Diagnosing and Treating Ankle Injuries

Posted February 3, 2021 by Stacie Grossfeld

If you have experienced a pop around your ankle, it can be pretty unsettling. Today we’re going to go over two common ankle injuries that can cause this: an Achille’s tendon tear and an ankle sprain. Read along to learn more about these two ankle injuries.

Achilles Tendon Tear

Achilles tendon tears are most likely to occur in men over age 35. The most common injury scenario for this injury involves playing basketball, tennis or another sport that requires significant pushing off with the ankle. At the time of the injury, a person with a tear will feel a large pop. Most people also describe a feeling like someone kicked them in the heel when the injury occurs. Immediately after the injury, there is swelling and pain, and it becomes difficult to walk.

Doctors can diagnose an Achilles tendon tear with a physical exam in which they feel for a defect in the tendon. They may also use an MRI scan to visualize the tear. Often times, though, the diagnosis can be made by a physical examination alone.

Doctors will treat this injury with surgery unless the patient is morbidly obese or diabetic. This is because morbidly obese patients and diabetics are at a higher risk for an infection with surgical treatment. Nonsurgical treatments for this condition involve casting the ankle.

The surgery is an outpatient procedure. After surgery, patients are non-weight bearing for several weeks. After that, they may be cleared for touch toe weight bearing (using toes for balance but not weight bearing). Full weight bearing is usually possible starting around six weeks after surgery. The speed of recovery is based on the repair quality, and recovery differs between patients.

Ankle Sprain

A pop felt on the outer side of the ankle after a twisting injury is often a sign of an ankle sprain. This injury may occur if your ankle rolls as you are putting weight on it. A ligament in the ankle is injured in an ankle sprain.

Often, after an ankle sprain people experience swelling and the ankle turns black and blue. Sometimes the discoloration can travel down to the foot. Doctors typically recommend an X-ray to make sure there are no fractures around the ankle joint.

To treat an ankle sprain, follow the acronym RICE. This stands for rest, ice, compression and elevation, which should be the first lines of treatment. You may also need to use anti-inflammatory medication to help reduce swelling and pain. Long-term, physical therapy is a key part of recovery to restore range of motion and help reduce swelling. Physical therapists can help you regain strength and stability around your sprained ankle.

If you play sports, your return time frame depends on the severity of the sprain. It can be as quick as 2 weeks with a mild sprain that you treat properly. More severe sprains may take as long as 8 weeks for a full recovery. In all cases, you may experience intermittent swelling for up to three months after the injury.

If you have experienced an ankle injury, you can trust the professionals at Orthopaedic Specialists to help you recover. To schedule an appointment with Dr. Grossfeld and the experts at Orthopaedic Specialists, call 502-212-2663 today.

Three Common Knee Injuries

Posted February 2, 2021 by Stacie Grossfeld

Knee Injuries

You’re planting your leg to make a quick turn and- pop! You hear a popping sound from your knee. This is an all too familiar of a situation for many people. There are three common injuries that cause a pop in the knee. These are an ACL tear, a meniscal tear, and a patella dislocation. Most often, for all of these knee injuries, you will experience pain and swelling. Here’s an overview of these three knee injuries.

ACL Injury

The ACL (Anterior Cruciate Ligament) stabilizes the knee. Planting and twistin, like while playing soccer or football, can cause an ACL tear. Running and coming to a sudden stop can also tear the ACL. Regardless of the cause, with an ACL tear, a knee pop and swelling will occur. There’s a significant amount of pain right when the tear occurs as well. In sporting contexts, players with an ACL tear are unable to continue competing due to the severity of the injury. With the proper initial treatment of resting, icing, and compressing, the pain can resolve in a matter of days.

Doctors diagnose an ACL tear with a physical examination. They check your injured knee for swelling and pain, comparing it to your healthy knee. They may also move your knee in a few positions to assess its range of motion. Doctors may also utilize diagnostic imaging like a MRI scan to assess the degree of tissue damage and the severity of the tear. In many cases, particularly for people with very active lifestyles, surgery is necessary to repair the ACL. During surgery, doctors reconstruct the torn ligament You will also need to pursue knee rehabilitation for a period of time to restore function and stability.

Meniscal Tears

Another common knee injury is a meniscal tear. Meniscal tears often occur due to trauma like aggressive pivoting in younger patients. In contrast, older patients can tear their meniscus with minimal force from day-to-day movement. In both cases, the tear causes a sharp pain along the joint line. This pain occurs with activity. A meniscal tear needs to be treated properly- the meniscus functions as a shock absorber in the knee.

