Orthopedic Surgery & Rehabilitation Associates

Orthopaedists specialize in the diagnosis, treatment, rehabilitation and prevention of injuries to and diseases of the musculoskeletal system – the network of bones, joints, ligaments, tendons, muscles and nerves that gives the body its shape and allows us to move. Many of the problems orthopaedists treat involve the joints, places in the body where two or more bones meet. Humans have three different kinds of joints: fibrous (in the skull), cartilaginous (in the spine) and synovial (the neck, shoulders, elbows, wrists, hands, hips, knees, ankles and feet). This last type is what we usually refer to when we say “joint.” Ligaments connect bones to each other, and tendons connect muscles and bones. These parts of our bodies can be damaged from a traumatic injury, disease, congenital disorder or the natural aging process. Commonly treated conditions include arthritis, back pain, carpal tunnel syndrome, bone fractures, sprains and strains, knee and shoulder problems, tendon and ligament tears, osteoporosis, sports injuries, and pediatric conditions such as club foot. Patients may be infants, adolescents, middle-aged or elderly. The introduction of minimally invasive techniques has meant that many patients can be examined and treated through tiny incisions, minimizing the trauma of “open” surgery and allowing them to enjoy a faster recovery and return to regular activities. Arthritis In a healthy joint, the bone ends are covered with a smooth cushion of cartilage and the joint is protected by a fluid-filled capsule called the synovium. Arthritic joints are swollen, or inflamed, usually because the cartilage has been damaged in some way. Patients with arthritis suffer pain, stiffness and swelling in the affected area or areas. Nearly one in three adults suffers from arthritis or other chronic joint symptoms. There are over 100 different types of arthritic diseases. The most common is osteoarthritis, a degenerative joint disease in which the cartilage protecting the bone ends wears away. Rheumatoid arthritis is an autoimmune disorder in which the body’s own immune system attacks the joint lining. A diagnosis of arthritis is made after an evaluation of symptoms, a physical examination and one or more diagnostic imaging tests. Unfortunately, most types of arthritis are currently incurable – but today’s treatment options can be very effective. Treatment typically involves a combination of anti-inflammatory medication and devices to relieve stress on the joint (canes, crutches or splints). Regular exercise, weight loss for overweight patients, and cortisone injections may also be helpful. In severe cases, orthopaedic surgery such as joint replacement may be the only way to improve or restore function and relieve pain. Osteoporosis Osteoporosis is a disease characterized by increasing bone loss which can lead to fractures, height loss and a hump-backed appearance. One in two women, and one in five men, over the age of 65 will suffer at least one bone fracture due to osteoporosis. A diagnosis of osteoporosis is made after a complete medical history, physical examination and laboratory tests, including X-rays and bone densitometry. Other possible causes of bone loss must be ruled out as well. Lost bone cannot be replaced, but the treatment team will work with you to prevent further weakening. The treatment plan may include exercise, diet changes, hormone therapy with estrogen (ERT) or anti-estrogens (SERMs), or bone-preserving medications such as Calcitonin or Alendronate. Joint Replacement Sometimes the best way to relieve pain and restore function to a joint is to replace all or part of it with a mechanical prosthesis. Prostheses are intended to relieve pain associated with arthritis, other chronic conditions, or traumatic injury. The most commonly replaced joints are the hip, knee, shoulder and wrist. Occasionally, an implanted prosthesis does not function as well as it was intended to. In this case a revision procedure may be performed to adjust or replace the mechanism.

Our mission at OSRA Physical Therapy and Hand Therapy is to provide you and your family with the highest standard of quality Orthopaedic care. Our Rehabilitation Team members have earned advanced degrees and credentials to better serve those who entrust their care in our hands. Our commitment to Orthopaedic rehabilitation provides our patients and community with a dedicated team, with over 80 years of combined experience. Our specialties include, but are not limited to, the rehabilitation of: General Orthopaedic Problems Spinal Disorders Fracture Care Joint Replacement Sports Injuries and Hand and Upper Extremity Disorders Clinical Objectives Determine functional deficits through evaluation Manage the acute stage of dysfunction to prevent chronic pain and/or disability Restore function through comprehensive therapeutic programs Improve knowledge to reduce risk of reoccurrence Services Provided Musculoskeletal Evaluations Physical and Hand Therapists perform evaluations in order to assess the extent and nature of the disability, and to allow formulation of a comprehensive treatment program. Measurements such as range of motion and strength are taken to obtain baseline information on areas of lost function. Evaluation results are reported to all referral sources shortly after assessment. Progress updates are forwarded for follow-up visits to the physician. Manual Therapy Manual Therapy techniques utilize the therapist’s hands to relieve pain, restore mobility of stiff or adhesive joints, and to promote appropriate healing in an operative or injured joint. Therapeutic Exercise Specialized exercise is performed during the treatment program to enhance recovery and functional restoration. Electrical Stimulation Electrical modalities are utilized to promote healing by reducing edema, relieving muscle spasm and reducing pain. Palliative Modalities When indicated, the use of therapeutic heat or cold may be used adjunctively in our treatment programs. Work Conditioning Individualized problem oriented programs are designed to rehabilitate an injured worker’s cardiovascular, musculoskeletal and respiratory systems in preparations for return to work. Pre-Operative Instruction Programs Patients who will be undergoing elective surgical procedures, such as joint replacement, are instructed in protocol-based exercise and gait training to facilitate quicker post-operative rehabilitation and return to function. Custom Splint Molding Our Hand Therapist custom-makes splints for medically necessary hand conditions. Splints are designed to control movement, prevent deformity, allow a joint to rest, or to help facilitate motion in a specific way.

