According to OAM physical therapy director, Jeffery D. Regan, “Research cannot definitively say one protocol is best.” He prefers the old-fashioned way: warm up, stretch, run, cool down, and stretch again.

warm up
A low grade warm up initiates the cardiovascular system and prepares muscle fibers, ligaments, tendons, and joints to work at a higher level. A good rule of thumb is to “get the heart rate up to the point of having a little sweat,” says Regan.

stretch (before and after)
There are two kinds of stretches—static and dynamic—both of which should be performed and often get ignored by runners. A good static stretch is held for about 1 minute and targets major muscles: hamstrings, quads, hip flexors, IT bands, low/upper back, chest, and shoulders. A dynamic stretch involves large, exaggerated ranges of motion—like lunges or quicksteps—that activate joints and muscle groups that may not be reached from an isolated, static stretch.

cool down
“If you’re functioning at a very high level, a proper cool down is as simple as a fast-paced walk for 5-10 minutes,” Regan recommends. “Allow your body to get the lactic acid out of its system.”

But, proper running preparedness involves more than pre- and post-activity body prep.
Learning how you run and when you should run can be just as important for performance optimization and injury prevention.

foot type
Foot type affects how you run. “There’s all different types of feet, which affects how you land, how you strike, how you push off,” explains Regan. Knowing their foot type can help runners select the right equipment designed for their specific needs. “Overpronators typically have a more floppy foot, without much rigidity, and may have a harder time pushing off. Anti-pronation shoes or stability shoes are available for them. Whereas supinators have higher arches and tighter calves, and there are shoes built for them, too.”

cross-training
Many runners training for a long race will run everyday, slowly adding more distance over time. “While that is good,” says Regan, “you’re almost subjecting yourself to the possibility of an overuse injury, because you’re constantly using the same muscles, joints, tendons, and ligaments.”  Alternating other cardiovascular exercises—like swimming, biking or weight-training—with your running schedule may save you some pain down the road.

Here are three tips from Regan for a safe and healthy running season:

1. Get your feet and flexibility checked. “With a quick physical therapist evaluation, you can learn what your biomechanics look like, how your lines look, if you have hip drop, etc. This especially applies to new runners who are getting ready to train for something they haven’t done before.”
2. Hydrate, hydrate, hydrate. Flush your body with fluids over the last days leading up to the race.
3. Give yourself enough prep time. “Don’t go straight to the starting line expecting everything’s going to be okay. Go to the race with plenty of time to do a proper warm up. I don’t know many runners who are willing to spend 30-40 minutes warming up and stretching. But when they do, it always aides in the mechanics of how well you perform.”

25K starting line at the 36th annual Fifth Third River Bank Run in Grand Rapids, MI. (Courtesy of MLive.com)

Orthopaedic Associates of Michigan, the largest independent orthopaedic practice in the state of Michigan, is among 101 area businesses selected for best practices in human resources.  The company improved its rankings in seven of the 10 key performance areas when compared to 2012, ranking in the 90th percentile among comparable organizations for work-life balance and 73rd percentile for strategic company performance. OAM also had a strong ranking in the employee engagement and commitment category.

“We recognize that our employees are the driving force that makes OAM one of the top orthopaedic practices in the country,” said Mary Dale, director of clinical resources and human resources at OAM. “This recognition is reflected in the fact that the C-suite executives and physician owners look to HR when making long-term decisions that will affect the staff. It’s my job to work along side the staff, identify areas for improvement, offer opportunities for professional development and find ways to continuously improve processes and work flow for the staff.”

According to the MBPA, an independent research firm evaluates each company’s entry based on key measures in compensation, benefits and employee solutions; employee enrichment, engagement and retention; employee education and development; recruitment, selection and orientation; employee achievement and recognition; communication and shared vision; diversity and inclusion; work-life balance; community initiatives; strategic company performance and the “Best of the Best Small Business.”

“Profitability and stability are essential for businesses in today’s economic climate,” said MBPA President Jennifer Kluge. “Companies that recognize that their employees are the key to their success, achieve staying power. Our 2013 winners style their business standards to ensure employee satisfaction, and they set standards for every business to aspire toward.”

Selected companies will be honored by the MBPA on Thursday, May 2 at The Pinnacle Center in Hudsonville.

Congratulations to Doctors John Anderson, Mark Asperheim, David Bielema, Donald Bohay, Robet DeMaaagd, John Maskill – Look for them here

PRESS RELEASE

Orthopaedic Associates of Michigan Opens First-of-its-Kind Urgent,
Specialized Orthopaedic Care Program in West Michigan

OAM NOW gives patients a choice for timely, affordable and quality urgent orthopaedic care

GRAND RAPIDS, Mich. – Feb. 18, 2013 – All it takes is one sports injury or twisted ankle from a slip-and-fall accident to realize that receiving urgent, specialized orthopaedic care can be a long, painful and expensive process – until now.