Doctors diagnose meniscal tears with a physical examination in which they move your knee in different positions to pinpoint the injury. They often use an MRI to visualize the injury as well. Meniscal tears, like ACL tears, should be treated with rest, ice, and compression initially. Longer-term, treatment includes physical therapy to improve motion and stability, and may also include surgery. In surgery, doctors can repair the tear with a low-risk outpatient procedure. Recovery from this surgery is quick.

Patella Dislocations

One final common knee injury that causes popping is a patella dislocation. The patella, also known as the knee cap, can dislocate when you plant and twist your let. Patella dislocations occur most commonly in younger females. People may feels something slip out of the joint if they experience a dislocation. Fortunately, most of the time, the dislocated knee cap spontaneously relocates on its own. However, on occasion it doesn’t. If this is the case, an ER physician will have to relocate the patella. Relocation is perform under a twilight type anesthetic.

Treatment for this injury involves a patella stabilization brace. Physical therapy is also needed to strength the muscles around the knee cap. Typically, people are able to resume full activity within eight weeks of the initial injury. If the patella dislocates again, you may need surgery. During surgery, doctors can reconstruct the medial patellofemoral ligament, the ligament that stabilizes the patella.

If you have experienced any knee injuries, you can trust the professionals at Orthopaedic Specialists to help you recover. To schedule an appointment with Dr. Grossfeld and the experts at Orthopaedic Specialists, call 502-212-2663 today.

What is a Hyaluronic Acid Injection?

Posted February 1, 2021 by Orthopaedic Specialists

Hyaluronic acid can be used to help relieve joint pain. Here are 10 facts you should know about this substance:

1. Hyaluronic acid occurs in your body.

It’s a clear, viscous fluid that naturally occurs around joints. Your skin, eyes, and connective tissues all harbor hyaluronic acid too.

2. It deteriorates when you have arthritis

Normally, Hyaluronic acid is a great lubricant between your bones in joints. However, if you have arthritis, the acid can become thinner and water-like, reducing its effectiveness. This can lead to more inflammation around arthritic joints.

3. Doctors can inject it into arthritic knees

Doctors can inject a chemically similar Hyaluronic acid fluid into your knee. This substance is thick and viscous, and gives a cushion around the knee like naturally-occuring acid does.

4. There are both single and multi-injection options

You may receive either one or multiple injections of Hyaluronic acid. Doctors typically prefer doing a single shot, as this ensures you only need a single office visit. Each injection to a joint carries some risk of joint infection as well, so a single treatment is preferable to avoid undue risk.

5. It’s made from rooster cone

As weird as it sounds, Hyaluronic acid is actually made from that red thing on top of a rooster’s head. Well, not directly from it- it’s derived from bacteria found on rooster comb. This bacteria is grown from that source specifically to ferment and create this acid.

6. It offers months of relief

A single injection will typically give an arthritic joint six months of pain relief, sometimes a bit more or less. Over time, pain will return to the joint, so another injection will be necessary.

7. It kicks in in a few days

Once you have received an injection, you can expect to have some relief in 2-5 days.

8.There are multiple brands

The market for knee pain relief due to arthritis has led to a competitive market for these injections. There are many different brands available to you. Your insurance company may dictate which brand(s) they cover, and many insurance companies do not cover the injection cost at all.

9. Typical insurance breakdown

Often times, Medicare will cover 80% of the cost of these injections. If you have a secondary insurance, they may cover the cost of the remaining 20%.

10. FDA approval

Hyaluronic acid injections are FDA approved for the knee only, and not for any other joints like the hip joint.

To schedule an appointment with Dr. Grossfeld and the experts at Orthopaedic Specialists for a Hyaluronic acid injection, call 502-212-2663 today.

PRP: Ten Facts You Should Know

Posted January 29, 2021 by Orthopaedic Specialists

PRP injections can help quicken the healing process for injuries. Here are 10 things you should know about this emerging treatment option:

1. Platelet-rich Plasma

PRP, or Platelet-rich Plasma, is used in emerging regenerative medicine therapies. It leverages the body’s ability to heal itself. It can help enhance the healing process for soft tissue injuries, joint pain, and other injuries.

