Understanding ACL Reconstruction and Recovery

ACL Reconstruction: Insights into the Procedure and Recovery

ACL reconstruction is a critical surgical intervention designed to restore knee stability and function following an anterior cruciate ligament (ACL) injury. This prevalent injury, particularly among athletes and active individuals, often results in pain and instability. Understanding ACL reconstruction repair, including its necessity, execution, and recovery process, is essential for anyone contemplating reconstructive knee surgery.

ACL reconstruction surgery is performed to replace the torn Anterior Cruciate Ligament (ACL) in the knee. The ACL is integral to knee joint stability, and injuries to this ligament are common in active individuals. The surgery involves reconstructing the damaged ligament using a graft sourced either from the patient or a donor, aiming to restore knee stability and mobility.

The primary goal is to enable patients to return to their pre-injury activity levels, especially in sports requiring quick direction changes, jumping, and pivoting. The surgery alleviates pain and swelling associated with knee instability and prevents further damage to the knee joint and surrounding structures.

Indications for ACL reconstruction repair include severe knee instability, difficulty engaging in physical activities, and recurring episodes of the knee giving way. Those with significant ACL tears, often diagnosed through physical exams and imaging tests, may find reconstructive knee surgery very beneficial, leading to improved knee function and enhanced life quality.

An ACL tear can drastically affect mobility and quality of life. Typical symptoms include a popping sound at the time of injury, swelling, instability, and an increase in pain when weightbearing. These symptoms prompt medical evaluation to assess injury severity and treatment options.

Not all ACL tears necessitate reconstructive knee surgery. Surgical candidacy depends on tear severity, patient age, activity level, and overall health. A thorough assessment by an orthopedic specialist, including physical exams and imaging such as an MRI and X-rays will initiate the diagnosis and treatment plan. The evaluation typically covers motion range, stability, and related injuries, such as meniscus or other ligament damage, forming a tailored treatment plan to guide recovery and determine if ACL reconstruction is essential for optimal knee function and return to activities.

The procedure begins with the patient under general or regional anesthesia. The Surgeon will make small incisions around the knee, using an arthroscope—a small camera—to guide the process. The damaged ligament is removed through a process called debridement, and a graft is prepared as a replacement. Grafts may be harvested as an autograft (tissue taken from the patient’s own body) or an allograft (donor tissue), commonly utilizing the patellar tendon (tendon below the kneecap), hamstring tendon (tendons at the back of the thigh), or quadriceps tendon (tendon above the kneecap).

Many athletes prefer autografts for quicker recovery, while allografts may be chosen for convenience and reduced donor site complications. Each option offers distinct advantages and is mutually determined by the Surgeon and patient prior to surgery based on the patient’s needs and activity level.

ACL Reconstruction Graft Harvest to repair an ACL Tear with Dr Craig Yager

ACL Reconstruction Graft Harvest to help repair an ACL Tear. Performed by Dr Craig Yager

Recovery from ACL reconstruction is progressive, varying per individual and spanning between six months to a year on average. Recovery is influenced by the injury severity, patient’s overall health, and strict adherence to the surgeon’s post-operative protocols. Early recovery weeks focus on swelling reduction and motion range restoration, progressing to weight-bearing activities and physical therapy.

The post-operative care is one of the most crucial determinations of a successful ACL Reconstruction recovery. Patients typically engage in a progressive rehabilitation program to restore knee strength and mobility. Initial care involves pain management and healing monitoring, then following surgeon guidelines, the start of rehabilitation including at-home exercises, specialized physical therapy, and follow-up appointments to assess progress.

Initially, exercises are aimed at strengthening the quadriceps and hamstrings, enhancing balance, and improving flexibility. As recovery advances, dynamic exercises and sport-specific drills restore function and prepare for a safe return to the patient’s activities. Adherence to the patient’s tailored rehabilitation program, lifestyle choices such as nutrition and rest will significantly enhance recovery outcomes after reconstructive knee surgery.

While ACL reconstruction is common and generally safe, it’s important to understand potential risks. Common risks, as with any surgery include infection, bleeding, and anesthesia reactions. If any of the previously instances occur, contact your Surgeon’s office.

On rare occasions, long-term complications can arise post-surgery, such as persistent pain, knee joint instability, or potential re-injury. To mitigate risks, follow your pre-operative and post-operative instructions diligently during ACL reconstruction surgery recovery.

Lastly, some patients may experience knee stiffness post-surgery however, following post operative rehabilitation protocols should minimize stiffness long-term. One of the best things to do prior to surgery is Prehabilitation—strengthening the knee muscles before surgery as best as you can. This can greatly enhance recovery outcomes and recovery time.

As mentioned, strict adherence to the structured post-operative rehabilitation protocol prescribed by your surgeon—combined with optimal nutritional support and sufficient rest—will significantly enhance your recovery. This comprehensive approach is essential for restoring knee function and stability, ultimately facilitating a safe and effective return to your regular activities.

To learn more about the sports specific injury treatments available at Colorado Springs Orthopaedic Group, visit the CSOG Sports Medicine Center page

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Understanding Shoulder Anatomy

The shoulder is one of the most complex joints in the human body and has the largest range of motion among all other joints. This intricate structure is comprised of several key components, including bones, muscles, tendons, ligaments, and eight distinct planes of motion. Let’s take a deep dive into each of these components to gain a better understanding shoulder anatomy.

Bones of the Shoulder Anatomy

The shoulder is primarily made up of three bones: the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). These bones work together to provide stability and mobility to the shoulder joint.

– Humerus: The humerus is the long bone in your arm that extends from the shoulder to the elbow. Its rounded head fits into the shallow socket of the scapula, forming the ball-and-socket joint of the shoulder that allows the shoulder to have a 360 degree range of motion.

– Scapula: The scapula is a triangular-shaped bone located on the upper back. It provides attachment points for several muscles and forms the back part of the shoulder socket.

– Clavicle: The clavicle is a long, S-shaped bone that connects the scapula to the sternum (breastbone). It helps to support the shoulder and allows for a wide range of motion.

Together, these bones create the Glenohumeral Joint and the Acromioclavicular Joint.

Bones of the shoulder, glenohumeral joint, acromioclavicular joint

Muscles of the Shoulder

The shoulder is supported by a group of muscles known as the rotator cuff, along with several other muscles that help to stabilize and move the shoulder joint.

– Rotator Cuff Muscles: The rotator cuff is made up of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles work together to stabilize the shoulder joint and facilitate rotational movements. An example of an external rotational movement would be the backstroke when swimming. As the swimmer’s arm moves out of the water and rotates back into position for the next stroke, the shoulder is externally rotating. Alternatively, during a front crawl / freestyle stroke in swimming, when the swimmer’s arm exits the water and moves forward to re-enter the water, the shoulder internally rotates. Give this a shot as you’re reading this blog and notice the natural change in direction your hand takes as your shoulder moves through these motions.

– Deltoid: The deltoid is a large triangular shaped muscle that covers the glenohumeral joint. It is responsible for lifting the arm and giving the shoulder its rounded shape. This muscle can be divided into three heads: the anterior head, lateral or middle head, and the posterior head, each of which originate from the clavicle or scapula, and connect to the humerus.

– Trapezius: The trapezius is a large muscle that extends from the neck to the middle of the back. It helps to stabilize and perform many movements of the shoulder such as elevating and depressing the shoulders and internally and externally rotating the arm.

– Rhomboids: The rhomboids are two muscles located in the upper back that aid in retraction of the shoulder blades.

– Pectoralis Major: The pectoralis major is a large muscle located in the chest that helps to flex, rotate, and move the arm towards the midline of the body.

Rotator Cuff Muscles

Deltoid

Trapezius

Rhomboids

Pectoralis Major

Tendons and Ligaments in Shoulder Anatomy

Tendons are tough, fibrous tissues that connect muscles to bones, while ligaments are thick, fibrous bands that connect bone to bone. Tendons and ligaments work together and play crucial roles in providing stability to the shoulder joint:

– Rotator Cuff Tendons: The tendons of the rotator cuff attach the rotator cuff muscles to the humerus and stabilize the shoulder joint during facilitated movements.

– Ligaments of the Shoulder: The shoulder joint is supported by several ligaments, including the glenohumeral ligaments, the coracoclavicular ligament, and the acromioclavicular ligament. These ligaments help to reinforce the shoulder’s stability and prevent injuries such as a dislocation.

Shoulder Planes of Motion and Movement Patterns

As mentioned, the shoulder joint is capable of an impressive range of motion and movement in multiple planes. The primary planes of motion of the shoulder include:

– Flexion and Extension: Flexion is the action of bringing the arm forward, while extension moves the arm backward. An example of this is when you are running, the motion you perform with your arms is flexion and extension of the shoulder.

– Abduction and Adduction: Abduction raises the arm away from the body, while adduction brings the arm toward the body. Think of when you perform a jumping jack, when you raise your arms over head, you are performing abduction of the shoulder. When you bring your arms back down to your sides, you are performing adduction of the shoulder.

– Internal and External Rotation: Internal rotation involves rotating the arm inward, while external rotation involves rotating the arm outward.

– Horizontal Abduction and Adduction: Horizontal abduction is the movement of moving the arm away from the midline of the body, while horizontal adduction is the movement of bringing the arm back toward the midline. Think of opening your arms to hug a loved one, that is horizontal abduction of the arms. When you hug your arms around that person, this motion is horizontal adduction.

The shoulder’s intricate structure of bones, muscles, tendons, and ligaments makes it an incredibly impressive joint, essential for many daily activities and athletic pursuits. However, this same complexity also makes the shoulder susceptible to numerous injuries. Understanding the components and movement patterns of the shoulder is crucial for maintaining its health and preventing potential issues.

Learn more about the shoulder and the different treatment options available for many common injuries and conditions by visiting our blog page

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If you or a loved one are experiencing shoulder pain that just won’t go away, give us a call. Our experts are all fellowship trained, board certified, and equipped to help you get back to the things you love to do as efficiently as possible.

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Understanding Adult Scoliosis

Scoliosis, a condition characterized by an abnormal curvature of the spine, is often associated with adolescents. However, adults can also develop scoliosis, and it can significantly impact their quality of life without proper management. Come with us as we dig into adult scoliosis, the various types, its causes, treatments, even a few physical therapy exercises you can try at home.

Types and causes of Adult Scoliosis

Adult Scoliosis can be classified into four primary types, each classified by the diagnosed cause:

Degenerative scoliosis: This is the most common type in adults and is caused by the degeneration (wear and tear) of the spine’s discs and joints. It typically occurs after the age of 40 and can worsen over time.
Idiopathic scoliosis: While this type is more commonly associated with adolescents, it can also persist into adulthood. Idiopathic scoliosis has no known cause.
Secondary scoliosis: This type is caused by another condition or factor, such as a spinal injury, muscle weakness, or neurological disease.
Kyphoscoliosis: This is a combination of scoliosis and kyphosis, where the spine has both a lateral curvature (scoliosis) and an abnormal outward curvature of the upper back (kyphosis).

Adult-onset scoliosis is a more general term for Adult Scoliosis used to describe any form of scoliosis that develops or is diagnosed in adulthood, encompassing degenerative, idiopathic, and secondary types.

Symptoms of Adult Scoliosis

Symptoms of adult scoliosis can vary in severity, however common signs include:

Uneven shoulders or waist
One hip higher than the other
Back pain or discomfort
Numbness or weakness in the legs
Difficulty standing upright or walking for extended periods

Treatment Options for Adult Scoliosis

The primary goal of treatment for adult scoliosis is to relieve pain, improve function, and prevent the progression of the spinal curvature. Options include:

Non-Surgical Treatments:

Physical Therapy: Tailored exercises to strengthen the core and improve posture.
Bracing: In some cases, a brace may be recommended to support the spine.
Medications: Pain relievers and anti-inflammatory drugs can help manage discomfort.

Surgical Treatments:

Spinal Fusion: This procedure involves fusing two or more vertebrae to correct the curvature and stabilize the spine.
Decompression Surgery: This surgery relieves pressure on spinal nerves caused by the curvature.

Physical Therapy Exercises for Adult Scoliosis

Physical therapy plays a crucial role in managing adult scoliosis. Below are a few exercises that have proven to be effective for many individuals:

Pelvic Tilts:

Lie on your back with your knees bent and feet flat on the floor.
Tighten your abdominal muscles and press your lower back into the floor.
Hold for a few seconds and then relax. Repeat 10-15 times.

Cat-Camel Stretch:

Get on your hands and knees.
Arch your back towards the ceiling (cat position) and then lower it towards the floor (camel position).
Perform this stretch slowly and repeat 10 times.

Latissimus Dorsi Stretch:

Stand with your feet shoulder-width apart.
Raise your arms above your head and lean to one side, feeling a stretch along the side of your body.
Hold for 20-30 seconds and switch sides. Repeat 3-5 times on each side.

Plank:

Lie face down and lift your body onto your forearms and toes.
Keep your body in a straight line and hold for 20-30 seconds, gradually increasing the duration as your strength improves.

Bird-Dog Exercise:

Start on your hands and knees.
Extend one arm forward and the opposite leg backward, keeping your back straight.
Hold for a few seconds, then switch sides. Repeat 10-15 times on each side.

If you or a loved one is experiencing symptoms of adult scoliosis, Colorado Springs Orthopaedic Group Spine Center Is here to help! Our specialists ensure each patient’s treatment plan is personalized to their individual needs helping them manage their specific condition and improve their quality of life. Our team is dedicated to getting you back to the activities you love, close to or completely pain-free.

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Spine Anatomy: A Comprehensive Guide to Exploring the Backbone

The spine, often referred to as the backbone, is a remarkable structure that provides structural support and flexibility to the human body. From the intricate cervical spine at the top to the sturdy sacroiliac joint (SI joint) towards the hips, each segment plays a crucial role in maintaining posture, supporting movement, and protecting the delicate spinal cord. Let’s dive into the intricacies of spine anatomy, exploring each section from the cervical spine down to the sacroiliac joint.

Anatomy of a Single Spinal Segment

Before we discuss the various levels of the spine, let’s take a look at the components that make up a single spinal segment, otherwise known as vertebrae.

Each spinal segment includes two vertebrae, separated by an intervertebral disc. Each vertebrae includes:

Body: The large, cylindrical part at the front, which bears most of the weight.
Vertebral Arch: Encloses the vertebral foramen (the canal through which the spinal cord passes).
Pedicles and Laminae: Form the sides and back of the vertebral arch.
Spinous Process: A projection where muscles and ligaments attach, extending backward from the junction of the two laminae.
Transverse Processes: Projections on each side where muscles and ligaments attach.
Facet Joints: The articulations between the inferior articular processes of the upper vertebra and the superior articular processes of the lower vertebra. These allow for motion and stability.

The intervertebral disc sits between the vertebral bodies and acts as a cushion and shock absorber.

Annulus Fibrosus: The tough, outer layer of the disc made of concentric rings of collagen fibers.
Nucleus Pulposus: The gel-like, inner core that provides the disc with its cushioning properties.

The spinal cord runs through the spinal canal formed by the vertebral arches. It ends around the L1-L2 level, where it tapers into the conus medullaris and then the cauda equina (a bundle of nerve roots).

Spinal Cord: The major conduit for signals between the brain and the rest of the body.
Nerve Roots: At each segment, pairs of nerve roots emerge from the spinal cord.
- Dorsal (Posterior) Root: Contains sensory (afferent) fibers that carry information to the spinal cord.
- Ventral (Anterior) Root: Contains motor (efferent) fibers that carry information from the spinal cord to muscles.
- Spinal Nerve: The dorsal and ventral roots combine to form a mixed spinal nerve, which exits the spinal column through the intervertebral foramen.

Cervical Spine

The cervical spine consists of seven vertebrae, labeled C1 to C7, and is located in the neck region. This highly mobile section allows for a wide range of head movements, including nodding, shaking, and tilting. The first two vertebrae, atlas (C1) and axis (C2), have unique structures that enable the pivotal motion of the head. Understanding the cervical spine is crucial not only for comprehending neck-related issues but also for recognizing its impact on overall spinal health.

Common Conditions of the cervical spine include: Cervical Radiculopathy a compression of nerve roots causing pain, numbness, or weakness in the arms. Cervical Spondylosis is another common condition and is generally age-related with wear and tear affecting the spinal disks in the neck. As you might have guessed, whiplash is another common injury to the cervical spine that occurs from a rapid back-and-forth movement, such as a car accident.

The Cervical spine innervates (supplies) many regions of our upper body with nerves and is why injury to any of the discs within, can have a dramatic impact

on functionality. The nerve innervations include:

C1-C2: Head and neck movements
C3: Diaphragm (breathing)
C4: Neck and shoulder movement
C5: Deltoid muscle, biceps (shoulder, upperarm)
C6: Wrist extensors, biceps
C7: Triceps, wrist flexors, finger extensors
C8: Finger flexors

Of course, there are many muscles that help stabilize and provide intentional motion to the cervical spine including:

The Sternocleidomastoid: Responsible for rotating and flexing the neck.
The Trapezius or ‘Traps’: Moves, rotates, and stabilizes the scapula (shoulder blade).
Levator Scapulae: Elevates the scapula and tilts its glenoid cavity downward.
Scalenes: Assist in breathing by elevating the first and second ribs.

Thoracic Spine

The next level of the spine is the Thoracic Spine, comprised of twelve vertebrae, T1 to T12. This region is the connection point for the rib cage, providing stability and protection for our vital organs. The thoracic spine is less mobile than the cervical spine however, still plays a pivotal role in maintaining an upright posture. Issues in this area can affect breathing, posture, and even contribute to conditions like scoliosis.

Similar to the Cervical spine, the Thoracic spine innervates many regions of our body with nerves including:

T1: Hand muscles.
T2-T6: Chest muscles.
T7-T12: Abdominalmuscles.

A few of the common conditions associated with the Thoracic spine include:

Thoracic Outlet Syndrome which is a compression of nerves or blood vessels in the thoracic outlet an a ring-shaped area in the lower neck and upper chest, between the clavicle (collarbone) and the first rib
Kyphosis which is diagnosed when there is an excessive outward curvature of the spine, leading to a hunchback appearance.
Scoliosis, termed when there is an abnormal lateral curvature of the spine, which can develop during adolescent growth spurts or even into adulthood.

Some of the muscles that help initiate movement with the thoracic spine are: the Rhomboids, the Latissimus Dorsi, the Erector Spinae, and the Serratus Posterior Superior.

The Rhomboids (major and minor) retract the scapula while the Latissimus Dorsi that extends, adducts, and medially rotates the arm. The Erector Spinae which is a group of muscles that help extend the vertebral column. Lastly, the Serratus Posterior Superior elevates the ribs and aids in respiration.

Lumbar Spine

The lumbar spine, consisting of five vertebrae, L1 to L5, is commonly referred to as the lower back. This region bears the majority of the body’s weight and is crucial for everyday movements such as bending, lifting, and twisting. The lumbar spine innervates many aspects of the lower body with nerves including:

L1-L2: Hip muscles.
L3: Knee extensors (quadriceps).
L4: Knee extensors, ankle dorsiflexors.
L5: Ankle and toe dorsiflexors.

Common Lumbar Spine Conditions include Herniated Discs, Sciatica, and Lumbar Stenosis.

The Muscles Involved in movement initiation include the Quadratus Lumborum which help with lateral flexion of the vertebral column, the Psoas Major that flexes the hip joint and provides stability to the lumbar spine and the Iliacus which works with the psoas major to flex the hip.

Sacrum and Coccyx

The Sacrum and Coccyx form the bony structure at the base of the spine. The sacrum, a triangular bone, connects the spine to the pelvic bones, contributing to the stability of the entire vertebral column. The coccyx, often referred to as the tailbone, consists of small, fused vertebrae and serves as an attachment point for various muscles and ligaments of the lower body.

The Sacrum and Coccyx innervate one primary aspect of the lower body, the Sacral Nerves located from S1-S5 and affect the buttocks, genitalia, thighs, and calves. These nerves are critical for bowel and bladder control.

Common Conditions stemming from injury of the Sacrum and/or Coccyx are Sacroiliac Joint Dysfunction diagnosed as pain due to abnormal motion or inflammation of the Sacroiliac joint and Coccydynia, tailbone pain usually caused by trauma to the coccyx.

The Gluteus Medius and Minimus, Piriformis, and Coccygeus muscles are the primary muscles enabling movement within the Sacrum and Coccyx.

Sacroiliac Joint (SI Joint)

The Sacroiliac joint, often referred to as the SI Joint, located where the sacrum and ilium meet, plays a crucial role in transferring forces between the spine and the pelvis. While limited in movement, the SI joint is essential for shock absorption during activities like walking, running, and jumping. SI Joint Dysfunction, diagnosed as pain and inflammation in this joint, is a common cause of lower back pain affecting many aspects of a person’s biomechanics

The SI Joint is innervated by the sacral nerve roots and provides sensory information from the lower back, buttocks, and legs.

The Iliopsoas, Hamstrings, Adductors, and Tensor Fasciae Latae are the SI Joints primary muscles, responsible for many movements within the hips.

Overall, understanding spine anatomy from the cervical spine to the SI joint is fundamental for healthcare professionals, exercise physiologists, researchers, and individuals alike who seek to maintain spinal health. Each segment contributes uniquely to the spine’s overall function, and recognizing the intricacies of these structures helps to address issues related to posture, movement, and pain.

If you or a loved one are experiencing any type of back or neck pain, give us a call to find out how the specialists within the CSOG Spine Center can help

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The Link Between BMI and Joint Health: How Weight Impacts Hip and Knee Joint Longevity

As we’ve heard many times before, maintaining a healthy body weight is crucial for overall health, however the impact of a healthy body weight on specific body parts, specifically the hip and knee joints, is often underestimated. Body Mass Index (BMI), a measure of body fat based on height and weight, along with the measure of relative muscle mass, can significantly affect the health and longevity of these weight-bearing joints. Today, we’ll discuss the correlation between BMI and joint health, with focus on the hip and knee joints, and how weight management plays a crucial role in preserving joint function and longevity.

It is important to note, muscle mass has a great influence on BMI measurements as BMI is factored upon height and weight and does not differentiate between muscle mass and fat mass. Muscle tissue is denser than fat tissue, therefore a person with a high muscle mass, but relatively low fat mass may have a higher weight resulting in a higher BMI measurement. This does not necessarily mean that the individual is overweight or unhealthy. The impact of BMI on weight-bearing Joint Longevity discussed within this article, does not pertain to those of high muscle mass with low fat mass measurements.