Orthopaedic Associates of Michigan(OAM), Michigan’s largest independent orthopaedic practice, has launched OAM NOW, a new program dedicated to providing urgent, specialized orthopaedic care requiring no wait and no referrals. The program – which features extended hours
until 9 p.m., a dedicated triage nurse and on-site support services such as MRI and physical therapy – is the first of its kind in West Michigan.

“Almost everyone at some point will experience an orthopaedic injury, whether through a household accident or sports injury. The immediate question is: ‘Where do I go for help?’” said Dr. Jim Ringler, president of OAM. “Our goal with OAM NOW is to take out the guesswork and give people the timely, specialized treatment they deserve – even if it’s after 5 p.m.”

The concept behind OAM NOW is that if patients suspect they have an orthopaedic injury*, they can bypass a hospital ER or med center and see an orthopaedic specialist, even in the evening – saving time, cost and discomfort. OAM NOW patients will be seen promptly for urgent needs by one of OAM’s 30 fellowship-trained orthopaedic surgeons who specialize in specific areas of motion, including spine, joints, hands and feet. Patients can receive most diagnostic and treatment services for acute conditions on-site, including MRI and radiology, physical therapy, occupational therapy and custom splinting.

“Anyone who has been to an ER for an orthopaedic injury knows you get in line with people who have the flu and everything else under the sun, and you wait,” said Ringler. “Even if you are seen fairly quickly, you won’t meet a specialist until the next day or longer. Meanwhile, you have paid the high cost of an ER visit, and you are still in pain.”

The OAM NOW program, located at 2680 Leonard St., NE in Grand Rapids, gives patients access to OAM’s established specialized orthopaedic services, with the following convenient features:

• Evening hours: OAM NOW is open until 9 p.m. to treat after-hours urgent orthopaedic injuries, since many orthopaedic accidents
  happen in the evening.
• Triage nurse: OAM NOW has a full-time triage nurse reachable at 855-OAMNOW1 dedicated to answering questions, managing urgent orthopaedic injuries and scheduling urgent care visits.
• On-site support services: Most diagnostic and intervention services are available on site, including advanced diagnostic technologies such as MRI and radiology equipment, physical therapy, occupational therapy and custom splinting.

While it is the first of its kind in West Michigan, the OAM NOW concept follows a growing national trend where more than 50 orthopaedic practices have added urgent care programs in major metropolitan areas around the United States.

* Orthopaedic injuries usually consist of non-chronic sports injuries, back and neck pain, muscular pain, strains, sprains, pinched
nerves and fractures. OAM NOW is not available for chronic conditions, chronic pain, acute paralysis, missed appointments, second opinions or narcotic medication refills.

About Orthopaedic Associates of Michigan
Founded in 1935, Orthopaedic Associates of Michigan (OAM) is the largest independent orthopaedic practice in Michigan and one of the most comprehensive practices in the state. OAM is comprised of eight specialized centers of excellence, providing total orthopaedic care – from diagnosis, to surgical and nonsurgical intervention, to rehabilitation therapy and wellness. OAM has four convenient locations throughout Grand Rapids, Mich., including its main campus at 1111 Leffingwell Ave. NE. Visit www.oamichigan.com to learn more.

About OAM NOW
Orthopaedic Associates of Michigan (OAM) features OAM NOW, a program dedicated to providing urgent, specialized orthopaedic care requiring no wait and no referrals. The program features extended hours until 9 p.m., a dedicated triage nurse and on-site support services such as MRI and physical therapy and is the first of its kind in West Michigan. Visit www.OAMNOW.com to learn more.

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Take Your Time

Remember, moderation is the key to safe exercise. If you take off a month or two from exercising, don’t expect to pick up where you left off. Getting in shape takes time and it’s important to listen to your body to avoid injury.

Diet + Exercise = Success

Proper nutrition and exercise complement each other well. Staying on track with nutrition can be difficult, but it’s important to give your body plenty of fruits, vegetables, lean meats and water.

Warm Up

It’s important to prepare for an exercise even before stretching. You can do this with a few jumping jacks, breathing slowly and deeply, or slowly going through the motions of the exercise.

Stretch

Stretching can help decreases muscle stiffness and increases range of motion. Never stretch to the point of pain and always maintain control. After a hard workout, stretching the muscles will keep them loose to avoid post-workout aches and pains.