Sports medicine is a subspecialty of Orthopaedic Surgery that deals with the prevention, diagnosis, treatment and rehabilitation of injuries suffered during athletic activity. The goal of treatment is to heal and rehabilitate the injury so patients can return to their favorite activities quickly. As with a sports team, there are many physicians who work together to help the patient regain maximum use of the injured limb or joint. “Players” on the team are typically the physician, orthopaedic surgeon, rehabilitation specialist, athletic trainer and physical therapist – and the patient him/herself. Our doctors have specialized training in the diagnosis, treatment and prevention of sports injuries, and can help athletes return to their favorite activities as quickly as possible through the most advanced, minimally invasive treatments available. Injury Prevention One of the main goals of our Sports Medicine Center is INJURY PREVENTION. Our doctors have spoken to local community groups, clubs, and coaching organizations about injury prevention for adolescent to masters athletes. We are active participants in promoting the STOP Sports Injuries program, an initiative started in 2007 by the American Orthopaedic Society for Sports Medicine/American Academy of Pediatrics to raise awareness of injury prevention and to offer education to extend an adolescent's athletic career. We offer educational materials for athletes, parents, and coaches regarding prevention of sport specific injuries, tips on recognizing an injured athlete, and discussing injuries with your child's coach at our office locations. As the number of athletes increases yearly, both the incidence and prevalence of sports injuries has increased. Several programs have been developed and distributed to aid in the prevention of injuries including anterior cruciate ligament (ACL) tears. We favor a prevention program that includes a warm-up, stretching program, strengthening program, and plyometric program. Several programs also include sports specific conditioning. The 11+ is a soccer specific prevention program recently shown to have contributed to a significant decline in the number of injuries in players. Materials can be downloaded at www.f-marc.com/11plus. Two excellent ACL prevention programs are available for female athletes at www.girlscanjump.com and www.smsmf.org. All of these programs are recommended for athletes 13 years and older. Baseball and Softball Programs Baseball and softball remain popular sports for adolescents, high school and collegiate athletes, and even the weekend warriors. These overhead athletes require specialized treatment and rehabilitation plans. The physicians and physical therapist at the Sports Medicine Center offer a comprehensive rehabilitation program for injuries to the pitching and batting shoulder, elbow, and wrist. Our rehabilitation programs are designed around the specific needs of the injured extremity and include the most recent and advanced concepts regarding the treatment of these injuries. Many of these injuries can be treated without surgery. At the end of a successful rehabilitation program, we offer interval training and throwing programs that can be performed with the athlete's parents or coaching staff to complete their recovery and transition back to play. We offer interval programs to complete the rehabilitation for a number of other athletic pursuits including golf, tennis, and volleyball. Arthroscopic procedures for the shoulder and elbow are minimally invasive, allow for evaluation of the entire joint, and are available to treat the overhead athlete. These procedures can be used for debridement of lateral epicondylitis in the elbow, labral repair in the shoulder, and even rotator cuff repair. Open ligament procedures about the elbow including direct ligament repair or ligament reconstruction (Tommy John) are also part of our treatment program. Knee Ligament and Cartilage Injuries As the level and intensity of competition rises, injury can occur to the knee ligaments and the articular cartilage (joint cartilage). We offer a wide range of services for the injured knee including the most current concepts in anterior cruciate ligament reconstruction (ACL). Meniscal injuries are often seen in the injured knee with an ACL tear. Operative techniques including arthroscopic meniscus repairs can be combined with the ACL reconstruction and newer “all-inside” techniques avoid the need for additional incisions. More advanced options such as meniscus transplantation are also part of our treatment pathway. The joint cartilage or articular cartilage can be damaged acutely (at the time the injury occurred) or through “wear and tear”. These injuries can sideline young and middle aged athletes. Conservative options are tried first and include bracing, corticosteroid injection, and viscosupplementation injections like Synvisc.

Common Causes of Shoulder Pain Your shoulder is a wonder of movement. As a ball-and-socket joint, its anatomy is complex and its range of motion versatile. But with this wide range of motion comes the risk for injury and shoulder pain. Shoulder pain can also result from simple wear and tear—problems that are common after age 60. Symptoms include: pain over the outside of the shoulder shoulder stiffness and limited mobility pain when reaching or throwing dull ache deep inside the shoulder pain that interferes with falling or staying asleep Common Causes of Elbow Pain Your Elbow is a wonder of movement. As a complex hinge joint, its anatomy for the flexion and extension of the forearm relative to the upper arm, as well as rotation of the forearm and wrist. With this wide range of motion comes the risk for injury and Elbow pain. Elbow pain can also result from simple wear and tear—problems that are common around age 40. Symptoms include: pain over in or adjacent to the elbow elbow stiffness and limited mobility pain when reaching or throwing dull ache deep inside the elbow pain that interferes with falling or staying asleep Common Causes of Hand and Wrist Pain Your Hands and Wrists are a wonder of movement. As an ellipsoidal type synovial joint, allowing for movement along two axes, and connects with the complex joints of the hand for a wide range of motion. With this range of motion comes the risk for injury and pain. Wrist or Hand pain can also result from simple wear and tear—problems that commonly begin between the ages of 20 and 40. Symptoms include: numbness or tingling in the hand pins and needles in the hand tenderness dull ache deep inside the wrist or hand pain that interferes with falling or staying asleep