The Impact of BMI on Hip Joints

The hip joint is one of the largest weight-bearing joints in the body and is responsible for supporting our body weight during both sedentary activities and when facilitating movement. Studies have shown that a higher BMI is associated with an increased risk of hip osteoarthritis, a degenerative joint disease characterized by the breakdown of cartilage and bone within the joint. This is because the excess body weight places additional stress on the hip joint, accelerating the wear and tear process and increasing the risk of developing osteoarthritis. Maintaining a healthy BMI through a nutrient dense diet and consistent exercise regimen can help preserve joint function and longevity.

The Effect of BMI on Knee Joints

Similar to the hip joint, the knee joint is also susceptible to the effects of excess body weight. Studies have demonstrated a clear link between higher BMI and an increased risk of knee osteoarthritis. The excess weight puts pressure on the knee joint, leading to cartilage damage and inflammation, which are key indicators of osteoarthritis onset. Additionally, higher BMI is associated with an increased risk of knee injuries, such as tears in the ligaments or meniscus, further compromising joint health. By maintaining a healthy BMI, individuals can help protect the integrity of their knee joints, reducing the risk of developing knee osteoarthritis and either delaying the need for a total joint replacement or avoiding one altogether.

The Role of Weight Management in Joint Health

Weight management plays a crucial role in preserving the longevity of the hip and knee joints. For individuals who are overweight or obese, losing even a modest amount of weight can significantly improve joint function.

Maintaining a healthy weight and BMI measurement is especially crucial when looking to qualify for a total joint replacement as BMI is one of the several factors considered when determining a patient’s eligibility for a hip replacement or knee replacement. Although there is not a specific BMI ‘cutoff’ that qualifies or disqualifies a patient, risks such as infections, blood clots, and anesthesia complications, exponentially increase in those with higher BMIs. Generally, a BMI below 40 is preferred as qualification for a total joint replacement to reduce these risks.

The decision to move forward with a hip or knee replacement surgery is inevitably up to the individual and their orthopedic specialist who will complete a comprehensive evaluation of the patient’s overall health, the severity of joint damage, pain during daily activities, and functional limitations. If recommended to reduce one’s BMI measurement, a combination of regular physical activity, such as low-impact exercises like swimming or cycling, or resistance training combined with a nutrient dense diet can help individuals achieve and maintain a healthy BMI, reducing the burden on their joints and maintaining joint health for the long run.

To schedule an appointment with one of our Board Certified and Fellowship Trained specialists, give us a call at 719-632-7669 or visit us at www.CSOG.net to learn more.

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Anterior Hip Arthroplasty, Advancing Hip Replacement Outcomes and Longevity

Hip replacement surgery has come a long way since its inception with new techniques continuously evolving to improve outcomes, patient satisfaction, and implant longevity. One such advancement is the use of the anterior approach hip replacement surgery, a technique that differs from traditional approaches (posterior and lateral) and offers many unique benefits. Today, we’ll delve into:

– What Anterior Hip Replacements are
– The History of Anterior Hip Replacements
– How they differ from other techniques
– What recovery generally looks like
– Candidacy for this innovative procedure

What are Anterior Hip Replacements?

Anterior hip replacement surgery is a minimally invasive surgical technique used to replace a damaged hip joint with an artificial implant. Unlike traditional hip replacement surgeries that access the hip joint from the side or back (lateral or posterior approaches), the anterior approach accesses the joint from the front (anterior aspect) of the hip, through a small incision.

A Brief History

While the anterior approach to hip replacement is often considered a modern innovation, its roots can be traced back to the early 20th century. Dr. Marius Smith-Petersen, an American orthopedic surgeon, first discussed the anterior approach in the 1940s. However, it was not widely adopted due to technological challenges and the popularity of other approaches. The first anterior hip replacement surgery was performed in 1947. It wasn’t until the late 20th and early 21st centuries that advancements in surgical techniques, imaging technology, and implant design made anterior hip replacement a more feasible option. Since these advancements, the procedure has gained immense popularity among surgeons and patients alike.

How Anterior Hip Replacement Differs

The anterior approach offers several advantages over traditional lateral and posterior approach hip replacement techniques including:

Muscle Preservation: One of the key benefits of the anterior approach is that it allows access to the hip joint without detaching muscles from the pelvis or femur. A muscle-sparing technique such as this, can lead to faster recovery times and in many cases, less postoperative pain compared to other techniques..
Stability: Thanks to this muscle preservation, the anterior approach shows an increased stability of the implant due to the preservation of the surrounding soft tissues and muscles. This added stability can reduce the risk of dislocation.
Additional Accuracy: The anterior approach provides excellent visualization of the hip joint, allowing for even more precise placement of the implant during surgery.
Faster Recovery: Patients who undergo anterior hip replacement surgery may experience a quicker recovery compared to other techniques. This is primarily due to the muscle preservation benefits, which can lead to less damage to the surrounding structures and a faster return to normal activities.

Video credit to Stryker Orthopedics

Anterior Hip Replacement Recovery

Studies show recovery from Anterior Approach Hip Replacement Surgery enables the potential for early mobility. One of the primary advantages of the anterior approach is that it typically allows for early mobility. Patients may be able to walk with a cane or walker soon after surgery, often times within a couple hours of surgery. This is due to the muscle preservation nature of the approach, again, leading to less damage to the surrounding structures and a faster return to normal activities.

While hip precautions are often recommended for all types of hip replacement surgeries to prevent dislocation of the new hip joint, the specific precautions may vary depending on the surgical approach. For example, patients undergoing an anterior approach may be advised to avoid certain movements that could strain the front of the hip joint especially within the initial recovery period.

Rehabilitation following an anterior approach hip replacement surgery typically focuses on restoring range of motion, strength, and function. To kickstart the recovery process, Physical therapy begins soon after surgery to help patients regain mobility and strength in the hip joint and return to normal activities, including driving, quickly and efficiently.

It’s important to note that the recovery process can vary from patient to patient due to individual factors regardless of the surgical approach. Factors such as age, overall health, and the extent of joint damage can all impact the recovery timelines and overall outcome. Patients should follow their surgeon’s postoperative instructions and participate in any rehabilitation programs as prescribed to optimize their recovery.

Who Would Be a Candidate?

While anterior hip replacement surgery offers many benefits, not everyone is a candidate for this procedure. Ideal candidates for anterior hip replacement surgery typically include those who are:

Physically Active: Patients who are physically active and in good overall health may benefit from the faster recovery times associated with the anterior approach.
Of Healthy BMI: Patients who are within a healthy BMI generally have better outcomes with the anterior approach, as excess body weight can put additional stress on the hip joint and may impose greater risk of complications during and after surgery. Tune into our blog discussing The Link between BMI and Joint Health
Motivated Patients: Patients who are motivated to actively participate in their recovery process, including following postoperative rehabilitation protocols, achieve better results with the anterior approach.

Candidacy for any hip replacement technique ultimately comes down to what is best for the individual patient and their lifestyle as discussed with their orthopedic specialist.

In conclusion, Anterior Hip Arthroplasty surgery is a modern hip replacement technique that offers several advantages. With its muscle preserving technique, increased stability, and faster recovery times, it has become an attractive option for many surgeons and patients seeking hip replacement surgery with hopes of returning to activities.

If you’d like to discuss your candidacy for an anterior hip replacement, give us a call at 719-632-7669 to schedule with one of our board certified Joint Replacement specialists.

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The Fellowship Trained and Board Certified Difference

When it comes to Orthopaedic care, choosing the right physician is crucial for ensuring optimal treatment and recovery outcomes.

Amongst Orthopaedic physicians, there are different levels of training and certifications. Each can significantly impact their level of expertise and capacity for providing the full spectrum of comprehensive care. When looking at a physician’s bio, especially those that are apart of the team here at CSOG, you’ve likely seen the terms: fellowship trained and board certified. But what do these terms actually mean? What type of training has the physician gone through to receive these credentials?

Fellowship Training:
Specialization and Expertise

What does fellowship trained mean? Fellowship training is an additional period of intensive, specialized training that orthopaedic surgeons pursue after completing their residency program. During this fellowship, physicians focus on a specific area within orthopaedic surgery, such as sports medicine, joint replacement, spine surgery, foot and ankle surgery, or hand and upper extremity surgery, among others. These fellowship programs require physicians to participate in hundreds of specialized surgeries to develop advanced skills and expertise in their chosen subspecialty before they’re eligible to receive the fellowship trained credential.

Benefits of Fellowship Training

Enhanced Knowledge and Skill Set: Fellowship-trained orthopaedic physicians possess a deeper understanding of their specific area of focus due to their additional, rigorous training that allowed them to gain extensive hands-on experience from leaders within the orthopedic world. This experience enables them to address complex cases and provide highly specialized, individualized care.
Leaders of Orthopedic Advancements: Fellowships provide consistent access to the latest research, techniques, and technologies in the specific subspecialty. Not only does this exposure keep physicians abreast of recent advancements, it allows them to continue development upon such innovation to ensure patients receive the most effective and lasting treatment options.
Collaboration and Networking: Fellowship programs often foster collaboration and networking among specialists, enabling physicians to consult with colleagues and share knowledge across the nation. This collaborative environment further enriches their expertise and promotes the exchange of best practices.

Board Certification:
Recognized Expertise and Quality Assurance

What does Board Certified mean? Board certification is a rigorous process that evaluates a physician’s knowledge, skills, and clinical experience in a particular medical specialty. To become board certified, orthopaedic surgeons must complete a specific number of postgraduate training years. Then, they are eligible to complete a comprehensive oral and written examination administered by the American Board of Orthopaedic Surgery (ABOS) or an equivalent board such as the American Osteopathic Association (AOA) for Doctor of Osteopathic Medicine (DOs).

Importance of Board Certification

Expertise Verification: Board certification serves as an independent validation of an orthopaedic surgeon’s knowledge and expertise in their specialty and demonstrates that the physician has met the meticulous standards set by the ABOS or the equivalent certifying body.
Commitment to Continuous Learning: Maintaining board ce
rtification requires ongoing professional development through continuing medical education (CME) credits. These CME requirements ensure that certified physicians stay current with advancements in their field and provide patients with the most up-to-date care.
Quality Assurance: Board certification acts as a quality assurance measure for patients, as it signifies that the orthopaedic physician meets or exceeds the established standards of practice.

The Doctor’s Timeline

Becoming a physician is no easy feat. Especially one with high distinctions of Fellowship Training and Board Certification. On average, in addition to completing a four-year undergraduate degree, a physician must complete four years of medical school. After medical school, they will complete a five-year residency program. Orthopedists such as ours within CSOG, then apply for a fellowship program. Only the best candidates are granted participating into these fellowships that typically last an additional year. To become board certified, the physician must meet their respective board’s mandated training hours. Depending on the board, this can take between 3-7 years. Added together, a fellowship trained and board-certified Orthopaedic physician has undergone anywhere between 17-21 years of training and education.

With their Fellowship training and the addition of a Board certification, physicians are focused extensively on specific subspecialties, with the advanced skills necessary to ensure high quality outcomes backed with quality assurance to their commitment of providing high-quality care. In the realm of orthopaedic care, patients can rest assured they’re in qualified hands when seeking specialized or complex treatments through fellowship-trained and board-certified orthopaedic physicians.

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What is Osteoporosis?

Osteoporosis is a disease that occurs when bone density and/or the quality of your bone decreases, causing weak bones. It occurs when the density and quality of bone are reduced. Normally, bones go through a process called “Remodeling” where old bone is broken down and new bone is built in its place. However, in osteoporosis, the creation of new bone is unable to keep pace with the removal of old bone, resulting in a net loss of bone mass.

Who is at risk for Osteoporosis?

There are several clinic risk factors that can contribute to the development of osteoporosis including:

Age: Around the age of 40, the bone building part of the remodeling process begins to slow down which results in a net loss over time. This imbalance becomes even more prevalent after menopause.
Gender: Women are more likely to develop osteoporosis than men due to hormonal changes during menopause.
Genetics: A family history of osteoporosis can increase the risk.
Hormonal changes: Low estrogen levels in women and low testosterone levels in men can lead to bone loss.
Unhealthy Lifestyle Habits and Vitamin Deficiencies: Lack of physical activity, a diet poor in calcium and vitamin D, smoking, excessive alcohol consumption, and certain medications can all contribute to bone loss.
Medical Conditions: Some medical conditions, such as celiac disease, rheumatoid arthritis, and hormonal disorders, can increase the risk of osteoporosis.
Medications: Long-term use of certain medications, such as corticosteroids and some anticonvulsants, can weaken bones.

Each of these, especially when compounded, can ultimately result in a fracture or at minimum, an increased risk of fracture which can occur even with minor trauma or stress on the bones. The most common sites of an osteoporotic fracture are wrists, hip, and spine. Fractures, particularity those of the hip, have potential for serious consequences for older adults and can lead to decreased mobility and independence.

How is Osteoporosis Prevented and Managed?

Preventing and managing osteoporosis typically involves lifestyle changes including adopting a nutrient dense diet and vitamin regimen, regular weight-bearing exercise, smoking cessation, alcohol moderation, and possible medication management. It is important to know this is a lifelong diagnosis with several possible treatment pathways that are individualized to each patient. A detailed interview along with imaging and labs will help determine treatment recommendations.

Regular bone density testing can help diagnose osteoporosis early and help guide the treatment process as well. Early detection and proactive management are essential in reducing the risk on further onset and the risk of potential fractures.

What is Bone Density?

Bones density, also known as Bone Mineral Density, is the total amount of bone mineral within boney tissue. Bone Density is measured using low-dose x-ray tests called DEXA or DXA scans that measure calcium and additional minerals within the bones. This measurement helps determine the strength and thickness (density) of bone which then helps providers predict a patient’s fracture risk.

Stay tuned as we continue our Bone Health series and further discuss treatment methods, FRAX scores, and much more.

CSOG Bone Health Program

Hip Anatomy and Functions of the Hip

Hip Anatomy

The hips and structures within the hips are some of the most important and complex structures in the human body. They play a crucial role in our everyday movements, from walking and running to sitting and standing. Understanding Hip Anatomy is essential to maintaining optimal hip health and longevity. Join us as we explore the fascinating intricacies of the hips, from the bones and joints, to the muscles, ligaments and primary functions that support our everyday movements.

Bones of the Hip

There are five bone structures that make up the hip. Three of which come together to form the primary hip structures: the Ilium, the Ischium, and the Pubis, with the other two, the Femoral Head and the Acetabulum, forming the hip joint.

Ilium: This large, wing-shaped bone forms the upper part of the hip, providing stability and support for the joint.
Ischium: The ischium is the lower and posterior part of the hip bone. It forms the “sit bones” and supports our body weight when we sit.
Pubis: The pubis is the anterior part of the hip bone and is responsible for connecting the two hip bones at the front of the pelvis.

The Hip Joint

The hip joint is a ball-and-socket joint, designed for both mobility and stability. It consists of two primary components:

Femoral Head: The rounded head of the femur (thigh bone) fits into the acetabulum, creating the ball part of the ball-and-socket joint. This structure allows for a wide range of motion in multiple directions.
Acetabulum: The acetabulum is the socket or cup-shaped structure in the hip bone that receives the femoral head and provides stability to the joint.

Ligaments of the Hip

Within our hip anatomy, we have several ligaments that hold the bones of the hip together and provide stability to the joint.

Iliofemoral Ligament (Y-shaped ligament): This ligament is the strongest in the body and helps to prevent overextension of the hip joint.
Pubofemoral Ligament: This ligament reinforces the front of the hip joint and assists in preventing hyperextension.
Ischiofemoral Ligament: Located on the back of the hip joint, this ligament stabilizes the joint during internal rotation and extension.

Muscles of the Hip

Now that we’ve covered the bones and ligaments that form the hips’ basic structures, let’s dive into the anatomical components that give us the strength and support to move and stabilize ourselves through space: the muscles of the hip.

The hip joint is surrounded by a complex network of muscles. Some of the key muscles include:

Gluteus Maximus: This is the largest and most powerful hip muscle, responsible for hip extension (extending the leg backwards) and external rotation (moving the leg outwards).
Gluteus Medius and Minimus: These muscles lie on the outer side of the hip and are responsible for hip abduction (moving the leg away from the body), internal rotation (rotating the leg inwards) and external rotation (rotating the leg outwards).
Iliopsoas: This is a group of muscles responsible for hip flexion (bending the hip joint), helping you lift your knee towards your chest or hinging over to pick something up.
Adductors: The adductor muscles on the inner thigh allow for hip adduction (moving the leg toward the midline of the body).
Iliotibial Band (IT Band) is a thick band of muscle fascia that originates at the lateral portion of the iliac crest and inserts at the lateral condyle of the tibia (shin bone). Its main function is the provide stabilization to the pelvis and aid in posture control.

Adductors, iliopsoas, muscles of the hip

Iliotibial band (IT Band), muscles of the hip, anatomy of the hip

Movements of the Hip

These muscles help facilitate the four primary movements of the hip: Flexion, Extension, Internal Rotation, and External Rotation.

Hip Flexion: involves lifting the thigh toward the abdomen or vice versa, bringing the abdomen closer to the thigh. This movement is essential for activities like walking, running, lifting the leg, walking up stairs, hinging over to pick something up, sitting in a chair, etc.
Hip Extension: involves extending the leg backward and is executed when your back leg is straightened as you walk. You execute hip extension anytime you stand up from a seated position or run.
Hip Internal Rotation: occurs when the thigh is rotated or turned inwards towards the midline of the body. Anytime we cross our legs, we are performing hip internal rotation.
Hip External Rotation: occurs when the thigh is rotated or tuned outwards, away from the body. We perform this movement when we take a turn during a walk or sit in the butterfly stretch position during a yoga class.

It’s no wonder, when we injure even a small structure in our hips, it can take its toll on our everyday movements. This is why, we at Colorado Springs Orthopaedic Group emphasize strengthening your hip muscles, core, and leg muscles in efforts of preventing injury during activity. Strengthening these muscles through a full range of motion will also aid in maintaining your mobility.

Whether you’re an athlete or just someone who values their joint health, be sure to check out our Healthy Hips series on our website at https://www.csog.net/blog/ to learn more about hip anatomy. Tune into our Youtube channel to learn how taking an interest in ways to optimize hip strength and mobility can dramatically affect your hip and overall physical longevity.

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Healing Connection with Eric Jepson, DO

with Eric Jepson, DO , written by Alyssa Shikles of Colorado Springs Magazine. Photography by: Meegan Dobson

It takes a skilled doctor to ease a worried patient’s mind. After all, no one visits the doctor for fun. You go because something’s wrong or because you’re afraid something’s wrong. You’re looking for hope in the midst of pain, for answers when your own body feels unknown and uncertain. In these moments of stress and anxiety, a good doctor—with a comforting word and a desire to meet patients where they are—can have an incredible emotional and physical impact.

For Eric Jepson, MD, an orthopedic surgeon at Colorado Springs Orthopedic Group (CSOG), this is the most critical and challenging facet of his job. For him, fixing the body is easy; the hard part is gaining trust and making patients feel cared for.

When I sat down to talk with Dr. Jepson in CSOG’s south office a few weeks ago, I experienced first-hand how relational he is. There’s something about him that exudes not only kindness and understanding but relatability and genuine interest in others. He has a keen listening ear, and though I came to his office to interview him, I was surprised when he often flipped questions back on me. How long have I lived in Colorado Springs? Do I love the outdoors? How did I handle my first Colorado winter? He wanted to get to know me, and I felt seen.

This small interaction is just a sampling of how Dr. Jepson interacts with patients daily. But to him, making patients comfortable and being present for them is fundamental to his day-to-day work. Anyone can work with a scalpel or heal a wound if they study hard enough, but learning to connect with others relationally? That’s what makes a stand-out physician.

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As the world’s fastest growing crime, generating over $100 billion per year, Human trafficking is a tragedy taking place everyday, everywhere, including here in our home town of Colorado Springs.

What is Human Trafficking?

Human trafficking involves the use of force, fraud, or coercion in exchange for labor, services, or a commercial sexual act.

Causing someone under the age of 18 to engage in a commercial sexual act, regardless of using force, fraud, or coercion is human trafficking under US Law. Traffickers will use various forms of force, fraud, and coercion to control and exploit victims including imposing of debt, fraudulent employment opportunities, false promises of love or better life, phycological coercion, and violence or threats of violence. This tragic crime hinges on the exploitation of another person. Often people think human trafficking must involve the victim being transported from one place to another however, this is not the case at all. It does not require transportation to be considered a crime and can be committed against an individual who has never left his or her hometown.

Victims can be of ANY race, gender, age, ethnicity, and socioeconomic class. Many victims do not seek help either due to extreme feelings of vulnerability, fear, and even guilt, absorbing the responsibility for the crime as their own. Traffickers will many times exploit these vulnerabilities to victimize people.

The primary industries, legitimate and illegitimate include those of forced labor and sex trafficking.

DHS law enforcement alone identified hundreds of girls, boys, women, and men as victims of human trafficking in the US every year.

Identifying Human Trafficking

Often ‘hidden in plain sight’, recognizing the signs of human trafficking is the first step in identifying victims. No single indicator is proof this crime is occurring however, when compounded may indicate a potential situation.

Reclaiming Hope

is a local non-profit organization journeying with the survivors of Human Trafficking. They help victims at the point of recovery, during restoration and reintegration by addressing their physical, emotional, and spiritual needs.

When a survivor is recovered, their first connection with Reclaiming Hope comes through their Hope Bags program. These bags are distributed through law enforcement partners when a victim is recovered. Each bag includes new clothing, hygiene items, a blanket, comfort items, snacks and a personal note. Over 5K bags have given survivors a sense of comfort and dignity.

Reclaiming Hope helps survivors past the point of recovery into restoration and reintegration through their Hopeful Women Mentor Program, where women are matched with trained, accountable mentors dedicated to walking along side victims.

To learn more about identifying the signs of Human Trafficking and how you can get involved in putting a stop to this tragic crime within our local community, visit Reclaiming Hope

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8 Tips to Help with Recovery from Shoulder Surgery

Shoulder surgery can be a daunting experience and the day to day can be quite challenging post-surgery. However, in addition to following the essential instructions provided by your doctor to ensure a full and proper recovery, being ready at home can dramatically help reduce any anxiousness and make the process more comfortable.

Below are eight at-home success tips to help you to prepare and make the most out of your recovery from shoulder surgery.