Safe Equipment

When exercising in cold weather, dress in layers that can be removed and wear comfortable, loose-fitting clothes that are light are better for releasing body heat. Use shoes that provide you with support and are not too worn. Make sure you know how to properly use a piece of exercise equipment before trying it out.

Multiple Exercises

When you work out you should try to incorporate cardiovascular, strength, and flexibility exercises to keep you from getting bored. This combination of exercises will also lessen your chances of injury.

Drink Water

Always have enough to avoid dehydration, heat exhaustion, and heat stroke. It’s a good idea to drink one pint of water 15 minutes before you start exercising and another pint after you cool down. Have a drink of water every 20 minutes or so while you exercise.

Cool Down

A good cool down should last twice as long as your warm up. Slow down and lessen the intensity of your exercise for at least 10 minutes before you stop completely.

Rest

Scheduling regular days off helps your body recover. Fatigue and pain are also good reasons to avoid exercising.

For questions or to schedule an appointment with an OAM physician, please call 616-459-7101 weekdays 8 am – 5 pm.

Following are several tips to help prevent falling while walking on the ice.

• Select proper footwear. No single shoe sole material is perfect under all conditions, however, footwear with rubber or neoprene composite soles provides better traction on ice and snow than leather or plastic.
• Walk consciously. Be alert to the possibility that you could quickly slip on an unseen patch of ice. Avoid the temptation to run to catch a bus or beat traffic when crossing a street. You can test your travel path by sliding your shoe or boot on it to see if it is slick.
• Walk cautiously. Your arms help keep you balanced, so keep hands out of pockets and avoid carrying heavy loads that may cause you to become off balance.
• Walk “small.” Avoid an erect, marching posture. Look to see ahead of where you step. When you step on icy areas, take short, shuffling steps, curl your toes under and walk as flatfooted as possible. Spread your feet our slightly like a penguin. Walking like a penguin on ice increases your center of gravity.
• Many injuries occur when entering or exiting a vehicle. Be particularly careful and hold onto you vehicle to help support yourself.
• Be sure you remove snow immediately, before it becomes packed down and turns to ice. Pay special attention to your porch stoops, steps, sidewalk and driveway by applying ice melt. This is the best way to prevent the formation of ice patches.

The most common injuries we see at OAM due to winter slips and falls are neck and back strain and broken wrist, elbow or hand. While falling, it is instinctive to try and catch yourself, which is why so many patients we see have landed on their hand incorrectly, causing the wrist, hand or elbow to break. If you experience an injury while falling, or develop pain that persists after falling, it is important to see a doctor to determine the type of injury and its severity.

If you feel yourself starting to fall, try to avoid landing on your knees, wrists or back. Try to fall on a fleshy part of your body, such as your side. If you are able to relax your muscles when you fall, you may injure yourself less.

Senior citizens are particularly susceptible to slipping and falling. If you have an elderly relative or neighbor, be sure to check on them often, see if you can help keep their walkway and driveway clean and safe. Consider helping your elderly neighbors or family members by running errands for them so they do not have to go outside during icy conditions.

If you have fallen and are experiencing pain or have an injury, the doctors at Orthopaedic Associates of Michigan can help. Please contact OAM at 616-459-7101 for an appointment.

Sources:
SeniorYears.com, WebMD, http://safety.lovetoknow.com/snow-safety-falling

While prosthetic knees are expected to last as long as 20 years, the failure rate due to improperly balanced replacements or post-operative infection is a serious concern, since do-overs cause patients additional suffering and are more costly than the original operation.

IMPROVE OUTCOMES

OrthoSensor, a small company based in Sunrise, has developed a high-tech device that provides real-time data to orthopedic surgeons during knee replacement surgery and could help improve outcomes and reduce failure rates in this increasingly common operation.

The four-year-old company, which so far has raised $42 million in venture capital, is also advancing work on other implantable devices for orthopedic patients, including tiny units that electronically transmit data to physicians and nurses on internal temperature, blood acidity levels and other indicators that can be used to detect infections following orthopedic surgeries, as well as implants that send out sound waves to assess bone density.

“Our lives have been transformed by new technology in computer programming, cell phones, the Internet and miniaturization,” said Jay Pierce, the company’s president and CEO. “Everything is getting smaller. We have combined advanced technology, wireless communications, sensors and microelectronics to produce ‘intelligent orthopedics,’ devices that improve outcomes in musculoskeletal disease and reduce healthcare costs,” said Pierce, who has worked in the medical device, technology and communications sectors for more than 27 years.