2. Natural way to reduce inflammation

Since PRP uses platelets from your body, it’s a completely natural way to help heal your body and reduce inflammation. The injections do not involve any synthetic painkillers or other medications.

3. Treats tissue damage

Doctors inject PRP into the area where there is tissue damage or inflammation. It is commonly used to treat injuries like achilles tendinitis, tennis elbow and plantar fasciitis.

4. PRP contains growth factors and anti-iflammatory proteins

By concentrating platelets from your body, doctors are able to amplify the healing capabilities your body naturally produces. Within PRP, there are anti-inflammatory proteins and growth factors that help your body heal efficiently.

5. Longer lasting than hauronic acid when used in an arthritic joint

Another benefit of PRP is that lasts longer than other treatments for arthritis. For instance, while you may need hauronic acid injections every few weeks, PRP injections often provide benefits for months.

6. In-office procedure

Doctors obtain PRP by drawing blood from your arm and then spinning it in a centrifuge. This concentrates the platelets. They then inject the concentrated platelets in the injured area of your body. Everything can be done in-office.

7. Simplicity

One of the advantages of these injections is the simplicity of the process. Doctors can distill healing capabilities from your body and inject you with an amplified version of these capabilities, all in the office during your visit.

8. Used commonly in pro athletes

Tiger Woods was one of the first pro athletes to use PRP injections. It helped him heal an ACL injury. Tennis star Rafael Nadal has also used these injections to help heal his knee.

9. No risk of allergic reaction or disease transmission

Another advantage of PRP treatment is that it carries zero risk for negative reactions or disease transmission. This is because it is derived from your own blood. This natural treatment avoids some of the risks associated with other treatments for injuries.

10. Highly effective

PRP can be an effective treatment option for people looking for accelerated healing. In particular, injured athletes, people with injuries who lead active lifestyles, and people with arthritis are some groups that may benefit significantly. PRP can help lead to faster healing and recovery.

To schedule an appointment with Dr. Grossfeld and the other experts at Orthopaedic Specialists, call 502-212-2663 today.

Avoid a New Year’s Resolution Fitness Injury

Posted January 28, 2021 by Orthopaedic Specialists

A new year’s resolution might be on your mind right now. Many of us find ourselves setting lofty health and fitness goals for the new year. Striving for better health and wellness is wonderful. However, you should be careful to avoid a few common pitfalls as you introduce new activities into your life. Here’s a look at some ways you can prevent an injury as you strive to hit your fitness goals in the new year.

Over-Exercising

There’s nothing wrong with setting goals for increased exercise. When approached properly, it can be a great way to improve your health. However, it is very easy to end up doing too much too fast and get injured. So, the first thing you should keep in mind is how fast you are increasing activity. Gradually increase your level of activity, with staggered days of rest in between ideally. This will give your body time to adjust. It can be helpful to switch up your kinds of exercise too. Instead of going right into 5 or 6 days per week of running on the road, try to mix in some hiking, cycling, core work,and other activities. This will prevent overuse injuries that can arise when you do a lot of repetitive activity before your body is ready for it.

Knowing Your Body

As you slowly increase your activity level, it’s important to notice how it feels. Get used to listening to your body. Notice if something causes pain, or if pain lingers long after exercise. Keep an eye out for more worrying symptoms like pain that does not fade after a few days, or increases to your resting heart rate. These can be warning signs of more serious injuries like stress fractures and overtraining syndrome. You should work with a doctor to assess your situation if you are experiencing any of these warning signs.

Treat your body well after exercising as well. If you do experience pain, rest and ice any affected areas. You can spend some time doing targeted stretches for any tight muscle groups too. Plus, you might

Nutrition to Fuel Your New Year’s Resolution

As we increase our activity level, it’s important to adjust how we eat as well. More exercise means more calories burned, and the need for more calories so your body can stay healthy. In fact, cutting too many calories while increasing activity level can increase the risk for injury in some cases. You should also focus on healthier eating here as well. Incorporate whole grains, vegetables, fruit, and healthy fats and proteins into your diet as you build your activity level.

Working With A Doctor

If you do find yourself struggling with an injury, you should consider working with a medical professional. The experts at Orthopaedic Specialists use cutting-edge practices and research to help people from all walks of life heal and live healthy, active lives. From cortisone injections to surgery and innovative regenerative medicine, we can help you heal and get back to doing the activities you value.

To schedule an appointment with Dr. Grossfeld and the other experts at Orthopaedic Specialists, call 502-212-2663 today.