1. Follow Your Doctor’s Instructions

After surgery, your doctor will provide you with detailed instructions on how to care for your shoulder. It’s essential to follow these instructions to ensure that you recover as quickly as possible. Some of the instructions may include initial physical therapy exercises, pain medication recommendations, and keeping your shoulder immobilized with a properly fitted sling. Instructions vary per procedure so be sure to diligently read through all information provided to you.

2. Consider Which Arm Your Surgery Will Be On

If surgery is taking place on your dominant arm, you’ll want to prepare by practicing daily tasks with your non-dominant arm.

As most people do not practice being ambidextrous, everyday tasks such as brushing your teeth, going to the bathroom, drinking from a cup, eating, opening doors, etc. all may be a learning curve for the first few weeks. Practicing these types of tasks prior to surgery may help ease this learning curve once surgery has taken place.

3. Prepare to Get Dressed and Do Your Hair

Throughout the first few weeks after surgery, you may not be able to:

lift your arm above your head
lift your arm out in front of you
lift your arm out to the side of you

To help with this, loose-fitting shirts, button-downs, and zip-ups are highly recommended for use after surgery. There are post-surgical shirts available at various online retailers if that’s an option you’d like to use as well.

It’s also recommended to practice doing your hair with one hand for those who may need to do this independently post-surgery. If you do a google search for “how to put hair in a ponytail with one hand” or something similar, you will find many tutorials to help get the hang of these tasks.

4. Build Your At-home Recovery Supply

Many patients find having little everyday items (such as those listed below) can make a big difference during shoulder surgery recovery. So you don’t have to worry about venturing out soon after surgery, it is recommended to stock up on a few weeks’ worth of food and toiletries as well.

Long-handled back scrubber
Detachable shower head
Shower chair
Frozen meals
Multiple button-down shirts, front closure bras, zip-up sweaters or hoodies, oversized t-shirts, looser fitting pants
Pillow wedge

5. Get Plenty of Rest and Reduce Stress

Getting plenty of rest is crucial to a successful recovery. Your body needs time to heal, and rest is the best way to facilitate that process. It’s normal to experience fatigue after surgery, so be sure you rest whenever you feel tired. Sleeping in a recliner or propping yourself up with multiple pillows can help reduce pain and inflammation.

Additionally, it’s important to reduce your stress throughout recovery. Dialing back on your daily responsibilities should be a priority. Prepare those who are typically dependent upon you so they are ready when the time comes, and you can truly optimize your recovery.

6. Focus on Nutrition and Hydration

Following a whole food nutrition plan is essential for recovery from surgery. Be sure to eat a well-balanced diet that includes:

plenty of fruits and vegetables
lean proteins
whole grains

This will ensure you’re receiving all the essential vitamins and minerals necessary for proper healing.

Hydration is also a very large component of ensuring a full recovery. Approximately 60% of our bodies are composed of water. Consuming enough water helps to avoid any potential complications such as infections and helps to boost the immune system that is typically weakened after surgery. The US National Academies of Sciences, Engineering and Medicine recommends adults consume between 92oz – 124oz of water per day. This equates to about 3-4 32oz bottles throughout the day.

7. Take It Slow and Be Patient

Recovery takes time, and you shouldn’t rush the process. Remember that taking it slow doesn’t mean you can’t do anything; it simply means for the first few weeks you’ll want to opt for light activities or adventures. With doctor guided permission, you can gradually increase the intensity of everyday activities. Remember to avoid any activities that put pressure on your shoulder, don’t lift anything heavy until your doctor gives you the go-ahead, and ask your loved ones for help when necessary.

8. Handling Setbacks

Throughout your recovery journey, you may experience setbacks. This is normal and you shouldn’t get discouraged. A few tricks that have helped many patients push through recovery are:

Keeping a positive attitude and focusing on your recovery goals.
Celebrate small victories, like being able to move your arm a little more each day.
Remember, your body is healing, and it will take time.
Embrace this period of more down time than you’re used to, and remember recovery is temporary. You’ll be back to doing the things you love to do soon.

We understand the process of recovering from shoulder surgery is not easy. It requires patience, perseverance, and following your doctor’s instructions to a T. As mentioned, it is temporary and ultimately will be the vehicle to get you back to living pain free. Prepare ahead of time, get plenty of rest, focus on your nutrition and hydration, and you’ll be back to the swing of things.

At Colorado Springs Orthopaedic Group, our teams are always here for you whenever you need us throughout your recovery journey. If you have any questions or concerns, simply send a message to your surgical team through your patient portal or give us a call at 719-632-7669. We’ll be back in contact with you as soon as possible.

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Anatomy of the Knee

Running, jumping, walking, hiking, our knees support us through it all. To help provide these high-impact functionalities, the knee’s structure is one of the most complex and critical joints within the human body. Let’s take a closer look at the anatomy of the knee to better understand the knee and its many functionalities.

Bones of the Knee

The knee joint is formed by the femur (thighbone), the tibia (shinbone), and the patella (kneecap). The femur is the largest bone in the body and it forms the upper part of the knee. The tibia forms the lower part of the knee and is the weight-bearing bone of the lower leg. The patella is a small, flat bone located in front of the knee. It slides along a groove in the femur as the knee bends and straightens.

Ligaments of the Knee

Within the knee, we have four primary ligaments: the ACL, PCL, LCL, and MCL. Ligaments are strong, fibrous tissues that connect bone to bone and provide stability within the joint.

The Anterior cruciate ligament (ACL) is located in the center of the knee. The ACL helps prevent the tibia from moving forward excessively.
The Posterior cruciate ligament (PCL) is located in the center of the knee. The PCL helps prevent the tibia from excessively moving backwards.
The Lateral collateral ligament (LCL) is located on the outside of the knee. The LCL helps prevent the knee from bending outward too an excessive degree.
The Medial collateral ligament (MCL) is located on the inner most side of the knee. The MCL helps to prevent the knee from bending inward to an excessive degree.

Bursae of the Knee

Bursae are small, fluid-filled sacs. They can be found in many areas of the body and serve as friction reducers for the tissues surrounding a joint. In the knee, we have three primary bursas: The Suprapatellar bursa, the Prepatellar bursa, and the Infrapatellar bursa.

Menisci of the Knee

Between the Femur and Tibia, there are two cushion like structures. These structures are referred to as the Menisci, or Meniscus in singular context. The Menisci act as shock absorbers when performing activities such as running, jumping, walking, etc. and help to distribute our body weight evenly across the knee joint.

Tendons of the Knee

Let’s start by addressing what tendons are and what they do. Tendons are fibrous tissues that connect muscles to bones and help initiate movement as our muscles contract and relax.

For example, as you take a step forward, your quadricep muscles contract. The quadriceps tendon that’s attached to the quadricep muscles then helps initiate movement within the patella, the patellar tendon and tibia so that the entire lower leg moves forward in congruency.

You may have heard of a condition called Patellar Tendonitis. This refers to an injury of one of the primary tendons within the knee, the Patellar Tendon. The Patellar Tendon connects the patella to the tibia and with the help of the quadriceps tendon, is responsible for extending the knee when you kick, run or jump. It is one of the most injured tendons especially amongst those who frequently run or jump on hard surfaces.

The second most primary tendon within the knee is the Quadriceps Tendon. This tendon connects the quadricep muscles to the patella and in conjunction with the patellar tendon, helps to extend or straighten the knee.

To recap Tendons vs Ligaments:

What they connect:
- Tendons connect muscles to bones
- Ligaments connect bone to bone

What they do:
- Tendons help initiate movement between muscles and bones
- Ligaments help hold structures together and provide stability within those structures

The Iliotibial Band (The IT Band)

You’ve probably heard of the IT band before. But what is it and what does it do? The IT band is a band of thick fibrous tissue that runs from the hip down to the lateral aspect of the Tibia. This band of tissue helps to provide stability to both the knee and hip and as it runs down to the top of the Tibia, helps to prevent dislocation of the knee as well.

Muscles of the Knee

The knee is surrounded by several muscle groups, each of which help maintain stability and move the knee joint through motion in conjunction with ankle and hip joint movements when performing daily activities.

The Quadriceps

Starting from the top and front (anterior) side of the knee, we have the four quadricep muscles that attach at the base of the femur, just above the knee joint:

The Rectus Femoris
The Vastus Lateralis
The Vastus Medialis
The Vastus Intermedius

The Hamstrings

On the back (posterior) side of the leg are the three hamstring muscles:

The Biceps Femoris
The Semimembranosus
The Semitendinosus

The hamstrings attach at the base of the femur and top of the tibia. If you touch the back of your knee, you may be able to feel where these insertion points are located. The hamstrings are the muscles that control flexion or bending of the knee and help to stabilize the knee when it’s extended (when the quads are contracted and the leg is straightened). They also assist in turning the knee inwards (referred to as internal rotation) and outwards (referred to as external rotation).

The Calf Muscles

Moving down to the lower part of the knee, we have the Anterior Tibialis on the front side and the Gastrocnemius and Soleus muscles on the back side.

The Anterior Tibialis originates at the top of the tibia and is responsible for deceleration during activities. When strengthened appropriately, it reduces the amount of force our knees experience when slowing ourselves down. An easy way to remember the Anterior Tibialis is to remember ‘anterior’ refers to the front side. So the Anterior Tibialis is on the front aspect of the tibia (shin bone).

Moving to the back or posterior side of the lower leg, the Gastrocnemius has two muscle heads, the medial (inner) head, and the lateral (outer) head. Both of which originate on the back of the femur and run down to the Achilles tendon. Similarly, the soleus muscle originates at the base of the femur, runs down to the heel bone via the Achilles tendon, and lies underneath the lateral head of the gastrocnemius. Both the Soleus and Gastrocnemius (gastroc for short) support the hamstrings in knee flexion and provide stability to the knee when you jump, run, flex or extend the knee during activities.

The Gastroc or Gastrocnemius Calf Muscle

The anatomy of the knee is a very complex but with these complexities come numerous functionalities. These features make the knee truly one of the most amazing joints and allow us to perform so many daily activities from walking up stairs, to hiking, biking, and everything between. It is however, important to note that with great complexities, comes great need to take care of these joints as the risk for injury to any of the structures within is increased substantially.

Tune into our knee blogs to learn more about the knees, some of the most common injuries and conditions we see here at Colorado Springs Orthopaedic Group, injury prevention techniques, and when it’s recommended to see an orthopaedic specialist for further evaluation.

If you or a loved one are struggling with chronic knee pain, give us a call to schedule an initial evaluation. Our board certified and fellowship trained orthopedic specialists want nothing more than to see you back doing the things you love to do.

Visit our providers page to meet our specialists.

CALL (719) 632-7669

Why Can’t I find Relief from Plantar Fasciitis?

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Are you asking yourself this question but don’t know where to turn? We’re here to help. Plantar fasciitis is a common condition affecting people of various ages. To understand what plantar fasciitis is and why it occurs, a brief overview of the anatomy of this region of the foot can be very useful. To begin, we will breakdown the anatomy of the plantar fascia and how it relates to daily activities.

Is Plantar Fasciitis a Tendon or Ligament?

The Plantar Fascia is a connective tissue structure that originates from the heel bone and inserts at the flexor tendons at the base of the toes. The plantar fascia consists of three bands, the medial band, central band, and lateral band. These help to support the arch of the foot and assist with normal foot mechanics while walking. While individual anatomy may vary, most people have a broad ledge of bone at the base of the heel where the plantar fascia begins. This is commonly referred to as a “heel spur” but is a normally occurring structure that does not contribute to development of Plantar Fasciitis symptoms.

Plantar Fasciitis anatomy useful to learn how to treat plantar fasciitis and techniques used in physical therapy for Plantar Fasciitis

Why Won’t My Pain Go Away?

Plantar fasciitis refers to symptoms of pain on the bottom of the heel. Often people experience heel pain with the first steps out of bed in the morning, when standing for long periods of time, or with transitioning from sitting to standing positions. These symptoms often occur from wearing non-supportive shoes or from an increase in weightbearing activities. Symptoms may also arise spontaneously. Treatment is often required to help symptoms resolve.

Who Treats Plantar Fasciitis?

Plantar fasciitis is often diagnosed clinically by an orthopedic provider who specializes in Foot and Ankle conditions. The provider will evaluate your symptoms and likely order radiographs, otherwise known as X-rays, to help diagnose and treat plantar fasciitis. If needed, an MRI may be ordered to rule out any other potential causes of pain.

How to Treat Plantar Fasciitis

running shoes to help with plantar fasciitis. Techniques used in physical therapy for plantar fasciitis helped this runner learn how to treat plantar fasciitis

A multitude of treatment options may be utilized to resolve or lessen plantar fasciitis symptoms. Many people respond well to conservative therapy. Therefore, this is often the first course of action for the treatment of plantar fasciitis. A major component in conservative treatment is supportive footwear. Walking barefoot on hard floors or walking in non-supportive shoes may exacerbate symptoms. Due to this, sneakers with thick, cushioned soles are commonly recommended for plantar fasciitis as they provide extra support to the heel with weightbearing. Some recommended shoe options include the brands HOKA and Oofos.

In addition to supportive shoes, other devices may also be incorporated for additional relief. A gel heel cup can be added to shoes for extra cushion.

Furthermore, some doctors may recommend a brace to find relief. Bracing involves the use of a night splint while you sleep, which helps to keep the foot in a neutral dorsiflexed (toes toward your head) position and assists with reducing morning symptoms

Physical Therapy for Plantar Fasciitis Pain

Physical therapy is another vital component of conservative treatment for Plantar Fasciitis. Tightness in the Plantar fascia is often found in association with tightness in the calf muscles and the Achilles tendon. A program specific to stretching the plantar fascia and the Achilles tendon may provide marked relief for your plantar fasciitis symptoms. Other modalities in physical therapy such as ultrasound or dry needling can also be utilized. Often a 4–6-week program is initially recommended, although additional physical therapy may be required. Recovery time with conservative management varies based on severity of symptoms, lifestyle, and compliance to the treatment regimen. Click here to learn 3 stretches you can do at home to help with Plantar Fasciitis pain.

How to Relieve Plantar Fasciitis Pain at Home

In addition to your prescribed Physical Therapy exercises, oral NSAIDs (non-steroidal anti-inflammatories such as ibuprofen, Aleve, Advil, etc.), rest, and ice can aid in providing symptom relief while at home. The use of supportive house shoes and avoidance of walking barefoot can also help alleviate symptoms and prevent pain.

Additional Treatments Options

If conservative treatments fail, an injection may be the next best step. Steroid injections are a common treatment option; however, they are associated with increased risk of plantar fascia rupture and fat pad atrophy. Due to these risks, steroid injections should be avoided if possible. A safer alternative to steroid injections is a treatment called PRP or Platelet Rich Plasma. PRP for Plantar Fasciitis involves collecting plasma from your own blood and then injecting this nutrient rich substance into the plantar fascia to help promote healing. While not yet FDA approved, this has been shown as a very effective treatment option for many patients struggling with Plantar Fasciitis symptoms. There is a brief period of down time following PRP injections. This typically involves patients being placed into a cast for a couple of weeks followed by a walking boot. Physical therapy is utilized in conjunction to optimize improvement. After 6-8 weeks most patients will begin gradual return to full activity.

Mechanism of Injury for Plantar Fasciitis

The plantar fascia can also be susceptible to rupture or tear with sudden insult or injury to the tissue. Often, plantar fascia rupture or tear occurs in patients with a history of steroid injections. This is a further indication to caution the use of steroid injections as a treatment modality. Symptoms of a Plantar Fascia rupture includes a sudden popping sensation in the arch of the foot followed by tenderness and bruising. If you happen to experience such symptoms, please seek out attention from an orthopedic specialist. An MRI may be ordered to confirm the tear and then a conservative treatment program will be prescribed for you. Treatment of a Plantar Fascia rupture typically involves a period of immobilization and management of symptoms with ice and NSAIDs. Recovery can take a couple of months and some patients may still have chronic symptoms as a result of the injury.

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Brad D. Dresher, MD Orthopaedic Foot and Ankle Doctor

BRAD DRESHER, MD

Dr. Alex Simpson, DO Orthopaedic Foot and Ankle Doctor

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Cubital Tunnel Syndrome

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Terms to know:

Physiologic effect: activities that affect body movement without any relation to a specific disease.
Physiologic cascade: sequence of repeated activation reactions due to a series of developments from a specific initial stimulus – example: compressing a nerve can cause muscles to involuntarily spasm due to a lack of blood flow and neurological control over the signal sent to the muscles in which that specific nerve controls.
Sensory Nerve Fibers: transmit sensations, such as temperatures and pain, to the brain and spinal cord. These fibers control the sensations you feel on your skin or within your body.
Peripheral Motor Nerve Fibers: transmit signals from the brain and spinal cord to muscles. These fibers tell your body how to move and function.
Vascularized Fat Flaps: fatty tissue that has blood vessels capable of delivering nutrients to cells within the tissue.
Muscle Atrophy: muscle weakness or loss of muscle mass

What is Cubital Tunnel Syndrome?

“Cubital tunnel syndrome” is a collection of symptoms of the upper limb caused by increased pressure within or on the ulnar nerve as it passes along the backside or inside aspect of the elbow. This is indicated within the illustrations below. It is one of many “compressive neuropathies” in which our nerves contribute to symptoms of pain, numbness, and/or motor dysfunction. These symptoms occur from a physiologic cascade of breakdown within the nerve triggered by reduced blood flow to the lower arm.

A way to demonstrate this physiologic breakdown is to take your finger and press on your skin. You’ll notice, your skin will temporarily turn white as pressure is applied due to the lack of blood flow to that specific area. The same thing happens with our nerves when there is external pressure applied to a nerve that reduces the local blood flow into the area. This can also occur when there is internal pressure within the nerve. Nerves typically display a surge of dysfunction symptoms that are initially temporary but can lead to irreversible long-term changes if not addressed.

Nerve Compression

For those interested in this sequence of breakdown and dysfunction, nerve compression in short produces diminished local blood flow from pressure placed on the compressed area. Reference back to pressing your finger on your skin for any amount of time. This reduction of local blood flow then creates altered signals to your brain. Similarly, consider the times your foot falls asleep when one leg is crossed over the other. This painful tingling and perhaps muscle clumsiness, is rapidly reversed when you simply change the position and “shake it out”. In other words, when you restore local blood flow.

However, over time chronic nerve compression leads to swelling within the nerve. This results in an alteration of the protein transport sequence necessary for proper nerve fiber function along the length of the nerve. See the illustrations below. In addition, compression on the “insulation” (called Myelin) around our peripheral nerves that promotes faster conduction, reduces the ability for nerve fibers to transmit a signal to the muscle to operate. After prolonged periods, this can lead to muscle atrophy.

Normal-Neuron-Signal-Transportation-from-Cell-to-Muscle

Nerve Breakdown and Dysfunction

Sensory nerve fibers tend to display breakdown and dysfunction first, with motor nerve fibers secondarily. Eventually, with prolonged compression, the normal connective tissue around the nerve fibers becomes thick and scarred resulting in reduced capacity of the fibers themselves. Once this occurs, there is potential that these fibers may not recover full function, even if the nerve is later decompressed through surgical intervention.

Unfortunately, although this sequence has been well defined in animal studies, it is difficult to predict the timing of this deterioration in humans. There are several variables that may contribute to either the resiliency or vulnerability of individual patients to progress to the endpoint of permanent nerve fiber scarring and dysfunction. Because of this, if you are experiencing ongoing symptoms of any form of nerve compression, it’s recommended to be seen by an orthopedic specialist.

Carpal Tunnel Syndrome vs Cubital Tunnel Syndrome

The well-known Carpal tunnel syndrome is the most common compressive neuropathy in the upper extremity and involves compression of the median nerve at the wrist. Alternatively, Cubital tunnel syndrome, as discussed here, is slightly less frequent and results from compression of the ulnar nerve as it travels along the inside of the elbow. We have normal structures that surround and support the location of the ulnar nerve as it travels behind the medial epicondyle. The medial epicondyle is that bony prominence on the inside of your elbow. However, with cubital tunnel syndrome, these normal structures, along with a normal increase of tension along the ulnar nerve as the elbow bends, can create diminished local blood flow and initiate the breakdown and dysfunction cascade mentioned above.

Upper-Extremity-Nerves-Carpal-vs-Cubital-Graphic

The symptoms resulting from this breakdown are usually quite easily recognizable. Patients usually complain of:

Numbness along the ulnar border of the hand (ring and small finger)
Tenderness along the inside portion of the elbow
Clumsiness and weakness in the hand

Many patients will experience the symptoms of numbness along the side of the hand and elbow pain during the night, as most of us sleep with our elbows bent. Symptoms may also occur with similar positions during the day. These can be activities such as talking on the phone, typing, leaning on a surface, or vigorous pushing and pulling. Most patients will notice numbness, typically around the inside of the elbow first. Clumsiness may emerge later. Over time, with chronic compression, the numbness will persist around the clock and patients will exhibit actual atrophy of the smaller muscles within the hand. When addressed soon enough, we can aim to stop the process before it reaches this stage.

Some patients can have these problems secondary to instability of the ulnar nerve. You’ll notice when the nerve is instable, it will snap back and forth over the bony prominence on the inside of the elbow whenever flexing or extending the arm.

Cubital Tunnel Syndrome Treatment

It is important to note that not all patients will manifest these exact symptoms. There are obviously variant presentations that require your physician to be attentive to symptoms and additional examination findings. Let’s discuss the process of what goes into the diagnosis of Cubital Tunnel Syndrome and the various treatment methods available.

Diagnosis

Aside from taking your injury history and listening to your symptom patterns, your clinician will perform a physical exam. This exam will include isolating the level of the injury to the nerve, the degree of nerve dysfunction, and other contributing factors. Consider that these symptoms may also be manifestations of compression of a cervical nerve root in the neck, compression of a group of nerves passing underneath your clavicle. This condition is specifically referred to as Thoracic Outlet Syndrome.

Additionally, compression elsewhere along the ulnar nerve within the arm, or compression of the ulnar nerve within the wrist, could be potential causes for your symptoms. Furthermore, sometimes symptoms of hand clumsiness or muscle atrophy is a manifestation of peripheral neuropathy, an intrinsic disease of the nerves themselves, independent of compression. Diabetic neuropathy is one form of this potential cause.

To help distinguish your diagnosis, your physician may also employ electrodiagnostic studies (often referred to as an “EMG”). These EMG’s are performed by an outside provider to help “map out” locations and severity of your nerve compression. From here, your physician will work with you to build a treatment plan suitable for your individual needs.

