an expert opinion.

10 Tennis Elbow Facts

Posted March 9, 2020 by Orthopaedic Specialists

1. It is an overuse injury.
2. Pain is located over the lateral epicondyle which is the bony part of the elbow located on the outer side.
3. Any activity that requires wrist extension will hurt; such as picking up a cup of coffee or shaking someone’s hand.
4. The elbow may feel stiff in the morning.
5. X-rays will not show the pathology. MRI scans will reveal inflammation, partial tears or complete tears of the common extensor tendon.
6. Treatment involves wearing a tennis elbow band 24/7 except for personal care for 6 weeks. The band should be placed two fingers breath below the bone where the pain is located.
7. Click here for tennis elbow stretches.
8. NSAIDS or a topical anti-inflammatory cream can help.
9. If the above fails then a PRP or cortisone injection is an option.
10. If the injections fail, an MRI scan is obtained, and based on the MRI findings surgery may be indicated.

Five Facts You Need to Know About Tennis Elbow If You Are a Tennis Player

1. It is typically a technique problem. How many times have you seen a pro player wearing a tennis elbow band? (Almost never)… It tends to occur from hitting the ball late. Talk to your tennis pro to see if they can pick up on a technique error that can be corrected.
2. Racquet modifications required. Purchase a more flexible racquet. Many racquets that are on the market today are very powerful and stiff. The stiff racquet transmits the force of the ball up the racquet into your elbow. Purchase a more flexible raquet. Talk to your local tennis pro or a store that sells tennis racquets. Many of the internet stores will have consultants you can talk to over the phone to help guide you in racquet selection.
3. Check your strings. You should be using a blended string that is more forgiving. Stay away from the monofilament strings. Your tennis professional will know what to recommend. Consider using a higher gauge string like 16 or 17.
4. Restring your racquet at 2-4 pounds less than what it is currently strung. That will help to decrease the stress on the common extensor tendon.
5. Over wrap your grip by one or two layers. The larger grip will decrease the force on the common extensor tendon when you squeeze the racquet.

For more information on treating tennis elbow, contact Stacie Grossfeld and the Orthopaedic Specialists at 502-212-2663.

Patient of the Month: Anne Shelburne

Posted February 27, 2020 by Orthopaedic Specialists

Meet our patient of the month Anne Shelburne!

Anne and her husband, Tim, are both retired attorneys, who after meeting at the Brandeis School of Law, practiced law for 30 + years in Kentucky and North Carolina. Now the duo design, produce and sell decorative and functional art crafted from clay and wood out of their studio in Spencer County. Hobbies that once served as therapy during their careers as lawyers have now become their full time passion. Anne is a ceramicist, and Tim a woodworker. You can follow their work on Instagram at the handle @ridgeworksky or purchase it at the Edenside Gallery on Bardstown Road.

Anne fondly refers to her female figurines (pictured below) as “Queens.” She strives to depict the beauty, strength and resilience of women in each figurine.

Recently, while Anne was glazing one of her favorite Queens, it fell and the arm broke off at the right shoulder. Rather than discarding the broken Queen, Anne fired her and was pleased with the results, although she only has one arm. As fate would have it, just a few weeks later, Anne would suffer from a similar injury at the beach (fortunately she would get to keep her arm).

During a trip to North Carolina for an art show, Anne lost her balance on the beach while photographing gulls, landing on her right shoulder. Though she initially thought she had dislocated it, Dr. Grossfeld would later diagnose it as a displaced acromion fracture, an extremely unusual injury.

Luckily, with the right preventative measures, exercises and physical therapy, Anne has been able to avoid surgery and is recovering well. She’s even turned to her art as part of the healing process, beginning with a super imposed image of her one armed Queen onto the X-ray of her now healing fracture.