Pronation: What Runners Need to Know

Posted January 21, 2021 by Orthopaedic Specialists

Many runners have probably heard the word pronation thrown around. But what exactly is pronation? Follow along to learn more about pronation and what you need to know as a runner!

Pronation

In a running context, pronation simply refers to the inward rolling motion of the foot as it strikes the ground during walking or running. Pronation is a natural movement that allows feet to absorb shock and keep ankles and legs aligned during motion. The normal amount of pronation tends to be about 15 degrees. This means the foot rolls inward (towards the body center) about 15 degrees during activity.

Here’s how it works normally. As you push off with your foot, all of your toes are involved in helping this happen. The biggest two toes do the majority of the work, while the other toes provide support. The sole of the foot is in a neutral, flat position during this motion (not tilted inward or outward). The foot begins to roll outward a bit as you push off, and the arch stiffens and rises to to give some stability. Then, as the heel strikes the ground, the foot arch begins to flatten again (rolling inward).

However, many people may pronate (roll inward) more or less than normal. This can lead to issues for runners in particular, who are often repeating foot strikes thousands of times per run. Next, we will take a look at overpronation and underpronation.

Overpronation

Overpronation occurs when your feet roll inwards more than 15 degrees. The ankle continues to roll inward on push off (instead of starting to roll out), meaning the biggest two toes do all of the work and have no support from the other toes. People with flatter feet may be more likely to overpronate. Overpronation can cause issues with your knees, shin splints, and strain on the two big toes.

Underpronation

Underpronation (also called supination) is the opposite of overpronation. Here, the foot is not rolling in (pronating) enough during the toeing off part of motion. The outside edge of the foot and smaller toes end up doing a lot more work than normal. People with high arches may be more likely to underpronate. Some injuries associated with this include plantar fasciitis, ankle sprains, IT band syndrome, and achilles tendonitis.
Avoiding Injury

It’s crucial to get a professional opinion on your movement patterns if you believe you are not pronating correctly. While many people believe particular types of running shoes will help fix under or over pronation, this isn’t really shown consistently by studies. You should consult with a medical professional to get a diagnosis of your gait. They can help you with any therapeutic treatment or custom orthotics you may need to help treat and avoid injury.

Knowing your gait and what adjustments you may need to make is important when you are a runner. Fortunately, Orthopaedic Specialists can help! You should seek diagnosis and treatment from a qualified medical professional like Dr. Stacie Grossfeld if you are injured and want to get back to the activities you love. To schedule an appointment with Dr. Grossfeld, call Orthopaedic Specialists at 502-212-2663 today.

Patient of the Month Kelsey Evans

Posted January 14, 2021 by Orthopaedic Specialists

Meet this month’s patient in the spotlight, Kelsey Evans!

Having recently suffered a fractured radial head, Kelsey is a brand new patient of Dr. Grossfeld’s. “Even with limited activity, I feel a sense of “freedom” simply due to not needing a cast and because Dr. Grossfeld encouraged movement for faster healing. I’m hopeful that I’ll have no long term issues or restrictions due to the positive outlook I was given since the start of my injury.”

Kelsey and her family show cattle, specifically Chiangus. “We travel across the country competing and promoting our livestock. It’s a project that takes commitment and dedication every single day.”

“Having grown up within the livestock and Agriculture industry, I couldn’t imagine doing anything else as I’ve gotten older and had a family of my own. As you can imagine, the physical demand to achieve this is somewhat large which is why the biggest fear I have is not making a full recovery with my arm.”

So far, Kelsey has been able to maintain a somewhat normal life during recovery. Please join us in wishing her nothing but health and healing in 2021!

Platelet Rich Plasma: A Treatment for Osteoarthritis and Inflammation

Posted December 17, 2020 by Stacie Grossfeld

Platelet Rich Plasma Is Used to Treat Osteoarthritis and Inflammation

Platelet Rich Plasma is used to treat osteoarthritis and inflammation . PRP is short for platelet rich plasma. Treatment of inflammation and osteoarthritis involves using PRP. This is a new area of orthopaedics called orthobiologics. This is an area of medicine where we use the body to treat the body. PRP is generated by drawing blood from your arm.

The patient is having their blood drawn to use for a PRP injection

The blood next goes into a special tube. Then, the tube with the blood is placed in a centrifuge. The centrifuge spins at a rapid rate for 20 minutes. In conclusion, this process separates the platelets and plasma. This combination of blood products is called platelet rich plasma.