Initial Treatment

Initial treatment for patients with early symptoms and findings, involves avoiding compression and traction (pulling) on the ulnar nerve. For example, you will want to avoid leaning on your elbow or activities such as heavy weightlifting where weight is pulling on the affected arm.

The simplest initial treatment for pain relief is to use a nighttime splint to block hyperflexion of the elbow. Hyperflexion while sleeping is often the main contributor of symptoms for patients with this problem. For many patients, “Nerve glide” exercises such as the below, may also be helpful. There may, however, be some patients who do not respond to these exercises.

This condition, in its earliest form, is often reversible and over 50% of patients do not require surgery. Improvement in symptoms may be gradual and take a few months.

Cubital Tunnel Syndrome Surgery

If symptoms persist or if you exhibit more advanced phases of nerve compression, your physician may recommend surgical treatment to decompress the nerve and enhance blood flow. The most basic surgical measure is “decompression” of the ulnar nerve as it passes through the cubital tunnel. Sometimes, this is enough, allowing the nerve more mobility with less local compression as it glides through the cubital tunnel. However, this procedure may not be effective for every case.

The most common procedure performed is the decompressing of the nerve followed by “transposition” of the nerve to the front of the elbow, just anterior to the medial bony prominence. With this maneuver, the nerve is both decompressed and placed in a position where it is no longer subjected to stretching or tension. In some cases, the nerve may be left lying just superficial to the muscle on the inside of the elbow. Alternatively, the nerve can also be buried within that musculature to further decrease tension.

Whatever the procedural method selected, the nerve needs to glide freely with minimal tension or kinking around anatomic structures.

Ulnar nerve glide floss

Cubital Tunnel Surgery Recovery

Our physicians rarely immobilize, or restrain, the elbow following ulnar nerve decompression or transposition surgery. This is because we want your nerve to glide freely and limit potential for scarring. However, we do not want any form of violent pushing, pulling, or twisting over the initial 4-to-6-week window. To provide protection against these violent movements, we will prescribe for your surgical dressings to be in place for the initial 7 days. After those 7 days, you will typically be able to remove the dressing and allow running water (faucet or shower) over your wound. We usually have patients return for a follow up visit within 10-to-14-days post operation to complete a wound check and suture removal.

Most patients do not require formal physical or occupational supervised therapy after cubital tunnel syndrome surgery. However, we may provide instructions for simple exercises that you can perform independently at home. If further supervised visits are needed, our occupational therapists are certainly available to accommodate as such.

Things to Know Before Cubital Tunnel Syndrome Surgery

All surgical procedures incur some risk. However, those specific to ulnar nerve surgery are localized to:

Wound infection (fortunately the risk for infection is quite low)
Direct injury to the ulnar nerve
Persistent or even temporary worsening of symptoms
Numbness on the posterior aspect of the elbow (due to a small sensory nerve branch separate but overlying the ulnar nerve)
Recurrent symptoms

Let’s discuss why symptoms would occur again. This is because some patients are genetically more predisposed to developing scar tissue around nerves. Unfortunately, we are not able to identify those who are predisposed to such scaring before surgery. However, the good news is, those of us surgeons seasoned in peripheral nerve surgery are quite familiar with patients exhibiting this phenomenon. In the event this scarring occurs, it may require further surgery. This additional surgery would include concurrent measures with use of different materials to encase the nerve. Alternatively, we can utilize vascularized fat flaps to surround the nerve and limit further scar formation.

What to Expect After Cubital Tunnel Syndrome Treatment

Nerve recovery and symptom resolution varies widely. Some patients note resolution of burning and tingling within just a few days or weeks. For others, depending on the degree and chronicity of nerve compression pre-surgery, this may take a few months. This is particularly the case with patients who demonstrate muscle atrophy changes pre-surgery. Unfortunately, many of those patients will not regain normal muscle function. With this, the goal with nerve compression surgery is to stop the process of ongoing muscle atrophy from lack of neural input. Neural input is in essence, the lack of brain neurons that tell the muscle to function. Fortunately, sensation for less severe cases may recover over a few months. For patients who have had severe or chronic compression, sensation is estimated to take anywhere between six to nine months.

If you are experiencing any symptoms of Cubital Tunnel Syndrome or any other nerve injury, call us today. Our physicians will develop a treatment plan to ensure you do not suffer from any further muscle atrophy and sustain as much normal motor function as possible.

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Developed by the Colorado Springs Orthopaedic Group Hand and Upper Extremity Center

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Total Knee Replacement vs Partial Knee Replacement

Joint Replacement surgeries, specifically Knee Replacement surgeries, have become some of the most common procedures performed across the globe. This is due to many types of arthritis affecting our joints and causing joint damage. Much like the end of a chicken bone, our bones are covered with a thin but resilient layer called Hyaline Cartilage. Arthritis can be thought of as the progressive deterioration, or wear, of this layer. As this happens our underlying bones begin to rub against each other causing the substantial pain so many experience. These various types of arthritis can be caused from previous injuries, autoimmune conditions, or even simple wear and tear from activities and aging. Whatever the cause, the results can be debilitating.

Symptoms of Arthritis

Symptoms of Arthritis range from mild stiffness and soreness to the loss of proper anatomical (muscular and skeletal) function, severe pain consistently felt within the joint, and the inability to walk. As a result, many ask when is it time to see a doctor to seek pain relief for arthritis? In short, if the pain is keeping you from performing your day-to-day activities, we recommend scheduling with a fellowship trained orthopedic joint specialist to see what treatment options will suit your individual symptoms and needs.

Bi-Lateral-Osteoarthritis-in-Knees-x-ray-with-detail-600x479

Treatment for Arthritis

For those who come to us with various symptoms of arthritis, there are a few initial steps that need to occur so we can appropriately diagnose your pain as arthritis pain and thus develop a suitable treatment plan for you.

The first step in diagnosis is taking you through a full examination of the joint in question and taking x-ray images. From here, you and your physician will work together to develop a treatment plan specific for the patients needs and lifestyle. In many cases, conservative treatments such as physical therapy or injection therapy, will be recommended as a starting point. If conservative treatment options are unable to help settle the arthritis pain, surgery is often our next best option.

Over the years, the surgeries used to treat arthritis pain have become very commonplace, exceptionally reliable, and tremendously rewarding for both the patient and surgeon when the patient returns to the activities they we’re limited from prior to treatment.

Total Knee Replacement vs Partial Knee Replacement

In most cases “Knee Replacement” can be thought of as a “Knee Resurfacing”. Essentially, the surgeon will remove the worn cartilage layer from the knee and replace (resurface) it with a new layer made of a very smooth hard metal and a medical-grade plastic to restore the joint.

Total Knee Replacement

In the knee, there are three main areas where our bones come in contact with each other. The femur, (thigh bone), the tibia (shin bone) and patella (kneecap). Restoring all three of these areas at one time is what we medically classify as a Total Knee Replacement. In many cases, by the time a patient comes to see us, their cartilage damage is severe enough, a Total Knee Replacement is the most appropriate treatment.

Partial Knee Replacement

Alternatively, there are some instances where only one of these three areas is the culprit for arthritis pain. In this case, a less invasive Partial Knee Replacement may sufficiently relieve the patient’s pain.

A Partial Knee Replacement procedure involves the removal of the one area of damaged cartilage and replacing it with a similar yet more localized hardware. The knee’s unaffected areas are left alone. With most cases, this procedure can be accomplished through smaller incisions causing less surgical injury to the knee. In other words, a Partial Knee Replacement could be classified as a minimally invasive surgery with less harm done to the knee compared to a Total Knee Replacement.

What to Expect with a Knee Replacement?

One thing to always remember, just because a procedure CAN be performed, does not mean it is always the correct choice. Always thoroughly discuss treatment options with your surgeon when making decisions to undergo surgery. To elaborate, there are some cases where you may not a good candidate for either one of these procedures. Your size, age, weight, overall health, outcome expectations, and physical limitations or abilities all play a role in whether a knee replacement will be the correct procedure for you. With this, no matter if a partial knee or a total knee replacement is chosen, the procedure must be able to:

Be performed safely
Improve your function
Improve your quality of life
Meet your physical ability expectations and support most tasks that you will place on it after surgery.

Furthermore, each procedure requires a visit to either a hospital or a surgery center, where the surgery is performed through an incision over the front of the knee. During the procedure you will be under anesthesia.

Keep in mind, a Total Knee Replacement and a Partial Knee Replacement will both involve some amount of downtime and commitment to a rehabilitation period after surgery. However, with technology advancements we are now able to have most patients up walking with assistance immediately after surgery. Additionally, in many cases we can perform the procedure as an outpatient procedure and send you home to recover the same day as surgery.

Knee Replacement Recovery Time

Although a partial knee replacement may be slightly less painful and overall an easier recovery than a total knee replacement, they are both very dependent on a strict and crucial rehabilitation period. The patient’s diligence with their postoperative physical therapy protocols is critically linked to the success of their surgery. Also, as mentioned previously, your preoperative condition and overall health status greatly affects success of the surgery as well as the time to reach full recovery. If post operative rehabilitation is adhered too, many patients are walking independently within days to weeks following the procedure. Likewise, some patients are able to go back to work within four to ten (4-10) weeks as well. After either type of knee replacement surgery, you can expect to see progressive improvement in your knee’s pain and function for up to a year.

If you are suffering from pain and stiffness in your knees that is not adequately controlled with a conservative treatment, talk with your orthopedic surgeon or call us today to schedule your initial evaluation.

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Developed by the Colorado Springs Orthopaedic Group Joint Replacement Team

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How to Treat a Sprained Ankle

Symptoms, Diagnosis, Treatment, and Recovery

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What is an Sprained Ankle?

An ankle sprain usually occurs when the ankle is twisted, causing injury to the soft tissue of the ankle. This occurs most commonly during athletic activities or with awkward falls from a curb or a step. They are one of the most common injuries that we treat in our practice. It is also estimated that millions of people suffer an ankle sprain each day.

Ankle Sprain Grades

Within the ankle there are numerous tendons and ligaments however, when an Ankle Sprain occurs, it typically involves the ligaments specifically.

To define, a ligament is a thick band of tissue that connects bone to bone. A sprain of the ankle results in the stretching or tearing of one or more of these ligaments.

There are a few different severities, otherwise referred to as ‘grades’, of an Ankle Sprain. These grades range from one (1) to three (3).

A Grade One (1) ankle sprains is a stretch of the ligaments.

Grade Two (2) ankle sprains are partial tears of the ligaments within the ankle.

A Grade Three (3) ankle sprain is a complete tear of the ligaments.

High Ankle Sprains vs Low Ankle Sprains

If you’ve injured your ankle before, you may have heard the terms ‘High Ankle Sprain’ and ‘Low Ankle Sprains’. To differentiate the two, a High Ankle Sprain is when the sprain damage occurs at the high ankle ligaments that connect from the tibia to the fibula.

Alternatively, a Low Ankle Sprain involves the ligaments just below the ankle joint, commonly referred to as the subtalar joint. Click here to learn more about the subtalar joint and additional Ankle Anatomy.

Low ankle sprains can be further classified as Inversion Sprains or Eversion Sprains. The majority of ankle sprains tend to be inversion ankle sprains and occur when the ankle rolls inwards. Whereas, an eversion ankle sprains occurs when the ankle rolls outward.

Low inversion ankle sprain from lateral view. Including grades of ankle sprains

low eversion ankle sprain including various grades of low ankle sprains and how an ankle sprain can occur

How to Treat a Sprained Ankle

Sprained Ankle Symptoms

Soon after the initial injury occurs, the ankle will become swollen, painful, and can be accompanied by excessive bruising. You will also notice moving or walking on the ankle can be very difficult due to the pain and swelling.

Ankle Sprain Diagnosis

At Colorado Springs Orthopaedic Group (CSOG) and within our orthopaedic urgent care, CSOG Express Care, we can help make the initial diagnosis of an ankle sprain through an in-person examination. In conjunction with this exam, we will take X-ray images of your ankle to confirm that there is not a break in any of the ankle bones. Many patients ask if an MRI is needed to confirm the degree of an ankle sprain. To answer this, an MRI of your ankle is not always apart of the initial image ordering. It can however, be warranted and ordered if your ankle fails to improve after a period of prescribed physical rehabilitation.

Sprained Ankle Treatment and Recovery

Treatment can begin by using the PRICE principle: Protection, Rest, Ice, Compression, and Elevation.

In addition to using the PRICE principle, a walking boot or brace is used to protect your ankle and allow the ankle ligaments to rest in a favorable position.

Crutches can also help prevent any weight bearing on the ankle, and casts may be used in severe ankle sprain cases. The healing of the ligaments usually takes around six (6) weeks, but the swelling may be present for several months.

After one (1) to three (3) weeks of rest and rehabilitation, we can begin Physical Therapy and proceed based upon the sprain’s severity. Depending upon the degree (grade) of the ligament damage, long term physical therapy and/or surgery may be suggested.

How to treat a sprained ankle including a high ankle sprain

Chronic Ankle Sprains

Chronic ankle sprains are generally considered those that occur repeatedly however, they can also be sprains that have failed to improve over a significant period of time. This is usually the result of inadequate initial treatment of a recent ankle sprain or due to a very severe original ankle sprain.

When the ankle is not treated correctly after the initial sprain, then the ligaments can heal in a stretched out fashion leading to what’s known as a “loose” ankle. Those with loose ankles tend to have a lack of confidence in their ankle stability and suffer from weak ankles that may hurt and give out frequently.

If this is the case, when you are seen by a physician at Colorado Springs Orthopaedic Group, they may refer you to our in-house orthotic team at Audubon Orthotics and Prosthetics Services, to fit you with a stabilizing ankle brace in efforts of preventing future re-injury.

If you have suffered an ankle sprain or have experienced multiple ankle sprains, do not hesitate to reach out to the Foot and Ankle Center at CSOG. After a thorough evaluation to include X-Ray and potentially MRI imaging, our team will work with you to develop an individualized plan to make sure you regain confidence in your ankle stability for the long term.

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What is Frozen Shoulder?

Causes, Symptoms, and Treatment Options

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Terms to know:

Humerus: upper arm bone
Scapula: shoulder blade
Clavicle: collarbone
Shoulder Capsule: group of strong connective tissues that encapsulate and secure the shoulder’s ball and socket joint
Contracture: when a soft connective tissue around a joint becomes stiff, constricted, or shortened.
Manipulation under Anesthesia (MUA): when the patient receives general anesthesia and a series of stretching, traction, and mobilization is performed by the surgeon.
Arthroscopy: a minimally invasive surgical technique that involves using a camera and specially designed instruments that are inserted into the joint via several small incisions.

Shoulder Anatomy

The shoulder is a ball-and-socket joint that is made up from three bones: the Humerus (the upper arm bone), the Scapula (commonly known as the shoulder blade), and the Clavicle (collarbone). The humerus fits right into a shallow socket that is formed within the scapula, right under where the clavicle sits above the scapula. Strong connective tissues surround this joint and hold these boney structures in place. These tissues are referred to as the Shoulder Capsule in medical terms. Additionally, Synovial fluid resides within the shoulder capsule and shoulder joint to help the shoulder move with ease.

Adhesive-Capsulitis-anatomy-normal-vs-inflammed-600x373

What is Frozen Shoulder?

Frozen shoulder, also known as Adhesive Capsulitis, is a condition where the shoulder capsule surrounding the shoulder joint becomes stiff and in turn causes pain in the shoulder. It is a relatively common cause of disabling shoulder pain and dysfunction. Although it is not as common as a rotator cuff problem, the pain it causes is typically much more severe.

Frozen Shoulder Stages

There are three (3) stages of Frozen Shoulder.

Stage one (1) is referred to as the ‘Freezing” stage. This is when pain can worsen and range of motion becomes more limited. This stage typically lasts between six (6) to nine (9) weeks.

Stage two (2) is the ‘Frozen” stage. In many patients, pain may subside to some degree however, stiffness typically remains. Day to day activities can also be very difficult during this stage that can last anywhere between four (4) to six (6) months.

Stage three (3) known as the ‘Thawing’ stage, is when the shoulder stiffness starts to decrease and motions begins to slowly improve. It is within this stage when a patient will begin to return to their normal or close to normal strength as well. This stage is the slowest progression stage and can take anywhere from six (6) months to three (3) years.

What Causes Frozen Shoulder?

Frozen shoulder affects approximately three (3%) percent to five (5%) percent of the general population and tends to affect patients between the ages of forty (40) and sixty (60) years old. The cause of this problem is not well understood however, it involves scarring and contracture of the joint capsule. This scarring and constriction leads to limited mobility of the shoulder joint.

Many who are affected by frozen shoulder do not have any predisposing conditions, however those with diabetes, hypothyroidism or hyperthyroidism, cardiovascular disease, fibrocystic breast disease, or Parkinson’s disease may be more at risk. Additionally, Frozen Shoulder can also develop following trauma to the shoulder, or even after a previous shoulder surgery.

Frozen Shoulder Symptoms

The hallmark physical examination involved with the diagnosis of frozen shoulder is assessing the loss of passive and active mobility in the shoulder joint. Patients often do not acknowledge the significant loss of motion when it occurs as it usually develops slowly and many unconsciously compensate by using more scapular (shoulder blade) motion when performing day to day activities.

Frozen Shoulder Treatment

The good news is that Frozen Shoulder will usually get better without any formal treatment. The bad news is that it can take a very long time (up to several years), and patient symptoms will often trigger them to seek treatment to shorten the course of this problem. To help with this, there are a variety of conservative treatment options available with surgical treatments typically utilized as a last resort for the appropriate patients.

Conservative Treatment Options

Conservative treatments include modalities such as physical therapy for joint mobilizations, oral non-steroidal medications, and steroid injections that can help improve the pain level and restore functional motion. With this, the primary objective in the conservative treatment of frozen shoulder is to control pain while the problem resolves on its own. Studies have shown that, approximately more than ninety percent (90%) of patients see substantial improvements with these various conservative treatments.

Moreover, additional conservative treatment methods have been developed in recent years. These methods however, remain considered as experimental procedures and are not yet approved through the FDA. To learn more about these alternative treatments, we recommend that you further discuss with your physician.

As an alternative to conservative methods if pain and functional limitations are not responding to these conservative treatments, surgery or a Manipulation under Anesthesia can be considered to restore proper mobility. Both conservative and operative treatment methods have shown great success in relieving pain from Adhesive Capsulitis and restoring mobility within the shoulder joint.

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Surgical Treatment Options

There are two general operative treatment options to help treat Frozen Shoulder: Manipulation under Anesthesia (MUA) or Arthroscopic Surgery.

Manipulation under Anesthesia

The first, Manipulation under Anesthesia, is performed with the patient completely sedated by an anesthesiologist with intravenous medication. After the patient is asleep, the surgeon simply manipulates the shoulder in a very specific manner to break apart the scar tissue and restore the shoulder’s range of motion. The key to success with this procedure is for the patient to participate in physical therapy and maintain the range of motion after the manipulation.

Arthroscopic Surgery

Secondly, surgery can be performed as an outpatient procedure where the patient will return home the same day as surgery. Typically an Arthroscopic technique is used during this operation. To define, Arthroscopy is a minimally invasive surgical technique that involves using a camera and specially designed instruments that are inserted into the joint via several one quarter inch (1/4”) incisions. The instruments are utilized to cut and remove the scar tissue that is restricting movement. This approach is very effective in restoring normal, or near normal, range of motion. The key with this procedure is that the patient does their part with following their prescribed post-operative physical therapy protocols.

Following surgery of this kind, the arm is kept out of the sling and full range of motion is encouraged from the day of surgery. Daily physical therapy is typically prescribed for the first couple weeks after surgery to help maintain the motion attained during surgery and strengthen the muscles around the joint. This procedure is effective in restoring and maintaining the motion of the shoulder in over ninety (90%) of the cases that require surgery.

If you believe that you are suffering from symptoms of a frozen shoulder, call our office today to schedule with one of our Fellowship Trained Shoulder Specialists. Let’s get you on the road to recovery!

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Jamie Friedman, MD

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Ankle and Foot Anatomy Basics

Basic anatomy for any joint structure within the body includes bones, joints, muscles, tendons, and ligaments. For our purposes, we will be discussing anatomy of the ankle and foot structures specifically.

Terms to Know:

Lateral: outside
Posterior: backside
Anterior: frontside
Medial: inside
Distal: situated away from the center of the body
Proximal: situated closer to the center of the body than distal

Anatomy of a Joint Structure

A joint is a part of a body where two or more bones meet. The ends of these bones are covered by Cartilage. To define, Cartilage is a connective tissue structure that helps provide shock absorbing properties when performing activities. In addition to cartilage, Synovial Fluid presents within each joint space and promotes smooth movement of the joint. There are also important connective tissues called Tendons and Ligaments that make up each body structure. A tendon is a tissue that connects muscle to bone. Similarly, ligaments connect bone to bone.

Ankle Anatomy

The ankle joint is formed where the bones of the lower leg, the Tibia and Fibula, meet the Talus. With this, the portion of the fibula, located at the ankle level, is referred to as the Lateral Malleolus while the portion of the tibia at the ankle level is referred to as the Medial Malleolus. These two (2) ankle bones are commonly fractured in injuries. Additionally, just below the ankle joint is the Subtalar Joint, which is located between the Talus and the Calcaneus. The Calcaneus is also known as the heel bone.

Each of these joint junctions are responsible for allowing movement of the ankle in four different directions: Plantarflexion, Dorsiflexion, Inversion, Eversion. To demonstrate these directions, point your foot. Your ankle is in the Plantarflexed position. Now, bring your toes towards your head. This is the Dorsiflexion position. From here, if you move your toes inwards you will be in the Inverted position. Alternatively, if you move your toes outwards, you will be in the Everted position.

In many cases, normal wear and tear from aging can predispose the ankle joint to arthritis. However, wearing appropriate footwear for your activities and performing ankle strengthening and stretching exercises can delay the onset of arthritis. Tune into our blog Osteoarthritis vs Rheumatoid Arthritis to learn more about the causes of arthritis and ways to prevent or delay its onset.