The company’s first product, the OrthoSensor Knee Balancer, contains sensors that help orthopedic surgeons properly balance a knee implant by transmitting data over a wireless system to a computer screen during the operation. Using this data on the screen, they can make adjustments to soft tissue around the knee and optimize implant placement.

The goal of this device, now being used in trials by 30 hospitals and orthopedic teaching centers in Florida, New York, Michigan and 12 other states, is to achieve extremely accurate implant placement that will improve function of the new knee and reduce the need for costly revision surgery.

The knee balancer, which costs about $500 and is made in Phoenix, is used only once and then discarded to avoid the possibility of infection. It received approval from the U.S. Food and Drug Administration in late 2010 and took about two years to develop.

Before the OrthoSensor Knee Balancer was available for trials earlier this year, surgeons relied on their knowledge, experience and the “feel” of the implant and the patient’s leg to decide if a new knee was properly balanced.

“When we do knee replacements today, surgeons make their cuts, plant the prosthesis and then test how the prosthesis feels in their hands. That is the art to the procedure,” said Dr. Martin Roche, chief of orthopedics and director of the Holy Cross Orthopedic Institute in Fort Lauderdale, who developed the idea for the knee balancer and founded OrthoSensor in 2008.

‘OPTIMUM RESULT’

“If one of the ligaments on each side is tight or loose, that is judged by the surgeon as he tensions and sees how the knee moves,” added Roche, who trained at the University of Miami and has been working in joint replacement at Holy Cross for the last 15 years. “With OrthoSensor, we’re integrating sensor technology into the trials, so now I can quantify how tight or how loose I am in that patient’s knee joint. This allows me to loosen or tighten ligaments, change the rotation of the implants or use different thicknesses in the bearings to obtain the optimum result.

Despite their many years of training and experience, orthopedic surgeons up to now could not count on precise data about the alignment and balance of knee replacements.

“We developed the knee balancer to deal with the unmet need of avoiding and reducing implant failure, which can be caused by misalignment or infection,” OrthoSensor’s CEO said. The cost of revisions — or redoing knee and hip implants — will reach an estimated $8.6 billion by 2015, Pierce added, and each revision normally costs more than the original operation. About seven percent of all knee replacements need revisions each year, he said, and 35 percent of all implant failures occur within two years of the original operation.

“We are very much focused on improving clinical outcomes and reducing costs,” said Pierce, whose company has grown to about 30 employees.

Roche, who holds multiple patent applications and has served as a consultant to DePuy Orthopedics and the Florida Marlins, so far has done more than 250 knee replacements with the OrthoSensor Knee Balancer and is educating other surgeons on its use.

Dr. Alejandro Gonzalez Della Valle, an orthopedic surgeon based in New York City, has been using the OrthoSensor Knee Balancer for the last several months. “OrthoSensor is doing something orthopedic surgeons have needed for a long time,” said Gonzalez Della Valle, who is associate attending orthopedic surgeon at the Hospital for Special Surgery in New York City.

‘REAL TIME’

“This device gives a very accurate measurement that corresponds to the pressure of the ligaments. You get the information in real time,” he added. “It makes knee surgery much more precise and it helped me be a better surgeon.”

Gregory J. Golladay, M.D., an orthopedic surgeon who specializes in minimally-invasive knee replacement and hip replacement at the Orthopaedic Associates of Michigan in Grand Rapids, has been using the OrthoSensor Knee Balancer since the first quarter of this year. “Many patients say that the new knee feels normal, and prior to OrthoSensor this was not unheard of, but was unusual,” he said.

Orthopedic surgeons will do about 660,000 knee replacements this year in the U.S., and one-sixth will be revisions, added Golladay, who was a consultant to OrthoSensor and helped develop the device. The results of the current trials using the OrthoSensor could show that it plays an important role in reducing the need for revisions.

Aside from the knee balancer, OrthoSensor is also working on other devices to provide physicians with real-time data on implants during and after operations. Scheduled for launch in 2013 are new OrthoSensor devices for knee alignment and hip positioning surgeries. Implants that can monitor load, range of motion, and loosening are projected to be available in late 2014.

Using microelectronics and the latest technology, other implants under development will be able to provide data on infection, pain and bone density. Batteries in these implantable devices are designed to last 20 years.

DEVELOPING PRODUCT

Roche, who for many years was interested in using sensors and technology for surgery and patient care, worked with Fort Lauderdale-based Mako Surgical Corp. in 2005-2006 to help develop its RIO Robot arm for orthopedic surgery. He later met with engineers from Medtronic, a medical technology company, to discuss how sensors he had acquired in Israel might be used in medicine.