The image shows a vial of PRP after the blood has been centrifuged

What is Platelet Rich Plasma’s Indications?

Doctors inject PRP in the area of the body where inflammation and or osteoarthritis is located. The platelets are full of natural anti-inflammatory factors. This reduces inflammation from the injection.

Who is a Candidate for PRP

Good candidates for PRP are people who have osteoarthritis or inflammation. Common diagnosis treated with PRP include tennis elbow, plantar fasciitis, Achilles’ tendonitis, golfers elbow and rotator cuff tendinitis.

People that have a disease process related to platelets are not good candidates. Especially if they are on medication for their platelet disease. Most people will try other treatment options prior to PRP. The reason being is that most insurance companies to not cover the injection therapy. The treatment becomes an out of pocket cost.

How Quick Does PRP Work?

Most patients will have good to excellent relief of their symptoms within 2 weeks when used for osteoarthritis. It may take 6 weeks before you feel the feel effect of the PRP if it is for an inflammatory condition such as tennis elbow or plantar fasciitis .

Patient of the Month Sam Shaheen

Posted December 10, 2020 by Orthopaedic Specialists

Meet this month’s patient in the spotlight, Sam Shaheen!

Sam owns and operates Shaheen’s, a 4th generation department store located in The Springs Store on Breckenridge Lane in Louisville, KY. Established in 1922, Shaheen’s has continued to serve the Louisville community with their clothing needs by offering custom in-house embroidery and work apparel. Throughout the pandemic, they have been deemed essential because of the work they do for area hospitals.

Recently, Sam suffered from a large Achilles tendon tear. While he can’t point to the exact cause of the injury, Sam suspects it is due in part to the many years he used to compete in road races, (racking up 60 miles a week) as well as a fractured leg from his time in the Army.

Luckily, Sam is recovering nicely after receiving treatment from Dr. Grossfeld. At the age of 68, Sam enjoys keeping up with his yard and playing a round of golf in his spare time.

Working from Home: Ergonomics

Posted December 3, 2020 by Orthopaedic Specialists

Working from home has become a new norm for many people during the coronavirus pandemic. There are a few challenges that come with setting up a workspace at home. Here’s an overview of what you should consider related to ergonomics in a home office.

Physical Setup

The physical layout of your workspace is a great place to start. If you sit while working, the chair you use is important. It should be supportive for your spine, and should allow you to rest your feet flat on the floor. You can also use a footrest to keep your feet flat if that works better for you. Additionally, if your chair has armrests, they should keep your arms in a neutral position. If you are using a desk, it should have room for your legs beneath it and should be compatible with your chair to create an ergonomic position.

If you are using a monitor or laptop, the screen should be about an arms length away from you and should be at or just below eye level. A keyboard and mouse can also be helpful, and can be set up to allow your arms to rest parallel to the floor. Last, any other accessories you need, from paper to pens and phones, should be within easy reach on the desk and should not require reaching.

Of course, some people prefer standing desks, which are a great option as well. If you use a standing desk, make sure you wear supportive shoes and stand in an upright position. A footrest or pad can help alleviate pressure from the floor as well. Otherwise, the same principals for sitting desk setups apply.

Body Positioning for Ergonomics

You also need to pair good body positioning with your layout for ergonomics. As alluded to before, your arm positioning is crucial. Your elbows should rest flat with the desk surface. This helps create the best wrist alignment. Additionally, you should not hunch over your work. Keep your back and neck straight whether you are using a chair or standing. Your monitor setup should allow you to keep your eyeline parallel to the floor, or at a slight downward angle.

Good Movement Practices

There are a few movement-related practices you should consider for ergonomics as well. For one, it can be easy to stay in the same position for long periods of time at home. There may be fewer opportunities for movement and interaction than in the office. Make sure you get moving regularly, every 30 minutes or so. This helps you break up static body positioning and avoid injuries that can develop from poor body positioning and movements. Even just a short break or walk can be helpful. Eye strain can be an issue as well. To avoid this, make sure you take an eye break from work every 20 minutes or so. You can simply look away from your work and focus on something farther away for about 20 seconds. This gives your eyes a needed break.

You should seek diagnosis and treatment from a qualified medical professional like Dr. Stacie Grossfeld if you are injured and want to get back to the activities you love. To schedule an appointment with Dr. Grossfeld, call Orthopaedic Specialists at 502-212-2663 today.