Muscular and Tendon Anatomy of the Ankle

The posterior side of the lower leg houses the calf muscles. These muscles attach to the Achilles tendon, which is the largest tendon in the body. This is exposed to large amounts of force in activities such as running or jumping, making it prone to injury. The Tibialis Posterior muscle also lives in the posterior side of the lower leg. Continuing, the tendon associated with this muscle crosses over the middle portion of the ankle and is called the Posterior Tibialis Tendon. Those with flat feet may be at risk for additional strain on this tendon, which if not addressed, can lead to tendonitis.

ligaments and tendons of the foot, Ankle anatomy, ankle bones Achilles-Tendon-Conditions

The lateral compartment of the lower leg contains two muscles, the Peroneal Brevis and the Peroneal Longus muscles. Subsequently, the tendons of these muscles travel on the outside of the ankle and can also be subject to strain with overuse. Other important structures over the lateral ankle include three (3) lateral ligaments: the Anterior Talofibular Ligament (ATFL), the Calcaneofibular Ligament (CFL), and the Posterior Talofibular Ligaments (PTFL). These structures are vital for stability of the ankle. Injury to these ligaments, as commonly seen with ankle sprains, can lead to long-term instability if not treated properly. Visit our blog What to do for a Sprained Ankle to learn more about how to treat an ankle sprain.

Ankle Bones, ankle anatomy, Ankle-Joint-Ligaments ankle bones, ligaments and tendons of the foot

Foot Anatomy

The feet each contain 26 bones as well as many soft tissue structures including tendons, ligaments, nerves, and vascular structures. In medical discussion, the foot is often broken down into three (3) portions: the Hindfoot, Midfoot, and Forefoot.

The Hindfoot

The Hindfoot contains the talus and calcaneus, otherwise known as the ankle bone (Talus) and heel bone (Calcaneus). As mentioned previously, these two (2) bones join to make up the Subtalar Joint and allow the foot to rotate in multiple directions at the ankle level. Additionally, the Plantar Fascia Tendon runs from the calcaneus to the end of the metatarsal bones located in the forefoot.

The Midfoot

The midfoot houses the five (5) tarsal bones and three (3) ligaments. These ligaments are referred to as the Lisfranc Joint Complex and connect the midfoot to the forefoot. The five metatarsal bones, to include the navicular, cuboid, and three (3) cuneiform bones, all help to form the arches of the foot. Alone, the midfoot bones do not provide all the stability for the midfoot. The Midfoot Ligament Complex is also responsible for providing stability. This complex of Lisfranc ligaments includes the Dorsal Lisfranc Ligament, the Interosseous Lisfranc Ligament, and Plantar Lisfranc Ligament. These ligaments help maintain alignment of the tarsal and metatarsal bones and act as shock absorbers during activity.

The Forefoot

Within the forefoot, you will find the metatarsals and the toe bones, medically known as the Proximal, Medial, and Distal Phalanges. The Distal Phalanges are located at the end of each toe while the Proximal Phalanges are situated closest to the metatarsals and allow the toes to bend. You will also find the four (4) deep transverse metatarsal ligaments within the forefoot. These ligaments help to stabilize the metatarsal bones and prevent the foot’s arch from widening or collapsing. These forefoot structures are key to navigating various surfaces and maintaining balance when performing activities such as walking, running, pivoting, or jumping.

Due to their weightbearing capacities and vital function in performing day-to-day activities, the feet and ankles can be subject to many different conditions that may cause discomfort. Because of this, Arthritis in the joints of the feet can occur secondary to routine wear and tear or following injuries. Additionally, different deformities such as flat feet, high arches, bunions, hammertoes, or mallet toes may occur. These deformities can result in pain, calluses, and difficulty wearing shoes. If you are experiencing any of these symptoms or conditions, please give our office a call and we will design a treatment plan based on your personal needs and get you back to the lifestyle you enjoy.

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The intrinsic anatomy of the ankle and foot can cause various injuries or conditions to become very complex. For more information on conditions of the foot and ankle and treatment options available, check out our blog series developed by our providers within the Foot and Ankle Center.

Developed by the Colorado Springs Orthopaedic Group Foot and Ankle Center

Brad Dresher, MD

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Kristina Hoffmann, PA-C

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G. Alex Simpson, DO

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Jasmine Wohlman, NP

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New FDA Approved Drug-Free Treatment for Painful Diabetic Neuropathy

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What is Diabetic Neuropathy?

Diabetic Neuropathy is chronic nerve damage in the upper and lower extremities caused by constantly high blood sugars. It is a chronic debilitating condition which can interfere with a person’s sleep, their functionality, and their overall quality of life.

Around 34 million Americans have diabetes (CDC, 2020) and roughly half of all adults with diabetes will suffer from Diabetic Neuropathy in their lifetime (Hicks, 2019). Of those, it’s estimated approximately 2.3 million will suffer from Painful Diabetic Neuropathy (PDN) with no relief by using current treatments and conventional medical management (Schmader, KE., 2020).

What are the Typical Symptoms of Painful Diabetic Neuropathy (PDN)?

Those who suffer from Painful Diabetic Neuropathy typically have daily continuous pain. Typical symptoms of include tingling, numbness, and pain in the extremities. This nerve damage can make patients more vulnerable to falls, burns, infections, ulcers, and long-term complications.

What Treatment Options are there to Relieve Chronic Pain from Diabetic Neuropathy?

Current treatment options aim to relieve the chronic pain that is frequently seen with Diabetic Neuropathy. These treatments often include pain medicines such as Tylenol or Aspirin. NSAIDS such as Ibuprofen or Advil, however, are not recommended for diabetic patients. Some patients with Diabetic Neuropathy are also treated with nerve medications including Neurontin (Gapapentin), Lyrica, and Topomax. When patients don’t respond to these medications, narcotics or opioids are often used.

Although narcotics can lessen pain, they have significant long term consequences including dependence, decreased benefit over time, and abuse. New federal guidelines aimed at reducing opioid misuse and abuse have resulted in many physicians denying or limiting opioid therapy for some chronic pain patients. Physicians are constantly looking to improve clinical and interventional tools to treat complex chronic pain. One of these advancements includes the development of Spinal Cord Stimulation (SCS).

Spinal cord stimulation has been available since the 1960s and uses a device called a Spinal Cord Stimulator to treat chronic pain. This small device is placed on the spinal cord to calm the spinal nerves and suppress the pain responses to the brain. As a result, pain lessens for the patient. Each device is programable to the individual patient’s needs. Additionally, Spinal Cord Stimulation allows for patients to go through a weeklong trial period to test their response to the device before permanent implantation.

There are many types of Spinal Cord Stimulators and the technology and programming options that come with them have made many advancements in recent years. These advancements have shown to provide better pain relief for many chronic pain conditions. Most recently, Spinal Cord Stimulation for Painful Diabetic Neuropathy (HFX™ for PDN) developed by Nevro, received FDA indication and approval to treat Painful Diabetic Neuropathy.

Who is HFX™ for PDN for and what does Spinal Cord Stimulator Surgery entail?

Patients suffering from Painful Diabetic Neuropathy specifically, who have not responded well to conventional medicine treatments are typically good candidates for a Nevro HFX™ for PDN Spinal Cord Stimulator trial. During this trial period, a temporary version of the stimulator is placed through a needle without undergoing surgery. The patient will then use this device for one week and monitor their pain levels, activity level improvements, and their need for pain medicine. At the end of the trial, the device is removed. Ninety percent (90%) of patients who go through the trial have enough to success to make the decision to move forward with a permanent stimulator (Diabetes Care, 2021).

Once this decision has been made, a permanent spinal cord stimulator can be implanted with a quick outpatient surgery. With any outpatient surgery, the patient is able to go home and recover the same day as surgery. The permanent implant procedure is done through two small incisions. After the incisions are made, a paddle with metal contacts is placed against the spinal cord and a rechargeable battery is placed below the skin.

What is the Average Recovery Time from Spinal Cord Stimulator Surgery?

Moderate activity is limited, and strenuous activity is restricted for approximately six weeks post-surgery. This recovery time ensures that the device is received well, and the body has time to heal. However, despite this dedicated recovery time, many patients can feel pain relief in as little as a few days after their operation.

Recovery is quick with approximately eighty six percent (86%) of patients with Painful Diabetic Neuropathy experiencing substantial, long-term relief after 12-months (JDST, 2021). Additional details of the study can be found here.

CONTACT THE SPINE CENTER AT CSOG

Stay tuned, ongoing studies are showing great success using Spinal Cord Stimulation (SCS) to help treat additional types of Neuropathy such as Peripheral Neuropathy.

Click Here for additional Data on Nevro’s HFX™ for PDN or visit https://www.hfxforpdn.com/

Dr. Roger Sung, MD Colorado Springs Orthopaedic Group

Dr. Sung is a Fellowship-Trained and Board-Certified Orthopedic Surgeon who specializes in Cervical, Thoracic, Lumbar, and Sacroiliac surgery, Microsurgery, and Minimally Invasive Spine Surgery techniques. He also performs complex spine reconstruction using minimally invasive techniques.

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Cartilage Restoration: Innovative Treatment for Knee Pain in Active Individuals

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What is Cartilage?

Articular (or hyaline) cartilage is a tissue in the body that lines the ends of the bones, providing a smooth surface for movement of the joint. It also serves as a shock absorber during activities. When there is an injury to the cartilage in a joint, it does not heal on its own as there is no direct blood supply to aid in this process. Instead, cartilage continues to deteriorate over time, especially with continued activity. This leads to a disease called Osteoarthritis. Fortunately, there are now procedures available to restore the cartilage in a joint without having to go through a joint replacement. The most common joint for a Cartilage Restoration procedure is the knee.

Treatment Options for Cartilage Disorders

There is a spectrum of treatment options for treating cartilage disorders including palliative, reparative, resurfacing, and reconstruction. Palliative treatment is known as Chondral Debridement, where the uneven surface of damaged cartilage is smoothed out during arthroscopic surgery. This does not replace injured cartilage but may relieve pain as there is no longer a loose flap of tissue moving abnormally in the joint. This may be an option for a patient with only a partial thickness cartilage injury or an older patient who does not participate in demanding activities. The recovery time for this procedure is minimal. The patient can be full weight bearing and does not have any range of motion restrictions after surgery.

When there is a very small, focal lesion of missing cartilage, the patient may be a candidate for a reparative procedure known as Marrow Stimulation. This procedure is sometimes referred to as Microfracture. With this procedure, holes are made directly into the lesion allowing bone marrow to escape into the defect. This allows for healing of the lesion with a substance known as Fibrocartilage, which acts similarly to innate articular cartilage when in a small area. This is a simple arthroscopic procedure but does require some restrictions during subsequent rehabilitation to allow the Fibrocartilage to develop and heal.

Cartilage Restoration for Active Individuals

When we think of true “Cartilage Restoration” procedures, there are really two different types – Resurfacing and Reconstruction.

Resurfacing: “Repaving the Street”

When the lesion is too large for microfracture but still only involves the surface of the bone, then a resurfacing procedure is warranted. There are several ways to resurface the end of the bone with new cartilage. One technique is to take the patient’s own unused cells out during an arthroscopic procedure and send them to a lab to be grown into new cartilage cells, which would then be placed over the lesion that is missing cartilage. This process is known as Autologous Chondrocyte Implantation and requires two surgical procedures – one to harvest the cells and another to put them into the defect. The benefits of this procedure are that it uses the patient’s own cells and is able to resurface a large area of damage. The recovery depends on where in the knee these cells are placed, but generally range of motion is encouraged early as cells adhere to the bone and proliferate right away. Patients are able to ride a bike within weeks and even start running after just a few months.

Another resurfacing technique is done by Allograft Implantation. Rather than two separate surgeries, this can be done in one arthroscopic or minimally invasive procedure. The defect is debrided, and the donor cells are pasted into place and fixated with a type of biologic glue. Similarly, patients progressively return to their normal activities within several weeks as the cells grow into real articulating cartilage.

Pre Cartilage Resurfacing Of The Patella

Post Cartilage Resurfacing Of The Patella

Reconstruction: “Filling the Pothole”

When a cartilage defect extends beyond the surface to involve the underlying bone, a structural graft is necessary in a reconstructive procedure to restore the cartilage. The size of the injured cartilage determines whether the cartilage can be obtained from the patient or must come from a donor. If it is a smaller lesion, then a cartilage plug (includes underlying bone) may be taken from a place in the joint that does not need it and placed into the defect. This procedure is called Osteochondral Autograft Transplantation and is typically done with a minimally invasive open incision. However, when the size of the defect is too large to take it from another place, donor tissue is required. In this case, a plug can be made to fit the size of the void after the missing cartilage and damaged underlying bone is removed. Even an oval shaped plug can be fashioned to fill a large, long defect over the weightbearing surface of the knee, which is termed a BioUni. These procedures are called Osteochondral Allograft Transplantations and may be an alternative to partial or total joint replacement for the right patient. Although they do take longer to heal compared to a cartilage resurfacing procedure, the patients generally return to activity within a few months and have excellent outcomes.

Large Cartilage Defect Of The Medial Femoral Condyle

Cartilage Graft Being Placed Into Defect

Cartilage Graft Placed Into Defect

Small Cartilage Defect Of The Medial Femoral Condyle

Harvested Cartilage Graft Ready for Placement

Large Cartilage Defect Of The Medial Femoral Condyle

Reconstruction Innovation

There is a very exciting new procedure using the Osteochondral Allograft Transplantation concept to replace the entire undersurface of the patella (kneecap). The patella cartilage is especially vulnerable to injury in athletes, specifically runners. Here in Colorado Springs, we see many patients with this problem who are told that their only options are to stop being active, live with the pain, or get a partial or total knee replacement. This procedure provides an opportunity to restore their cartilage and get them back to activities within a matter of months. We are excited to announce that Dr. Jamie Friedman is the first orthopaedic surgeon to bring this technology to the state of Colorado. The first patient to undergo this procedure here in Colorado Springs is currently doing his physical therapy and has registered to run a marathon this coming June.

Pre Total Biologic Resurfacing Of The Patella

Donor Patella Ready For Placement

Post Total Biologic Resurfacing Of The Patella

Cartilage Restoration and Joint Deformity: Knocked-Kneed and Bowlegged

Finally, one aspect of Cartilage Restoration that is often overlooked is the alignment of the joint itself. Many people are born either knock-kneed or bowlegged, but if there is too much of this deformity in the joint, it puts additional pressure on one side of the knee. If the underlying problem of leg malalignment isn’t addressed, it can cause continued damage to the existing cartilage and a cartilage restoration procedure may fail. In this case, the patient may be a candidate for realignment surgery to balance out the knee joint in conjunction with restoring the damaged cartilage. If the patient is too knock-kneed (Genu Valgum), then they may need what is called a Distal Femoral Osteotomy. This is when the bottom end of the thigh bone (Femur) is cut and straightened out with an opening wedge. If the patient is too bowlegged (Genu Varum) then they may need what is called a High Tibial Osteotomy. This procedure involves cutting the top end of the shin bone (Tibia) to straighten out the joint with an opening wedge. Although these deformity correction procedures require the longest recovery (several months), they save the patient from a joint replacement and have great long-term outcomes.

Valgus Malalignment Pre Distal Femoral Osteotomy Surgery For Knocked Knee

Valgus Malalignment Post Distal Femoral Osteotomy Surgery For Knocked Knee

Varus Malalignment Pre High Tibial Osteotomy Surgery For Bow Legged Knee

Varus Malalignment Post High Tibial Osteotomy Surgery For Bow Legged Knee

Is Cartilage Restoration right for you?

So, who is the right candidate for a Cartilage Restoration procedure? The ideal patient is young, active, and motivated. These patients are typically considered too young for a partial or total knee replacement (18-45 years old) and are still involved in an active lifestyle such as team sports, running, hiking, biking, skiing, etc. Patients who currently have pain in their knee with these activities are first assessed in the clinic and with x-ray images. Typically, advanced imaging with an MRI is necessary to fully characterize the cartilage and the underlying bone. If the surgery does not require a donor graft, then the surgical procedure can be scheduled right away. If a donor graft is necessary, then this graft must be ordered, and surgery is not scheduled until a match is found, which usually takes 4-8 weeks.

Cartilage Restoration Recovery

Cartilage Restoration procedures do take some time to recover from – weeks to months – but the patients who are determined to follow the rehabilitation protocols have great outcomes. The goal of Cartilage Restoration is to get patients back to the activities that they love to do without having a joint replacement.

Developed by the Colorado Springs Orthopaedic Group Sports Medicine Team

The Anterior Cruciate Ligament (ACL) and Sports Injuries

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We have all seen it before. An athlete is running and attempts to change directions and suddenly falls to the ground. They instinctively grab their knee. What could have possibly caused an athlete who has made that same maneuver many times to fall so suddenly? Before we answer the question, lets take a closer look at how our knees and the Anterior Cruciate Ligament are made and how they function.

ACL Anatomy

We often think of a knee as a simple hinge joint. One that straightens and bends or extends and flexes. The reality is much more complicated than that. The knee has three planes of motion with six different directions! Beyond flexion and extension there is also side to side motion as well as rotation. Each step involves varying degrees of each of these motions.

Ligaments are the structures that attach bone to bone and provide stability to the knee while still allowing the freedom of movement needed to walk, jump, skip, or run. There are four ligaments in our knee, the medial and lateral collateral ligaments on the inside and outside, and the anterior and posterior cruciate ligaments located in the middle of the knee. The medial and lateral collateral ligaments keep the knee from bending too far inside or outside. Alternatively, the anterior and posterior cruciate ligaments keep the knee from sliding too far forward or backward. This combination of all four ligaments is what keeps our bones appropriately aligned and provides stability to our knees.

Functions of the ACL

Now let’s go back to our athlete. One of the most common causes of sudden instability when changing directions is a tear of the Anterior Cruciate Ligament (ACL). This happens because the ACL has two primary functions. We have already talked about the first function, to keep the knee from sliding too far forward, this is medically known as Anterior Translation. The other function of the ACL is to keep the knee stable during rotation. The ACL and PCL are called “cruciate” ligaments because they cross over one another. This orientation gives significant stability to rotation in the knee. When an athlete plants their foot to change direction, the ACL is at maximum tension preventing both rotation and anterior translation. When the force from the athlete’s pivot is too much, the ligament fails. This causes sudden instability in the knee which can damage other structures in addition to the ACL.

One of the earliest symptoms of an ACL tear is significant swelling inside the knee joint. Because the ligament is located inside the knee, the tear causes bleeding inside the joint resulting in large amounts of swelling. It is often very difficult to walk immediately following an ACL injury. Patients with torn ACLs will often say their knee feels tight and it may be difficult to bend or straighten their knee.

Treatment Options for an Anterior Cruciate Ligament Injury

In the days following an Anterior Cruciate Ligament tear, the swelling will often subside, and motion will return. Many people can walk without needing crutches or a brace. Patients will often describe a sensation of feeling like their knee is unstable when they walk. Unfortunately, a torn ACL will not heal on its own. Our knee joint is filled with lubricating fluid that allows the joint to move smoothly. This is great for motion but limits the ability of structures inside the knee to heal. Because of the limited healing ability, the most typical treatment recommendation is an ACL reconstruction, or “rebuilding”, of the ligament, commonly performed using arthroscopic techniques.

There are two primary ways to rebuild the ligament. For younger patients, the preference is typically to use the patient’s own tissue to reconstruct the ACL. The most common tissue types used are the patellar tendon underneath the kneecap, hamstring tendon from the back of the thigh, or quadriceps tendon from the front of the thigh. Each tissue, or graft, has its own strengths and weaknesses and all have been used with great success. Surgeon and patient preference is often the deciding factor on which graft is best. Another commonly used tissue is called an allograft. This comes from a donor and is sterilized prior to the procedure to limit risk of infection or rejection.

Surgery typically takes 1-2 hours depending on the type of graft chosen and if any additional procedures need to be done at the same time as the reconstruction. Treating an ACL tear without surgery is rare. The lack of stability and increased motion in the knee following ACL injury is thought to increase risk of arthritis and additional damage in the future.

ACL Recovery Time

Postoperative ACL rehabilitation focuses on early range of motion and appropriate strengthening exercises to increase function while protecting the graft. Full graft incorporation is thought to occur 6 months following surgery although some studies show that the graft continues to evolve even up to 1 year following surgery. Objective criteria are typically used to guide return to sport protocols such as return of normal motion, strength the same as the other leg, and an appropriate time interval.

Good news for our athlete, Anterior Cruciate Ligament tears are commonly treated successfully, and athletes often return to the same type of sports activities. While the road to recovery may take several months, we can often expect to see that athlete competing at a high-level by the next season.

Developed by Dr. Craig Yager, Board Certified Sports Medicine Surgeon

ACL Injury Prevention with Tessa Kothe, DPT

Spinal Cord Stimulation (SCS) for Diabetic Neuropathy

In this Medical Minute, Dr. Roger Sung discusses a new drug-free treatment, Spinal Cord Stimulation (SCS) for diabetic neuropathy. We will discuss what diabetic neuropathy is, what spinal cord stimulation (SCS) is and how it works to treat Diabetic Neuropathy, and what to expect post-operation.

What is Diabetic Neuropathy?

Diabetic neuropathy is a type of nerve damage that is caused by high blood sugar within the body. This high level of blood sugar can injure nerves most commonly the nerves in the legs and feet. Symptoms generally include numbness or pain, but can also include digestive track issues, urinary tract issues, and issues with the blood vessels and heart.

For some individuals, symptoms are mild, but in some, more extreme cases can be extremely painful and disabling. According to the Mayo Clinic, nearly 50% of individuals with diabetes experience burning, tingling, and numbness associated with diabetic specific neuropathy.

If you or someone you know is struggling with painful diabetic neuropathy, this new drug-free treatment offered at Colorado Springs Orthopaedic Group may be an option.

What Drug-Free Treatment for Diabetic Neuropathy is available?

In collaboration with Nevro, a medical device company focused on individualized solutions for those suffering from chronic pain, we at Colorado Springs Orthopaedic Group are proud to offer the latest technology advancement, HFX™ for Painful Diabetic Neuropathy (PDN), a drug-free treatment addressing PDN through use of advanced spinal cord stimulation technology. Spinal cord stimulators (SCS) are electronic devices implanted against the spinal cord to disrupt nerve signals that are sent to the brain and cause pain. Through settings on the device’s remote control, patients can independently control their pain levels and find relief from living with PDN.

Studies have shown patients who have tried HFX™ for PDN, received 76% pain relief within the first six months of implantation. While there are some medication options to treat diabetic neuropathy, these medications generally have side effects. We believe this innovative treatment is a great Drug-free option for patients experiencing the pain and discomfort associated with PDN.

What does the Spinal Cord Stimulator Operation Entail?

After a thorough evaluation with one of our Board-Certified Spine Surgeons, they will determine if a patient is an appropriate candidate for HFX™ for PDN. If the patient and Surgeon agree to move forward with this treatment option, the surgeon will schedule the patient for an initial 7-day trial of the device. During the trial procedure, the surgeon will implant a temporary spinal cord stimulator along the patient’s spine and provide them with the tools and education to independently manage their pain throughout the next week. These trials allow patients to experience the device before they commit to receiving the permanent implant.