Roche and one of the engineers, Marc Stein, now chief technology officer at OrthoSensor, began collaborating. Roche subsequently met Pierce, then the CEO of Visible Assets, a company that made radio frequency identification tags for patients, and the three decided to work together at OrthoSensor.

“I always was interested in advanced technology, saw a medical need and was able to put the best team together,” Roche said. “With Baby Boomers aging, we’re expecting more knee replacements, and we will be expanding to other joints.”

BY JOSEPH A. MANN JR.
JOSEPHMANNJR@GMAIL.COM

Original Article: www.miamiherald.com

Foot and ankle problems have historically been under appreciated. Luckily within the past 15 years, better understanding of these problems, and ways to treat the problems have improved. With 28 bones and 34 joints in each foot, there are several possible reasons for foot pain, and many potential injuries and conditions that could occur.

Foot problems can be broken down into two categories – traumatic and non-traumatic causes.  Foot and ankle trauma has become more common and its treatment has become more complex, incorporating principles of anatomic reduction and rigid stabilization of injured bones and joints. Non-traumatic causes of foot pain can be harder to identify and may not be as obvious.

Foot pain is not normal, yet people experience it every day. Pain can be due to a variety of conditions, such as:

• Trauma
• Heel pain
• Plantar fasciitis
• Achilles tendonitis
• Bunions
• Arthritis
• Corns
• Calluses
• Hammertoes
• Flatfeet
• High arches

Feet have to function as levers and shock absorbers, especially considering that they support three times body weight when walking and 10 times body weight when running. It is necessary to take care of your feet, ankles and legs, as alterations in foot alignment or flexibility can adversely affect the ankle and leg, and vice versa.

Luckily, many conservative treatment options are available to maintain good foot health, and help prevent pain.

Daily stretching exercises can drastically cut down on foot pain.

• Exercises (see image)
• Shoe Modifications (i.e. soft heel, heal lift, widenedheels, stiff sole, extra depth shoe and soft leather shoes)
• Orthotics (any device that is placed inside the shoe to redistribute pressure or accommodate a deformity)
• Braces

Individuals with diabetes need to pay extra attention to their feet. It is important that they examine their feet often for any problems that may be found. Diabetic patients can have glucose issues that affect their nerves, which may make it difficult for them to feel problems with their feet.

For traumatic injuries or severe medical conditions of the feet, surgical treatment is an option. Surgical treatment can help restore function, allow for better shoewear, reduce pain, correct deformities, treat infections and fix traumatic injuries.

John G. Anderson, MD specializes in comprehensive treatment of foot and ankle disorders at OAM, including conservative and surgical care. Following is a question and answer session with Dr. Anderson in relation to foot and ankle problems he regularly helps patients with.

Q: What are the most common foot and ankle problems that patients come to you with?

A: The most common conditions that I see in patients include plantar fasciitis, heel pain, arch pain, forefoot pain, hammertoes, flatfeet, arthritis, broken bones, sprains strains corns and callusses.

Q: What are the most frequently asked questions that you are asked by patients who are experience the particular problems mentioned above?

A: All patients want to know what they can do to make the problem better. They inquire about the best ways to exercise to help their feet, if there are shoes I would recommend, if shoe inserts would help and if I feel surgery would be necessary to fix the problem that are having.

Q: What sets OAM apart from its competitors in regards to treating foot and ankle problems?

A: OAM has a comprehensive approach to treatment of foot and ankle problems.  We are a training institution involved in training of medical students, residents, and fellows from around the country and the world.  We do extensive research and have critically examined all of our outcomes and published in peer reviewed journals.  We are also a center of excellence in foot and ankle care and are recognized around the world as a tertiary treatment center for foot and ankle care.  We travel and lecture extensively to teach surgeons around the world and report on our techniques and outcomes and are leaders in our international organization, the American Orthopaedic Foot and Ankle Society, which is the largest group of orthopaedic physicians (non Podiatric) specializing if foot and ankle care.  We also strive to provide a friendly and compassionate professional approach to our community.

Q: Are you conducting any cutting-edge treatment options to help foot and ankle patients? We would like to share any details about treatments you are using that set you apart?

A: Many. We innovate and consult with industry to identify the latest cutting edge treatments and study them to scientifically validate the effectiveness of treatment.  Examples include  flatfoot reconstruction, fixation techniques for reconstruction, total ankle replacement (one of the largest centers in the US),  and new treatments for heel pain, to name a few.

If you are experiencing foot problems, please contact the Foot & Ankle Center at Orthopaedic Associates of Michigan at 616-459-7101. We will be happy to help treat your problem, and send you off on the right foot!