If the trial spinal cord stimulator implant is determined be an effective treatment for that patient, they will schedule the patient for their outpatient procedure that implants the permanent version of the device.

What is the Recovery Time for Spinal Cord Stimulation (SCS)?

The recovery time for the spinal cord stimulation implant operation is about six weeks however, many Patients are only generally sore for about one week. Moderate activity is limited during this time and strenuous activity is restricted for approximately six weeks post-operation to ensure that the device is received well, and the body has time to heal. Despite this recovery time, patients can feel pain relief in as little as a few days after their operation.

If you would like to see if this drug-free treatment can benefit you, call the Colorado Springs Orthopaedic Group at (719) 632-7669 to schedule a consultation!

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Spinal Cord Stimulation Review: Nevro Testimonial

“Thanks to HFX*, I no longer manage my day based on when I need to take the next pain pill,”

said John, whose back pain began in 2003 when he was injured while overseas with the military. In 2016, thirteen years after his initial injury, John underwent a spinal fusion but was then in a serious car accident that caused his back and leg pain to return.

John had been an active guy who played competitive hockey, participated in highly physical activities during his military career and kept up with his four young children. “However, my progressive back and leg pain reduced my activity level to almost nothing,” he explained. “I had to walk with a cane and take medication to control my pain level.”

After many other attempts to find relief, John was referred to Dr. Roger Sung, who recommended an HFX trial. “I had such significant pain relief during my April 2019 trial that it was like night and day,” John said. “I was even able to drastically reduce my doses of pain medications.” He decided to move forward with his HFX implant in June 2019.

“I have had 60-70% pain relief consistently with HFX and no longer walk with a cane or take medication,” John said. “I have truly regained my life with HFX.”

This is just one spinal cord stimulation review on the Nevro SCS system specifically. See what other patients have to say as they give their Spinal Cord Stimulation Reviews on our YouTube channel. Learn More about the Nevro SCS systems at www.NevroHFX.com

#NevroHFX #ChronicPain

Results may vary. Important safety & risk information: www.nevrohfx.com/safety

*HFX is a comprehensive solution that includes a Senza spinal cord stimulation system and support services for the treatment of chronic pain

What is an MRI & When is an MRI Needed?

Welcome to a Medical Minute segment with Dr. David Matthews a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses what is an MRI is & when MRIs are needed.

What is an MRI?

MRI (magnetic resonance imaging) is a way of using magnetic gradients and radio waves to capture images within specific areas of the human body.

When does a patient need an MRI?

Dependent upon the location and severity of an injury, there are cases where an x-ray image cannot detail the condition of soft tissues such as ligaments or tendons. Therefore, your physician may order an MRI to deeper evaluate the condition of such tissues.

How are they used in orthopedics?

MRIs are often ordered by your physician soon after your initial evaluation to capture detailed images of the injured body part and assist your physician with developing your individualized treatment plan.

What are the risks of an MRI?

As MRI machines are comprised of extremely high-powered magnets, it is required to remove any metals from your body prior to entering the machine. This may also include any implants or pacemakers therefore, it is crucial for patients to inform their physician and MRI technician of any implanted devices prior to scheduling an MRI. If the metal on your person is removable and all metal objects are removed prior to entrance, then the risks of having an MRI are minimal. Please call our MRI department at 719-867-7315 with any questions you have or to schedule your appointment.

Visit www.CSOG.net to learn more.

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What is Arthroscopic Surgery? Medical Minutes with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses the common question: ‘What is Arthroscopic Surgery?’

What is Arthroscopic Surgery?

Arthroscopic surgery is a minimally invasive technique where the physician accesses the joint through small incisions with a pencil-sized camera. This small camera allows the surgeon to see within the joint and repair the injured structures without making large incisions. This allows for quicker recovery times, and studies have shown improved long-term patient outcomes using this technique. Arthroscopic surgery is typically used to treat larger joints such as the shoulder, hip, knee, ankle, and some cases the thumb joint.

Is arthroscopic surgery better than traditional surgery?

Dr. Jones believes it depends on what injury needs to be treated and the severity of such injury when deciding between traditional or arthroscopic surgical techniques. There are some surgeries that provide better outcomes when using arthroscopically such as rotator cuff tears, ligament tears within the shoulder, and meniscus tears within the knee. However, other surgeries such as joint replacements or spinal surgeries are typically performed by way of traditional or alternative minimally invasive surgical methods.

To learn more about arthroscopic surgery options or to schedule an appointment with any one of our 16 fellowship-trained Orthopedic Physicians, call us at (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

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Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

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Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

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John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

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Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

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Joint Cartilage Restoration in Colorado Springs

Many Colorado Springs patients may wonder if joint cartilage restoration is the best treatment option for their joint issues. Joint pain and stiffness can be quite debilitating and worsen over time. Most people experience cartilage problems in their knees. However, it can also occur in the shoulder, elbow, hand, wrist, ankle, or hips. Unfortunately, cartilage does not heal on its own due to the lack of direct blood supply. One treatment for a cartilage injury or disease is to restore the cartilage rather than replace the joint.

If you are experiencing joint pain caused by cartilage damage, call us today to schedule a consultation and discuss treatment options with one of our Cartilage Restoration Specialists at Colorado Springs Orthopaedic Group. We can provide you an accurate diagnosis to determine the cause of your problem. We can also recommend an optimal treatment plan to help you become pain-free and active again. Call 719-632-7669 to schedule.

Below you will find additional information on the various Cartilage Restoration treatment options for joint pain offered at Colorado Springs Orthopaedic Group.

Causes

The general causes of cartilage damage include chronic or acute injury, trauma, disease, or degeneration. In all cases, the cartilage has been compromised and no longer provides smooth gliding or cushioning of the joint.

Cartilage Injury or Trauma:

If you fall or sustain a traumatic sports injury, you can tear or separate joint cartilage. Usually, the pain will be sharp and sudden. It is also possible to damage ligaments or tendons in the joint area at the same time. Thus, the pain, inflammation, and stiffness you experience could be caused by compounding injuries. Your joint may also lock-up, give way, or feel unstable when trying to bear weight on it.

Cartilage Disease or Degeneration:

Arthritis, specifically osteoarthritis, is the most common cause of joint pain. With arthritis, the cartilage is damaged and inflamed from long-term wear and tear. Sometimes the pain is persistent. Other times it can come and go, even while resting. Most often, the pain worsens when you try to use the joint or place weight upon it. You may also experience a grinding or clicking sensation. These symptoms can be exasperated by living a high-impact, rigorous lifestyle or by carrying extra body weight. To some degree, cartilage degeneration can be genetic.

Other Joint Issues That Have Similar Symptoms

Rheumatoid arthritis: Rheumatoid arthritis (RA) is a disease where your immune system attacks the lining of your joints. RA can cause pain and disfigurement.

Gout: Gout is caused by the buildup of uric acid in the joint. The acids crystalize and cause a flare-up of sudden and intense pain. Gout is common in the knees, fingers, and toes.

How to Restore Cartilage in Joints Naturally

Cartilage does not have a direct blood supply to bring healing nutrients to the tissue therefore, it generally does not heal on its own. In some cases, conservative treatment methods such as physical therapy can help with strengthening a joint, taking pressure off of the damaged cartilage however, if the damage or degeneration is too severe, surgery may be required to restore function and decrease the associated pain.

Cartilage Restoration Joint Surgery

With Cartilage Restoration Joint Surgery, your physician may elect to repair the damaged cartilage in one of two ways:

Cartilage Repair
The damaged cartilage may be removed using certain techniques, and the bone is resurfaced, like “repaving a street.” During the operation, the physician may use different innovative systems to accomplish this such as MACI©, DeNovo© (Zimmer-Biomet), or Biocartilage/Cartiform© (Arthrex). When the MACI© procedure is used, cartilage cells are retrieved from the patient, sent to a lab for processing, and later implanted back into the same patient to provide a smooth surface of their own cartilage. With the other options, cartilage cells from a donor are used to fill in the defect and provide an even cartilage surface. In both cases, the joint biology is restored, leaving no area of damaged cartilage.

Cartilage Reconstruction
If the bone underneath the cartilage is also damaged, the physician may perform a cartilage reconstruction procedure, similar to “filling in the pothole.” If the lesion is small, then healthy cartilage from an unused part of the knee may be transplanted to the area that needs it. This procedure is called an Osteochondral Autograft Transplant (OATs). For larger areas of damage, you may need a donor “plug” to fill in the defect. This procedure is called Osteochondral Allograft Transplantation (OCA). In both cases, the joint surface is restored with new cartilage and underlying bone.

Procedure

Typically, cartilage restoration joint surgeries can be done arthroscopically or with minimally invasive techniques. This means your physician will insert a camera called an arthroscope through small incisions made around the joint allowing the physician to see in detail within the joint. Minimally Invasive procedures are procedures where smaller incisions, compared to traditional open surgeries, are made allowing for less damage to the surrounding structures and for the body to heal at an accelerated rate, inevitably shortening the recovery time. These minimally invasive procedures also decrease the chance of infection and typically reduce scarring.
A typical joint restoration surgery can take anywhere between 1 to 4 hours to complete and is usually an outpatient procedure that allows you to recover in the comfort of your own home, the same day as surgery.

Our Cartilage Restoration Doctors

At Colorado Springs Orthopaedic Group, we are fortunate to have highly skilled and compassionate cartilage restoration joint surgeons who specialize in the diagnosis and treatment of all conditions affecting the joints and associated cartilage.

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two cartilage restoration surgery centers in Colorado Springs:

North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

Contact us today at 719-632-7669 to schedule a consultation and learn if cartilage restoration for joint pain is right for you. We are ready and dedicated to helping you get pain-free!

Visit us at www.csog.net to learn more.

Rotator Cuff Injuries & Surgery with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses rotator cuff injuries & surgery and what to do if you suspect an injury to your rotator cuff.

What muscles are involved within the rotator cuff?

The rotator cuff is composed of four muscles that surround the shoulder joint and keep it in place. Those four muscles are:

- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis

The Supraspinatus is by far the most common tear that Dr. Jones’ sees in patients. This is the tendon that is right on top of your shoulder.

What is the difference between a rotator cuff tear and a rotator cuff tendonitis?

Most rotator cuff tears result from overuse or recurrent injuries. Over time, without proper treatment, these recurring minor injuries can result in rotator cuff tendonitis. Most patients who have rotator cuff tendonitis experience pain, especially when weightlifting or when lifting objects in specific directions such as overhead or in front of the body. Those with suspected rotator cuff tears may experience a much more intense pain and can sometimes feel a crunching or popping when they move the shoulder in various directions.

Does a rotator cuff tear require surgery?

There are patients who have rotator cuff tears who do not need surgery. Some may not even know when they have a rotator cuff tear as pain intensities will vary person to person. Dr. Jones’ believes the first step to recovery is to always try conservative treatment options prior to discussing surgery. These conservative treatment options may include physical therapy or injection therapy to control pain and strengthen the supporting shoulder muscles.

What is the timeframe for athletes to play sports again after a rotator cuff tear?

All patients should take excessive caution for the first three to four months after surgery as the shoulder joint will take time to mature and heal. Additionally, the better the patient’s overall health, the better the healing process will go. Recovery time to get back to full activity without restrictions is estimated to take between six to twelve months.

What are the symptoms of a rotator cuff tear?

Symptoms of a rotator cuff tear include pain with lifting, especially if a patient is lifting something out away from their body or overhead. Another symptom is pain at night that either wakes them from their sleep or prevents them from falling asleep entirely.

To learn more about rotator cuff injuries and custom-tailored treatment options visit us at www.CSOG.net. To schedule an appointment, please call (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Accelerated Recovery Knee Replacement Surgery

Welcome to a Medical Minute segment with fellowship-trained, board-certified Joint Replacement Surgeon, Dr. Michael Feign, DO of Colorado Springs Orthopedic Group (CSOG). Join Dr. Feign as he discusses accelerated recovery knee replacement surgery and how technology advancements of Total Knee Replacement have accelerated the recovery processes as well as how to determine a successful surgery. Learn more about how to schedule an initial consultation with one of the Joint Replacement Specialists within the Comprehensive Joint Replacement program at CSOG.

Within the last 15 years, there have been many innovative technological advancements specific to Total Knee Replacement procedures. Since their initial development, a knee replacement surgery generally entails resurfacing an arthritic surface by placing an implant on top of the surface, providing the patient with better mobility, smoother motion within the joint, and less overall pain. With a 96-98% success rate, these procedures are used to help qualified patients get back to the activities they love to do as quickly as possible. The method of replacing an arthritic joint with an implant has not changed significantly in recent years however, advances in the material used for implants and the customization of each implant have shown to drastically improve patient outcomes when accompanied by advancements within pre- and post-operative patient care.

With traditional procedure technologies, patients were required to stay within the surgical facility for upwards of 5-6 days after surgery with little to no movement or physical therapy performed during at least the first 3-4 days. Now, with new technological advancements, patients may be required to stay at the facility for one night, with many patients capable of going home on the same day. This allows for those patients to recover in the comfort of their own home. In most cases, patients will now move around and perform low intensity physical therapy just hours after surgery. Incorporating this movement immediately after surgery is a key piece in initiating the recovery process.

The most influential changes within Total Joint Replacement procedures and the piece that has helped accelerate the recovery process, has been advancements within individualizing pre- and post-operative patient care. These advancements include how surgeons are able to prepare and customize implants prior to surgery, improvement within the process of preparing the patient for surgery when administering anesthesia, optimizing the patient’s health, strength and mobility before surgery through individually prescribed physical therapy, as well as improvements in post-operative pain management through the use of temporary nerve blocks and pain pumps.

Even though the outcome of these surgeries has been great for many years, Dr. Feign and his team are always trying to improve techniques to ensure the best outcomes and overall patient satisfaction. Measurement of a successful procedure can vary from physician to physician. Dr. Feign believes success occurs through use of a quality implant, the surgeon being well trained, the implant being well balanced, the right size and right positioning for the patient, as well as optimizing the patient and their individual needs to obtain their most optimal health. He personally measures a procedure’s success by frequently checking in with patients, even years after their procedure, and ensuring that same person is doing well with the same knee replacement and continues to do so 10 -15 years down the road.

The average recovery time for a knee replacement generally takes about one year. Within two to three months, most patients are back to doing normal day to day activities without assistance from others.

For more information or to schedule an appointment with one of the Joint Replacement Specialists of the Comprehensive Joint Replacement Program at Colorado Springs Orthopaedic Group, call (719) 632-7669 or visit our Joint Replacement Center webpage

Orthopaedic Walk-in Clinic in Colorado Springs

Welcome to a Medical Minute segment with Dr. Eric Jepson, fellowship-trained, board-certified Orthopedic Joint Replacement specialist as he discusses the walk-in orthopaedic Express Care clinic at Colorado Springs Orthopedic Group where no appointment is needed and we’ll have you in and out within half the time of the ER.

Express Care is an Orthopedic Urgent Care located within Colorado Springs Orthopedic Group. We are here to help expedite the treatment process of any acute or sudden-onset injuries.

Come on into our Walk-In Clinic

Often times, after someone has experienced an injury, they will go to the emergency department and wait upwards of several hours to be seen. Instead, you can be evaluated and initially treated by the providers at CSOG’s Express Care for the same injuries in half the time. After initial evaluation and treatment, each patient seen in Express Care is then scheduled for a follow up visit with one of our 18 fellowship-trained orthopedic specialists. During this follow-up visit, our specialists will review any x-ray images and further develop your customized treatment plan.

Please note, if you have a significant and emergent injury, it is recommended that you go to the emergency department.

Some of the many common injuries we see within our Express Care clinic include:

Ankle sprains and fractures
Hand, wrist, and upper extremity injuries
Sports injuries
We can also help if a new back pain symptom presents itself.

Sports Physicals

We also offer Sports Physicals for all local school districts for only $25. No insurance or appointment needed.

When seen within Express Care, you are guaranteed to be treated properly and efficiently by one of our highly trained orthopedic providers. Additionally, you do not need a referral to be seen within Express Care.

Where to find us

Our Express Care clinic is located at 4110 Briargate Parkway. Across the parking lot from Memorial North and Children’s Hospitals on the first floor within suite 145.

We are open Monday through Friday from 9 a.m. to 5 p.m., Saturdays from 8 a.m. to 12 p.m., and are closed on Sundays.

To learn more about the Express Care at Colorado Springs Orthopaedic Group, call us today at (719) 632-7669 or visit www.csog.net/services/our-express-care.

Knee Cartilage Restoration in Colorado Springs

Colorado Springs Orthopaedic Group is now offering several advanced knee cartilage restoration procedures to save patients from an early joint replacement. With knee cartilage restoration, the joint can be reconstructed or resurfaced, which helps the patient return to normal activities without pain. These surgical procedures have been successful in elite athletes and active adults, allowing them to return to their sport without any restrictions.

You might ask, ‘can cartilage be restored?’ Cartilage lacks a direct blood supply necessary to heal on its own; however, cartilage restoration procedures provide a viable option to restore cartilage to a fully functional state.

Below you will find additional information on the various Cartilage Restoration treatment options for joint pain offered at Colorado Springs Orthopaedic Group.

Cartilage Restoration Surgery in Colorado Springs

Dr. Jamie Friedman, fellowship-trained Sports Medicine physician is specifically trained to perform advanced Cartilage Restoration procedures.

Surface Cartilage Lesions
These occur when the cartilage damage extends only to the surface of the cartilage and has not affected the underlying bone. There are two primary procedures to address this type of injury:

Biocartilage allograft transplantation:: is a single procedure that can be done arthroscopically or as an open procedure. During the operation, Dr. Friedman utilizes one of several innovative systems to take cartilage cells from a donor and places them within the area of damaged cartilage to fill in the defect, providing an even cartilage surface for the bones to move smoothly across. This restores the joint biology, leaving no damaged cartilage.

Cartilage defect of the trochlea
(underneath the knee cap)

Cartilage defect debrided for clean edges

New cells implanted and sealed with fibrin glue

Autologous Cell Implantation:This is a two-stage surgery however allows the patient’s own cells to be used. During the operation, Dr. Friedman utilizes an innovative system called MACI©. When the MACI© system is used, cartilage cells are biopsied from the patient, sent to a lab, and later implanted back into the same patient to provide restored cartilage. The surgery to harvest the cells is done arthroscopically, while the implantation is done as a minimally invasive open surgery through a small incision.

Below are examples of MACI© on the Medial Femoral Condyle:

Biopsy of cartilage from a place that doesn’t use it

Debridement of two separate lesions on the condyle

Implantation of the cells grown from the biopsy

Structural Cartilage Lesions

When the damage extends past the cartilage and affects the underlying bone, there are two types of procedures to treat this injury:

Osteochondral Autograft Transplantation (OATs):used for smaller lesions and is not used on the patella. As shown below, the Osteochondral Autograft Transplantation takes a cartilage “plug”, or a bone graft with cartilage, from a different place in the patient’s knee, and Dr. Friedman puts it into the defect.

Osteochondral Allograft Transplantation (OCA):This procedure works for larger lesions. In fact, this procedure can be used to do BioUni, which covers the entire condyle similar to a partial knee replacement. This method can work on almost any surface of the knee, including the patella. The Osteochondral Allograft Transplantation works by taking a cartilage “plug” from a donor that matches the same contour and places it into the defect. Below is an example of OCA on a patella:

Large cartilage defect under the patella

The defect is debrided to make room for the graft

A cartilage graft is placed into the defect

Below is an example of OCA on the medial femoral condyle:

Large cartilage defect of the medial femoral condyle

A cartilage graft is placed into the defect

Malalignment of the Leg

There are two types of coronal malalignment of the leg:

Valgus Malalignment of the Knee:This is where a patient is too “knock-kneed”, which causes excessive pressure on the outside, or lateral, part of the knee. Dr. Friedman uses a distal femoral osteotomy to correct this. Below are before and after images of the distal femoral osteotomy procedure.

This leg is too “knock-kneed”, which causes too much pressure on the outside of the knee

After the procedure, the leg is more straight

Varus Malalignment of the Knee:This is where a patient is too “bow-legged”, which causes a lot of pressure on the inside, or medial, part of the knee. Dr. Friedman uses a high tibial osteotomy to correct this. Below are before and after images of this procedure.

This leg is too “bow-legged”, causing too much pressure on the inside of the knee

After high tibial osteotomy, the leg is more straight

Our Cartilage Restoration Doctors

At Colorado Springs Orthopaedic Group, many of our physicians have extensive training and experience in knee cartilage restoration surgery and will ensure your treatment is a seamless process.

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two convenient cartilage restoration clinics in Colorado Springs:

North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

Learn if you are a candidate to restore cartilage in the knee or another joint and call 719-632-7669 to schedule an appointment at CSOG for a medical evaluation and consultation.

ACL Tears & Reconstruction with Dr. Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group as he discusses ACL tears and reconstructions.

What is the ACL?

The ACL is one of the four main ligaments within the knee joint and is the commonly injured ligament within the knee. The ACL’s role is to provide stability when performing movements such as pivoting or twisting.

How does an ACL tear occur?

Many ACL tears arise from sports related injuries such as skiing, court sports, or field sports. These injuries can occur through non-contact and contact related incidents. An example of a non-contact ACL injury is when an athlete is running, they plant their foot and then pivot without rotating the planted foot with the upper leg causing excessive strain on this ligament. ACL injuries can also be from contact incidents such as a slide tackle in soccer, where another player hits the player’s knee in the opposing direction from which the player’s body is already moving.

How can an athlete prevent an ACL injury?

Proper conditioning and strengthening programs can help prevent ACL tears. There are even specific ACL prevention programs offered that teach how to jump, land, and cut, building the surrounding muscle tissue to support these ligaments within the knee. Training movement patterns in the lateral plane of motion is a great place to start with ACL injury prevention.

What do I do for an ACL tear?

One of the worst things you can do after an ACL tear is wait a few weeks until your knee starts feeling better, the swelling has dissipated and then the patient tries to perform the same activities that lead to injury. As ligaments have a reduced blood supply in comparison to their surrounding musculature, in many cases continuing activity without treatment could potentially lead to further extensive damage. Dr. Jones sees this occur quite often and urges patients to seek orthopedic medical attention, especially if you feel a ‘pop’ during initial injury. Our fellowship-trained Sports Medicine Program Physicians at Colorado Springs Orthopaedic Group specialize in ACL repairs and reconstructions. Give us at call at 719-632-7669 or visit our Walk-in Express Care Clinic if you suspect an ACL tear.

What are ACL treatment options?

The majority of ACL tears will require either an ACL Repair or ACL Reconstruction surgery to ensure proper healing and prevent future instability within the knee. Your physician will recommend the best ACL treatment option dependent upon the severity of the initial tear. With an ACL repair, the surgeon will reattach the torn ligament to its corresponding boney structure through use of minimally invasive arthroscopic techniques. During an ACL reconstruction, the most common ACL treatment, the surgeon will replace the damaged ligament with a new ligament either from another part of the patient’s body or from a donor using minimally invasive arthroscopic techniques.

To learn more about ACL injuries, or to schedule an appointment with one of our fellowship-trained orthopedic surgeons at Colorado Springs Orthopaedic Group, please call (719) 632-7669.

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Shoulder Fractures with Colorado Springs Orthopaedic Group

Welcome to a Medical Minute segment with Dr. Christopher Jones, MD, fellowship-trained, board-certified Orthopedic Sports Medicine Surgeon as he discusses shoulder fractures, how technology advancements have influenced the treatment process, and the typical recovery time to heal from a clavicle fracture.

What is the most common type of shoulder fracture?

The most common shoulder fracture that Dr. Jones’ and his team sees are clavicle fractures. Mountain biking is very common in the Colorado Springs community and people fall off their bikes and break their clavicles quite often.

If someone hurts their shoulder, at what point should they be seen by a physician?

If someone has broken their clavicle, they are going to feel it, hear it, and therefore know it. They are going to feel pain and there may be some visible evidence of deformity, significant bleeding, bruising, or tenting of the skin. Anyone experiencing these symptoms should be seen right away.

How has the treatment process of clavicle fractures changed over time?

There have been quite a few improvements to how clavicle fractures are treated now vs traditional methods. Historically, clavicle fractures were treated non-operatively. However, in recent studies, physicians are finding that these fractures typically do not heal as well as they thought they did when left untreated. During the injury evaluation process, there is a certain criteria that needs to be looked at such as x-rays, skin, and other things that would tell a physician if the patient needs surgery. Dependent upon these findings, the physician will develop a customized treatment plan to ensure efficient healing.

What type of procedure is used to treat clavicle fractures?

The clavicle will typically break in three different areas – either in the mid-shaft, which is the most common type of clavicle fracture, medial, and/or lateral segments of the bone. Treatment plans will vary drastically based on where the fracture is located however, plates and screws are the most commonly utilized tools to stabilize and piece the fracture back together. In some cases, a rod is inserted down the center of the bone.

What is the recovery time?

The average healing time of a clavicle facture that has not been treated operatively is approximately 16 weeks. Treating a clavicle fracture operatively significantly reduces the recovery time down to an average of 12 weeks. Recovery will vary dependent upon a patient’s diligence with their prescribed post-operative physical rehabilitation protocols.

To schedule your initial consultation, call us today at 719-632-7669.

To learn more about the comprehensive services available at Colorado Springs Orthopaedic Group, visit www.CSOG.net/services

Minimally Invasive Foot Surgery

Welcome to a Medical Minute segment with G. Alex Simpson, DO, Orthopedic Foot and Ankle Surgeon with Colorado Springs Orthopaedic Group as he discusses the latest advancements in Minimally Invasive Foot Surgery and how these techniques can be used to treat many painful foot conditions.

What is Minimally Invasive Surgery?

Minimally Invasive Surgery (MIS) is described from Dr. Simpson as “how we can operate on a patient without making a big incision.” With smaller incisions, there is less damage done to any surrounding structures which allows for decreased recovery time, minimized pain, and a much lower risk for infection.

What conditions can Minimally Invasive Foot Surgery be used for?

There are many different types of painful foot conditions and injuries where minimally invasive foot surgery specifically can be used for treatment. Some of which include:

Hammertoes
Bunions
Tendon injuries
Cartilage injuries
Plantar fasciitis

Talk with your physician to see if you might be a candidate for minimally invasive foot surgery as eligibility may vary case to case dependent on the severity of injury as well as the patient’s overall health. In most cases minimally invasive surgeries are an outpatient procedure, allowing the patient to go home and recover the same day as surgery.

How do these innovative surgery techniques help recovery?

Minimally invasive surgery techniques have been shown to help accelerate the recovery and rehabilitation process as well as significant improvements in outcome longevity. Recovery timelines will vary as mentioned previously due to the patient’s overall health, the type of injury treated, and the severity of the foot condition. However, being that we are eliminating the need for a large incision, generally speaking recovery is typically a little bit shorter with minimally invasive surgery because we decrease the time it would take to heal a larger incision. Again this does depend on a number of case specific factors and is not quantifiable in set timelines.

Learn More

If Minimally Invasive Foot Surgery is of interest to your painful foot condition, give us a call today at 719-632-7669 to schedule with a specialist from our Foot and Ankle Center team. They will help determine if Minimally Invasive Foot Surgery is the right treatment for you.

Visit the CSOG Foot and Ankle Center to learn more.

Ankle Replacement Vs Fusion in Colorado Springs

Welcome to a Medical Minute segment with G. Alex Simpson, DO, Board Certified Orthopedic Foot and Ankle Specialist at Colorado Springs Orthopaedic Group where he discusses ankle replacement vs fusion procedures. In this segment Dr. Simpson also discusses injuries that can initiate the onset of arthritis in the ankle.

During an ankle fusion, the surgeon will fuse the ankle bones together disabling movement within the joint. The goal of this procedure is to decrease pain within the joint. Alternatively, an ankle replacement replaces the tibiotalar joint (ankle joint) where your shinbone (tibia) sits on top of your foot bone (talus). This procedure does allow for movement within the joint after surgery.

Both Ankle Fusions and Ankle Replacements can be used to treat arthritis in the ankle.

What to Expect

After discussing symptoms and reviewing diagnostic imaging, your physician will work with you to develop a detailed treatment plan comprised of the most efficient treatment method to fit your needs. The right treatment typically varies upon:

Your natural anatomical bone placement
Your body’s natural movement translation within the joint
Quality of bone density
Your routine physical activity habits.

For those not eligible for a replacement, an ankle fusion remains a great treatment option for ankle arthritis.

Some examples of injuries that may lead to the onset of ankle arthritis include:

A bad ankle sprain that was never been treated
An ankle break where the bones are out of position for any period of time and where they may have healed in an abnormal way.

arthritis in the ankle treated with Ankle Replacement vs Fusion

How We Can Help

At CSOG, we offer a wide variety of services that can help patients accelerate their recovery processes. At both locations, our Audubon Orthotic and Prosthetic Services team can custom fit you to any necessary braces, orthotics, or stability boots. We also offer injection therapies, such as cortisone injections and in-house physical therapy services as conservative treatment options. These conservative options, specifically physical therapy, can help delay the onset of arthritis in the ankle as well as help accelerate your rehabilitation post-surgery.

If you’re curious as to which procedure, an ankle replacement or ankle fusion, is best for you, give us a call at 719-632-7669 today to schedule a consultation with one of our Foot and Ankle Specialists.

Visit the CSOG Foot and Ankle Center to learn more.

Cartilage Restoration Procedures in Colorado Springs

Articular cartilage is a smooth, white tissue that acts as a cushion between specific bones and allows your joints to move smoothly. When compromised due to traumatic or overuse injuries, you may experience significant pain and restricted mobility. Unfortunately, cartilage lacks a direct blood supply therefore, it does not heal on its own when damaged. Without treatment or alteration in perpetual activities, this can lead to the onset of early arthritis. However, with technological advancements, such as cartilage restoration procedures, joint preservation is possible for active individuals who may be too young to qualify for a joint replacement or would prefer not to receive a total joint replacement.

Fellowship-trained Sports Medicine Physician, Dr. Jamie Friedman of Colorado Springs Orthopaedic Group, is specifically trained in several advanced Cartilage Restoration procedures addressing:

Treatment for Surface Cartilage Lesions
- Autologous cell implantation
- Biocartilage cell allograft implantation
Treatment for Structural Cartilage Lesions
- Osteochondral Autograft Transplantation (OATs)
- Osteochondral Allograft Transplantation (OCA)
Treatment for Malalignment of the leg
- High Tibial Osteotomy (HTO)
- Distal Femoral Osteotomy (DFO)

With Cartilage Restoration, the joint can be resurfaced or reconstructed to a natural smooth surface allowing the patient to return to their normal activities with reduced or non-existent pain.

“I’m excited to bring Cartilage Restoration procedures to Colorado Springs. We have such an active population here, and nobody wants to be limited by joint pain. My goal is to get both the elite athlete and weekend warrior back to the activities they love. Cartilage Restoration makes this possible with minimally invasive techniques that provide many years of unrestricted activity without pain. Saving a patient from an early knee replacement is very rewarding.”
– Dr. Jamie Friedman, MD.

Cartilage Restoration Surgery

Cartilage Restoration is a treatment option that can delay or prevent the need for joint replacement surgery especially in younger adults. Each procedure type replaces the damaged cartilage and provides the knee joint with both the necessary shock absorbing and smooth gliding mechanisms to allow activities performed by the patient to occur without pain.

The best candidates for Cartilage Restoration surgery can range; however, are most commonly active young adults or those who have severe pain and are too young for a partial or total knee replacement.

Cartilage Damage Symptoms

Common causes of cartilage damage include repetitive wear and tear on the joint, a traumatic injury, or a sports injury. With sports or traumatic injuries, the twisting or jarring of the joint can cause the cartilage to tear or separate. It is common for cartilage damage to occur at the same time when ligaments or tendons around the joint are injured. For example, during an ACL or MCL tear, it is common to see a meniscus or articular cartilage injury.

Most symptoms present with increased pain or swelling after a particular activity or at the end of an active day. They may also have mechanical symptoms such as painful clicking or catching when the knee is bent or straightened. In very advanced cartilage loss, patients may be severely limited by this pain.

Symptoms indicating you may have cartilage damage include:
- Stiffness or pain within the joint
- Swelling of the joint
- Reduced range of motion
- Painful clicking or catching when you bend or straighten your knee
- Weakness or the feeling of being unstable

The presentation of pain will vary from patient to patient. For some, the pain is a persistent ache. For others, the pain comes and goes, and can be induced when suddenly bearing weight on the joint. You might also notice that your joint does not bend or twist as far as it used to. This limited range of motion could be caused by swelling, discomfort, or a mechanical issue within the joint.

Types of Cartilage Restoration

Dr. Friedman specializes in arthroscopic or minimally invasive Cartilage Restoration procedures. The below details the three main types of Cartilage Restoration procedures that are performed at Colorado Springs Orthopaedic Group.

Surface Cartilage Lesions:
This can be thought of as ‘repaving the street’. Dr. Friedman uses this technique when the cartilage problem is only on the surface.

Structural Cartilage Lesions:
This can be thought of as ‘filling in the potholes.’ Dr. Friedman uses this technique when the cartilage problem involves the underlying bone.

Malalignment of the Leg:
There are two types of Coronal Malalignment of the leg. Someone may either be too ‘knock-kneed’ also called genu valgus or someone may be too ‘bow-legged’ also called genu varum. An osteotomy is the corrective procedure to realign the knee joint in either case.

Cartilage Restoration Recovery Time

Recovery time for a Cartilage Restoration procedure will vary dependent upon which surgery is performed, adherence to physical therapy protocols, and the overall health status of each patient. On average, a patient will be partially weight-bearing for six weeks; however, they will start their rehab right away. As the cartilage continues to heal, the patient will increase their range of motion, strength, and balance typically returning to normal activities within three months. Overall, you can anticipate between four to six months to fully recover and return to more rigorous activities and sports.

Cartilage Restoration Physician:

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Cartilage Restoration Near Me

We have two cartilage restoration surgery centers in Colorado Springs:
North Location
4110 Briargate Parkway, Suite 300,
Colorado Springs, CO 80920
(719) 867-7320

South Location
1259 Lake Plaza Drive, Suite 100,
Colorado Springs, CO 80906
(719) 622-4524

Is Joint Cartilage Restoration Right for You?

You do not have to live with pain. If you are suffering from joint pain and suspect cartilage damaged, contact us at 719-632-7669 to schedule your initial consultation.

Visit us at www.csog.net to learn more.

CSOG Comprehensive Joint Replacement Program

Welcome to a Medical Minute segment with Dr. Tyler Bron, MD, Orthopedic Joint Replacement Surgeon as he introduces the New Comprehensive Joint Replacement Program at Colorado Springs Orthopedic Group.

Comprised of our four fellowship-trained Joint Replacement Surgeons and their teams, you can guarantee we will be with you every step of the way through your entire treatment journey! From initial consultation to post-operative rehabilitation, our clinical and case management teams will have you back on your feet as quickly as possible. When you become a patient of the Comprehensive Joint Replacement Program here at CSOG, you can expect a customized treatment plan designed specifically towards the severity of your condition using the most innovative and effective treatment methods available today.

Not only do our surgeons specialize in traditional joint replacements methods, they also specialize in minimally invasive surgical (MIS) techniques such as robotic assisted minimally invasive joint replacement procedures.

Outpatient total joint procedures performed in our ambulatory surgery center, The Orthopedic and Spine Center of Southern Colorado or within our community hospitals, allow the patient to recovery in the comfort of their own home the same day as surgery. Discuss with your physician if outpatient surgery is right for you as eligibility for these procedures may vary upon the severity of your injury or condition as well as your overall health.

CSOG has the largest group of fellowship-trained joint surgeons in southern Colorado and together have a combined 72 years of joint replacement experience. They pride themselves on the team approach, especially with severe cases our team of joint surgeons will meet and discuss in depth the most efficient treatment options to accelerate your recovery and get you back on your feet, doing the things you love to do, as quickly as possible.

To schedule your initial consultation, call us at 719-632-7669 today!

Visit www.CSOG.net to learn more.

Latest Posts

Understanding ACL Reconstruction and Recovery

Understanding Shoulder Anatomy

Understanding Adult Scoliosis

ACL Injuries With Dr. Friedman

Welcome to a Medical Minute segment with Dr. Jamie Friedman, Fellowship-trained Orthopedic Sports Medicine physician at Colorado Springs Orthopaedic Group as she discusses what an ACL injury is, how it is diagnosed, and what the typical recovery time after ACL surgery is.

What is an ACL injury?

An ACL, also known as the Anterior Cruciate Ligament, is a double bundle structure in the middle of the knee. It connects the femur to the tibia and one of the four main ligaments that provides stability within the knee. The ACL helps provide stability to the tibia, preventing it to slide too far forward as well as aids in stabilizing the knee during rotation and lateral movement patterns.

What are the most common ways to injure your ACL?

The most common way to injure your ACL is from a

non-contact activity where a pivoting action occurs. Activities that would cause this pivoting action include high intensity sports such as soccer, basketball, or skiing. Occasionally, ACL injuries can be caused by traumatic injuries such as a motor vehicle collision.

What are the symptoms of a torn ACL?

Typically, when a patient injures their ACL, they may feel or even hear a pop in their knee which is followed by immediate swelling of the knee joint. The swelling may be so severe that they have trouble bending or straightening their knee. They may also feel that their knee is giving away or that they can’t trust their knee to walk or do certain activities. This is a symptom caused by the instability from injuring this ligament.

How is an ACL injury diagnosed?

An ACL injury can be diagnosed through clinical examination and imagining, such as an MRI, to assess the integrity of the ACL and its surrounding structures.

When is surgery necessary for an ACL injury?

It is almost unavoidable to not have ACL surgery after a complete rupture.

What is the recovery time for ACL surgery?

After any ACL surgery, the patient will be placed in a knee brace and prescribed physical therapy exercises. During rehabilitation, the patient will work on range of motion, as well as strengthening of the lower extremity under supervision of their physical therapist. Typically, around the three-month mark, patients can return to light activities such as jogging or running in a straight line. From four to six months, dependent upon recovery progress, the patient can typically return to activities that involve jumping and pivoting. Most patients can return to normal activities after 6 months. For athletes, the recovery may be extending to nine to twelve months before they return to full sport competition to ensure proper recovery and strengthening.

To learn more about ACL injuries, custom-tailored treatment options or to schedule an appointment, call us at (719) 632-7669.

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Physical Therapy for Sciatic Nerve Pain in Colorado Springs

Living in Colorado, many of us thrive off experiencing the outdoors. However, there are some instances where one may start to experience nerve pain in your lower back and leg while enjoying our great landscapes. If this occurs, you may benefit from specialized physical therapy for sciatic nerve pain.

Pinched human sciatic nerve, anatomical vision. 3D Render.

Sciatica is a pain that radiates down the leg along the sciatic nerve. The sciatic nerve starts in your lower lumbar spine, specifically between your L4-S2 segments. It runs down each leg, supplying the upper legs with motor functions and the lower legs with motor and sensory functions.

What Causes Sciatic Nerve Pain?

There are various reasons why you may be affected by sciatica. In many cases, it may be caused by a herniated disk or a bone spur, which can pinch or aggravate the sciatic nerve. Another cause may be due to a lack of strength within the gluteal and piriformis muscles of the hips which can compress on the sciatic nerve during certain activities. As with any condition, there are various severities in which Sciatica can present.

Typically, mild to moderate sciatica will go away on its own. However, if you experience sciatic nerve pain for longer than a week, we recommend contacting your physician as specific treatment may be needed to alleviate the pain. With most mild to moderate sciatic nerve pain, your physician may refer you to a physical therapist to strengthen the surrounding musculatures as an initial conservative treatment method. At Colorado Springs Orthopedic Group, Physical therapy for sciatica is one of the many neuromuscular conditions our Physical Therapists specialize in and treat daily. This type of rehabilitation has been shown to be a highly effective treatment for alleviating mild to moderate sciatic nerve pain.

Please note, if you are experiencing severe sciatica pain caused by a traumatic injury, such as an auto accident or sports injury, seek medical attention as soon as possible. Likewise, if your pain significantly worsens in a short amount of time, we recommend seeing an orthopedic physician promptly. Our walk-in orthopedic urgent care, Express Care is open Monday through Friday, 7 am-5 pm and Saturdays 8 am-12 pm.

Sciatic Nerve Pain Symptoms

Symptoms of sciatica include radiating pain in the lower spine, pelvis, and hips, or in the buttocks and down the back of your leg. Women who are in the mid to late stages of pregnancy may experience mild to moderate sciatic pain as well due to compression on the nerve.

Some patients may experience sudden sharp pain when sneezing or coughing, causing extreme discomfort. Long periods of sitting can also aggravate the sciatic nerve and may require specific stretching or physical therapy exercises to help alleviate this pain.

Chiropractor or Physical Therapy for Sciatica?

Most can typically achieve sciatic pain relief by seeing a chiropractor or physical therapist. The type of treatment you choose is primarily a personal preference depending on what you hope to accomplish. Both medical professionals have training specific to evaluating and treating sciatica. Chiropractors can assist by assessing where bones may be misaligned or pinching the nerve. Alternatively, Physical Therapists can assess where muscular imbalances may be present and help you gain strength in the lagging areas. This focus can show great results by alleviating any compensation that may be resulting from or causing sciatic pain.

Chiropractic Adjustments for Sciatica:

The purpose of a chiropractic adjustment is to achieve short-term pain relief and is a hands-on manipulation technique of the musculoskeletal system. These adjustments can provide temporary pain relief as it allows for the surrounding musculatures to relax and increases the mobility within the adjusted joint. For example, a lumbar spine adjustment may reduce pressure on the sciatic nerve, temporarily easing the pain. Depending upon the source of sciatic pain however, a patient may only see temporary relief as imbalances within correlating muscular structures may pull on the joint during various activities.

A Japanese woman getting a foot massage at a seitai clinic

Physical Therapy for Sciatica:

With physical therapy, the aim is to promote long-term healing and restore optimal function to the body. Physical therapy treatments may include hands-on mobilization of specific joints, muscles, tendons, and ligaments. By assessing where specific muscles may be compensating for lack of strength within other correlating muscles and diligently performing strengthening exercises to correct these compensations, physical therapy specific to the treatment of sciatica can drastically improve range of motion, total body strength, and blood flow to the affected extremities. For example, properly activating and strengthening the gluteal muscles, can help rehabilitate the symptoms of a herniated disk, reducing the severity of sciatic nerve pain.

Benefits and Outcomes of Physical Therapy for Sciatica:

The primary benefits of physical therapy for treating sciatica include pain relief, improved range of motion, and restored motor skills and body functionality. Physical therapy for sciatica is also less expensive and less invasive than other methods, such as surgery, injection therapy, or medications. Most patients who are diligent with their recommended restorative physical therapy plan state their pain has reduced dramatically within a few weeks to a few months. On average, these patients experience long-term pain relief with less chance of the pain recurring.

The total number and the frequency of your physical therapy sessions will depend upon the severity of your sciatica, adherence to treatment, and the pain relief experienced throughout treatment.

Our Colorado Physical & Occupational Therapists

At Colorado Springs Orthopaedic Group, we work with some of the most elite Physical Therapists in Colorado Springs. Our teams are highly trained and highly experienced in their specialties. Contact CSOG’s Physical Therapy department today to request a list of our physical therapists and their teams.

To make an appointment at our North Campus location call (719) 867-7320

To make an appointment at our South Campus location call (719) 622-4524

Hip Labral Repair Vs Hip Reconstruction With Dr. Huang

Welcome to another Medical Minute segment with Dr. Michael Huang, Board-certified Orthopedic Sports Medicine physician at Colorado Springs Orthopaedic Group as he discusses the differences between labral repairs and reconstructions within the hip joint and when one surgery may be recommended over the other.

Hip labral repair vs hip reconstruction

The labrum is an O-ring shaped piece of cartilage surrounding the acetabulum, also known as the hip socket, that provides extra stability within the hip joint. The labrum can tear from overuse performing certain activities or from traumatic events. Unfortunately, a labral tear does not heal on it’s own due to the lack of direct blood supply as with any cartilage tear.
If conservative treatment options, such as physical therapy, injection therapy, or medications do not provide long-lasting relief, then surgery to repair the damaged cartilage may be the recommended next treatment option.

Both procedures, a hip labral repair and a hip reconstruction are surgeries utilized to treat labral tears within the hip. A Labral Repair is where the surgeon reattaches the labral tissue to the acetabulum. Once this is completed, the patient goes through an extensive rehabilitation process to ensure proper healing and restore functionality. Alternatively, when the tissue has been severely torn or a previous repair may have failed, surgeons may elect to perform a labral reconstruction. During this procedure, the surgeon will take a piece soft tissue, typically from the iliotibial band (IT Band) or hamstring tendon of either the patient or a donor and reconstruct the labral structure. This procedure can include either a partial or full reconstruction variant upon the severity of the initial tear.

What activities can lead to a labrum tear?

Labrum tears can occur in many ways however, many patients have a pre-disposition to a labral tear due to their hip anatomy. Athletic activities such as hockey, collision sports or general weightlifters who perform squats or box jumps on a routine basis may be at risk for a tear, especially if they have an anatomical pre-disposition.

Minimally invasive hip repair and hip reconstruction

Both hip repair and a hip reconstruction are relatively new procedures to be done arthroscopically. Arthroscopy procedures allow the surgery to be performed in a minimally invasive manner, preserving as much soft tissue as possible. Hip reconstruction surgeries are naturally more involved than a labral repair surgery therefore, recovery may vary based on the procedure performed. Both procedures are typically classified as Outpatient surgeries where the patient can return home the same day without staying in the hospital or surgery center overnight.

What questions should a patient ask a hip surgeon?

Due to hip arthroscopy being a relatively new category in general, there are not a lot of orthopedic surgeons that do hip arthroscopy surgeries. Dr. Huang’s first piece of advice is ensuring that the surgeon has experience and is very familiar with the procedure.

Dr. Huang also recommends that if there is a decision that needs to be made between labral repair and consideration for reconstruction, then it would be advantageous for the patient to ask the surgeon if they do reconstruction surgery. This is necessary because even among the surgeons that do hip arthroscopy repair, not all of them do reconstruction because it is technically much more demanding.

Colorado Springs Orthopaedic Group is fortunate enough to have experience in arthroscopic repair and reconstruction and have multiple physicians with a vast amount of experience performing both procedures. To learn more or to schedule an appointment, call us at (719) 632-7669.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

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Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Platelet-Rich Plasma Therapy (PRP) With Dr. Jones | Colorado Springs Orthopaedic Group

Welcome to a Medical Minute segment on platelet-rich plasma therapy (PRP) with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group.

The video below will cover what platelet-rich plasma therapy (PRP) is and how it can help heal an injury and avoid possible surgery.

What is PRP Therapy and where is it derived from?

PRP stands for Platelet-Rich Plasma and is derived from a patient’s blood. By way of centrifuge, the physician will separate out the platelets which are cells within our blood that help promote clotting and healing as they possess essential growth factors. There are two types of PRP. PRP that are made up of white blood cells, and PRP that do not include any white blood cells. If a patient is utilizing PRP the process is simple; the patient comes in for their appointment, the physician or physician assistant will draw the blood, and the blood is then spun within a centrifuge to separate out the different cells. That process takes between 7-20 minutes. Once the cells are ready, the physician will then inject the cells within the patient’s injured body part. The injection process typically takes less than one minute to complete.

What injuries can PRP help heal?

For ligament or tendon injuries, PRP can help a patient’s ability to heal by increasing the growth factor concentration. Injuries such as MCL tears or tennis elbow are commonly treated with PRP. PRP can also be used to treat arthritis or cartilage injuries because it helps diminish inflammation in the joint, which then diminishes pain symptoms.

How is PRP associated with Stem Cells?

Stem cell treatments have become popular and are in the same treatment family as PRP due to a similar goal of enhancing the patient’s ability to heal injuries or to fight off inflammation. However, stem cells do not exist within PRP.

What is the typical outcome or success rate for those patients who have underwent PRP treatments?

Dr. Jones has seen outstanding outcomes from patients who have utilized PRP treatments. He was an early adopter of the treatment and started using PRP treatments 12 years ago. PRP treatments have advanced over the years and additional literature has shown great success with their use. For example, in tennis elbow, PRP treatment studies have shown a 90% success rate.

If you have been experiencing pain, or have additional questions about PRP, call us today to schedule an appointment with Dr. Jones at Colorado Springs Orthopaedic Group!

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

General Orthopedics at Colorado Springs Orthopaedic Group

At Colorado Springs Orthopaedic Group, our physicians specialize in General Orthopedics and are trained to thoroughly assess a wide variety of bone conditions. These conditions range from head to toe and are conditions that may have affected surrounding structures within the joints, such as muscles, cartilage, tendons, and ligaments.

As one of our patients, you can expect to have very detailed and thorough discussions with your physician regarding your diagnosis and treatment options available to fit your general orthopedic needs. Our providers share information in easy to understand terms and actively encourage you to participate in your treatment’s decision-making process. Your care is about you and we want you to feel comfortable with the decisions made to help you get back to your pain-free lifestyle.

The most common General Orthopedics disorders and diseases include:

Fractures
Arthritis
Sprains and strains
Bursitis and tendonitis
Ligament and tendon tears
Cartilage Tears

Many injuries or conditions can be resolved with non-surgical treatment options such as physical or occupational therapy, cortisone injections, viscosupplementation, or PRP therapy. However, if you and your doctor determine that surgery is the best treatment option, our surgeons specialize in a number of minimally invasive procedures proven to accelerate the recovery process.

Arthroscopy

Arthroscopic procedures allow the surgeon to operate through smaller incisions with use of a miniature camera, also known as a scope, which enables the surgeon to view the joint with great detail while preserving the surrounding tissues, such as muscles and tendons. Arthroscopy has shown a number of recovery and longevity benefits compared to traditional surgical methods such as:

Smaller incisions enabling the surgeon to cut through less surrounding tissues, decreasing the chance for severe scarring.
Accelerate the recovery process as the surrounding musculature is not damaged to such great extents
Shorter recovery period
Decreased risk of infection

As with any procedures, candidacy for an arthroscopic procedure may vary dependent upon the severity of the injury and the patients overall health status. Discuss with your physician to see if arthroscopy is the best treatment option for you.

Call us at 719-632-7669 to schedule your initial consultation.

Orthopedic Trauma & Fracture Care in Colorado Springs

Trauma can occur from any injury that endured enough force to cause a fracture or significant damage within the body. Care for simple fractures (such as a transverse, longitudinal or stress fractures) may require only casting or splinting. Common causes of fractures include motor vehicle accidents, sports injuries, and falls. Care for severe or complex fractures (such as open fractures, pelvic fractures, femoral, tibial, etc.) often require surgical intervention.

The types of orthopedic trauma & fracture care we see include but are not limited to:

Simple Fractures:
- Transverse fractures
- Longitudinal fractures
- Stress fractures
Complex Fractures, to include but are not limited too:
- Open fractures
- Femoral fractures
- Non-healing fractures
- Fractures with deformity/angulation
- Fractures of the pelvis and acetabulum (hip joint)
- Joint (intra-articular) fractures
- Foot and ankle fractures
- Post-traumatic reconstruction

Every physician at Colorado Springs Orthopedic Group is trained to treat all types of traumas and fractures. After a thorough examination of the injury, your physician will order the appropriate imaging, such as x-rays or an MRI, to appropriately diagnose and develop a treatment plan best suited for the injury. Each treatment plan is customized to every patient and the needs of their injury.

Young girl wearing an arm brace seeking trauma & fracture care

For the highest quality orthopedic trauma & fracture care in El Paso County, call Colorado Springs Orthopaedic Group at (719) 632-7669.

Need to be seen today? Walk into our Orthopedic Urgent Care clinic, Express Care for immediate examination performed by one of our board-certified orthopedic trained Physician Assistants. With limited wait times and on-site imaging services, our Express Care team can have you on the road to recovery quicker and at a much lower cost than the ER. After your initial examination, you’ll be scheduled with one of our fellowship-trained orthopedic physicians to further discuss your customized treatment plan. Call 719-622-4550 or visit us at https://www.csog.net/services/our-express-care to learn more.

Common Ski & Snowboarding Injury Treatments with Dr. Huang

Welcome to a Medical Minute segment with Dr. Michael Huang, a board-certified physician at the Colorado Springs Orthopaedic Group, speaking today about common ski & snowboarding injury treatments.

The video below will cover how to best treat winter sports injuries such as injuries from skiing or snowboarding.

What are the most common ski and snowboard knee injuries?

The most common knee injuries are typically soft tissue injuries such as meniscus tears and ligament tears. Within the ligament tear category, the most common, and well known are anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries.

What happens if the ACL or MCL injury occurs while on skis or snowboards?

Skiing and snowboarding can cause ACL, MCL, or other injuries because the board under your feet puts a lot of strain on your knees. Skiing has been well studied and it has been found that the athlete gets in what is called the ‘backseat’ position which produces a rotational force across the knee that has been demonstrated to tear the ACL, MCL and sometimes the meniscus.

Exercises to prevent common ski and snowboarding injuries

Within the last few decades, there has been a lot of focus on preventing knee injuries. Before the ski season starts, gyms have even started to offer ski conditioning classes which Dr. Huang finds very beneficial. Courses such as these place an emphasis on building strength and coordination within plyometric movements, increasing cardiovascular fitness, as well as strengthening the core and hip stabilizer muscles.

To schedule an appointment with Dr. Huang, call our offices at: (719) 632-7669.
To learn more visit us at www.csog.net.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

The Comprehensive Joint Replacement Program

As Part of Colorado Springs Orthopaedic Group’s Comprehensive Joint Replacement Program,
our fellowship-trained joint replacement specialists will provide you with the
most comprehensive treatment possible to help you return to your active lifestyle.
We are here to help you get back out there, doing the things you love to do.

When you first visit us at Colorado Springs Orthopaedic Group, you’ll be introduced to our clinical team consisting of your Physician, Physician Assistant, Medical Assistant, Surgery Scheduler, and Case Manager. As part of the Comprehensive Joint Replacement Program, this group of individuals will be your direct line of contact to answer any questions or concerns you may have as you continue throughout your entire recovery process.

During your initial consultation, your physician will discuss recommended treatment options with you and design a comprehensive treatment plan to get you on the road to recovery. Our physicians will exhaust all conservative treatment options prior to recommending surgery. However, in severe cases or cases where conservative treatments have not provided adequate pain relief, surgery may be deemed necessary.

Schedule your inital consultation with one of our fellowship-trained Orthopedic Joint Specialists by calling 719-632-7669.
Consult with your physician for a proper diagnosis and recommended next steps. Our Total Joint Physicians will exhaust all conservative treatment measures prior to discussing surgery if your case allows.
If all conservative treatment options have been exhausted and your pain is still significant, surgery may be recommended. At this time you will be introduced to your case manager who will help you prepare for a smooth procedure and be your patient advocacy contact.
After surgery, you will be introduced to your post operative recovery team, including your lead physical therapist who will be with you every step of the way from the moment you leave the operating room to your post operative rehabilitation journey.

“Whether it’s from a recent surgery or surgery from years ago, our Comprehensive Joint Replacement Specialists can correct even the most complicated Total Knees and Total Hips.”

Our Comprehensive Joint Replacement Program Teams:

Clinical Team
Surgical Team
Post Operative Recovery Team

Specializing in:

Inpatient vs Outpatient
Total Joint Replacements
Accelerated Recovery
Joint Replacements

Arthritis and MAKO
Robotic Assisted Joint
Replacement Surgery
Complex Joint Revisions

Arthritis Team and MAKO Robotic Assisted Joint Replacement Surgery Complex Joint Revisions

Comprehensive Joint Replacement Program Specialists

What to Expect Pre-Operation

Have you ever walked into the hospital or medical practice intimidated and unsure of who would be taking care of you? Not anymore. At Colorado Springs Orthopaedic Group you can expect to know exactly who to contact every step of the way. During your initial consultation, your physician will discuss your symptoms, order any appropriate imaging from our in-house MRI and X-Ray services, and diagnose your symptoms with the highest standard of education and care for your lifestyle. From here, you can expect to either:

a) Try various conservative treatment methods such as Physical Therapy, weight loss, or injection therapies.

b) Discuss surgical options dependent on the severity of your symptoms.

If surgery is the chosen path, our clinical team will work with your insurance to find the best options available and ensure you are ready to go upon the day of surgery. It is highly important to communicate with your clinical team and ask any questions or concerns you may have and diligently follow instructions as provided.

What to Expect Post- Operation

Within 24 hours after your surgery, you will be introduced to your Physical Therapist Lead who will guide you through initial rehabilitation exercises. At this time, you will be prescribed at-home exercises that are critical to a smooth recovery.

Inpatient vs. Outpatient Recovery

Inpatient Surgery means that you will stay a minimum of one night in the hospital or surgery center under the watchful eye of your nursing team.
Outpatient Surgery provides the capability for you to recover within the comfort of your home the day of surgery, eliminating facility fees and the stress of staying in an unfamiliar area.

Case Management

Every patient in the Comprehensive Joint Replacement Program is dedicated to one of our board-certified Case Managers. They will be your direct patient care advocate from your initial consultation to graduation from post-operative Physical Therapy.

“Within about 24 hours after surgery, I never had another need for crutches, a cane, walker, anything like that and it has been absolutely fantastic.”

Accelerated Recovery Joint Replacements

One of the primary focuses of the Comprehensive Joint Replacement Program is to have patients mobile within hours after their surgery. Over the course of the last 10-15 years, advancements within surgical techinques such as smaller incisions and the anesthesia techniques, have enabled patients to recover not only much quicker but also recover in the comfort of their own home either the day following surgery or in many cases, the same day. Within hours after surgery, patients will be introduced to their post operative Physical Therapist who will demonstrate exercises enabling them to get up and move around the same day as their operation. Through extensive studies, ensuring same day mobility has proven to show drastically improved outcomes for patients and their overall recovery time.

Total Knee Replacements

There are three bones that come together to form your knee joint: the Femur (thigh bone), Tibia (shin bone) and Patella (kneecap). Attached to these bones are three primary muscles groups that assist in knee flexion, allowing you to walk, run, and step up and down stairs. These muscles are your quadricep, hamstring, and calf muscles. Lastly, your tendons and ligaments surrounding these structures help to keep the femur, tibia and patella secured within the joint.

Our physicians typically recommend conservative treatment options such as physical therapy, steroid injections, and weight loss prior to discussing surgical options. However, if all conservative options have been exhausted, your physician will discuss surgical treatment options such as a partial or total knee replacement. Once you and your physician have decided to move forward with surgery, your physician may elect to use traditional Knee Replacement techniques or Mako Robotic Assistance navigation software to customize your knee replacement implants specific to your individual anatomy. This customization process allows for a seamless implant fitting once in the operating room.

Total Hip Replacements

There are many conditions that can arise within the hip joint. Most commonly, patients complain of symptoms associated with bursitis, tendinitis, muscle strains, labral tears, and arthritis. Dependent on the severity of your symptoms, conservative treatment options may be recommended, with surgery as the last option. Our Joint Replacement surgeons specialize in both traditional Hip Replacement techniques as well as Robotic Assisted Hip Replacements.

Robotic-Assisted Minimally
Invasive Surgery: MAKO

Mako Robotic-Assisted Navigation has shown significant improvement in replacement longevity and overall patient outcomes for those patients who qualify for these procedures.

Did you know the average Total Joint Replacement can now last you over 20 years compared to the estimated 10-15 years in early 2000s?

Call us today at 719-632-7669 to learn how we can help you live a sustained pain free life.

Mako Robotic Joint Replacement Systems utilized for Knee Replacement and Hip Replacement

“From the onset of being treated within this group, I have been treated with the upmost respect and feel very fortunate to be a patient there. The entire staff is great. And I could not have asked for one of the best doctors there.” – patient of Dr. Tyler Bron

Complex Total Joint Revisions

In some cases, due to a variety of reasons, a Total Joint Replacement can fail. Some common reasons a failure may occur are normal wear and loosening of the joint while some causes may be due to infection within the joint. If this occurs, our Total Joint Replacement Specialists will assess and recommend revision procedures specific to your case.

Call us today at 719-632-7669.

Dr. Tyler Bron, MD Colorado Springs Orthopaedic Group

Tyler R. Bron, MD

Dr. Bron has completed a fellowship in Adult Reconstruction, specializing in the treatment of arthritic hip and knee conditions.

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Dr. Eric Jepson, DO Colorado Springs Orthopaedic Group

Eric K. Jepson, DO

As a board-certified orthopedic surgeon, Dr. Jepson’s specializes in the treatment of complex knee and hip problems, revision surgery, and new procedures for the treatment of arthritis.

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Michael Van Manen, DO

Dr. Van Manen focuses on total joint replacement and arthritis management of the hip and knee.

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Michael Feign, DO

As a Board-Certified Orthopaedic Surgeon, Dr. Feign specializes in the treatment of complex hip and knee injuries, hip and knee arthritis and Total Joint Replacements.

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Total Shoulder Replacement with Dr. Christopher Jones

Welcome to a Medical Minute segment with Dr. Christopher Jones, a board-certified physician at the Colorado Springs Orthopaedic Group. The video below will cover what a total shoulder replacement is, and when this surgery may be recommended.

What is a Total Shoulder Replacement Surgery?

A total shoulder replacement is when you are replacing the “ball and socket” of the joint with a metal humeral head and a metal-lined socket placed within the shoulder socket also known as the glenoid fossa. This surgery is typically necessary when a patient has a complete breakdown of all the cartilage within their shoulder joint, resulting in a loss of mobility and significant pain. Regaining shoulder mobility, functionality, and eliminating pain are the primary reasons to undergo a total shoulder replacement surgery.

What is the Lifespan of a Total Shoulder Replacement Surgery?

The vast majority of patients who require a total shoulder replacement have a genetic component of arthritis therefore, the younger a patient is when receiving a shoulder replacement, the more likely it is they may need a revision later in life. Current studies show that the average lifespan of a total replacement is approximately 20 years for 85% of patients. As these statistics are based on dated implant technologies, innovative advancements within implant technologies are showing drastic improvements in replacement longevity. Surgeons are hopeful these advancements will increase the lifespan of such implants.

What is the Recovery time of a Total Shoulder Replacement Surgery?

The full recovery time for any shoulder surgery averages around a year and may vary upon the severity of the initial injury and the procedure used to treat such injury. With this, the vast number of patients who have had shoulder surgery notice significantly less pain within six weeks after surgery.

Total Shoulder Replacement Surgery Technology and Innovations

As total shoulder replacement technologies continue to advance, many of the newer implants have a strong focus on bone preservation. In addition to utilizing the latest implants, Colorado Springs Orthopaedic Group also utilizes a groundbreaking innovation tool of three-dimension operative planning. This technology allows the physician to customize the shoulder procedure to the individual patient’s needs on the computer prior to walking into the operating room. To do this, they download the patient’s imaging into the software allowing the physician to place the implants in precise alignment with the bony anatomy allowing the physician to know exactly where to place the implant prior to walking into the operating room. This optimizes the patient’s recovery outcomes and the replacement’s longevity.

Reverse Total Shoulder Replacement Surgery

With Reverse Total Shoulder Replacement Surgery, the physician will swap the ball and socket around. This surgery is completed when the patient does not have a rotator cuff.
Call us at 719-632-7669 to schedule your initial consultation with one of our fellowship-trained, board-certified Orthopedic Shoulder Specialists today!

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Cartilage Restoration Procedure With Dr. Jamie Friedman

Welcome to a Medical Minute segment with Dr. Jamie Friedman, Fellowship-trained Orthopedic Sports Medicine physician at the Colorado Springs Orthopaedic Group. Join Dr. Friedman in the video linked below as she discusses cartilage restoration procedures, what specific injuries they can be utilized as a treatment option for, and how they can help delay the need for a total knee replacement for the appropriate patients.

What is cartilage restoration?

Cartilage restoration, also known as Articular Cartilage Restoration, helps the bones articulate or glide smoothly against each other when the natural cartilage has worn or been previously injured. Articular cartilage also provides a shock absorber for the knee joint, especially since it is a weight-bearing joint. Unfortunately, when the cartilage is injured, it does not heal itself because there is not a direct blood supply to it. This can lead to early arthritis if not treated appropriately.

What are some of the symptoms of a cartilage injury?

Cartilage injuries can either occur with a traumatic injury or over time with a repetitive motion such as general wear and tear on the joint. A patient will typically have increased pain or swelling after a particular activity or at the end of an active day. They may also have mechanical symptoms such as painful clicking or catching when they bend or straighten their knee. In very advanced cartilage loss, patients may be severely limited by this pain.

Who is a good candidate for a cartilage restoration procedure?

The best candidate for a cartilage restoration surgery is typically an active young adult. This prevents them from going on and developing early arthritis. These are also patients that have severe pain and likely too young for a partial or total knee replacement.

What are the cartilage restoration procedures that CSOG offers?

There is a wide variety of cartilage restoration procedures that CSOG is able to perform to help with joint pain. Some of the most advanced techniques are arthroscopic or minimally invasive surgery with a small incision near the joint. When the cartilage itself is the only thing involved, the physician will take cells from the patient, or from a donor, send them to a lab, and once the cells are returned, place them over the cartilage defect – kind of like filling in a pothole in the street. This is called Chondrocyte Implantation.

If the bone underneath the cartilage is also affected, then the physician will need to take a plug from the patient or a donor and put that into the defect. This is called Osteochondral Autograft Transplantation.

What is the recovery time for a cartilage restoration procedure?

It depends on what surgery is performed, but in general, the patient will be partially weight-bearing for six to eight weeks while allowing that cartilage to heal. At about two to three months, more range of motion gets added along with strength and balancing activities. It takes about four to six months to get back to a patient’s normal activities. Even though this is a longer recovery period than some of the other surgeries available, it has been shown to be greatly beneficial to eliminate the patient’s pain and save them from an early knee replacement.

To schedule an appointment with Dr. Friedman, call our offices at (719) 632-7669.

Physicians:

Jamie L. Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.
> Jamie L. Friedman, MD

Jammed Fingers & Finger Injuries with Dr. Dale Cassidy

Welcome to a Medical Minute segment with Dr. Dale Cassidy, a Board-Certified Orthopedic Hand physician at the Colorado Springs Orthopaedic Group. The video below will cover jammed fingers & finger injuries that we commonly see from our Colorado Springs clients.

Types of Finger Injuries

Sports injuries, falls, or hitting your finger the wrong way are some of the most common finger injuries seen here at Colorado Springs Orthopaedic Group. These experiences can result in jammed, sprained, or even broken fingers.

Jammed Finger & Finger Injury X-Rays & Treatment

Dr. Cassidy and his team utilize various imagining such as x-rays as the first step in the diagnosis process. Often times a patient may think they have a jammed finger. However, the x-ray images can show a more serious diagnosis. Depending on the severity of the injury it could be treated with a splint or brace. More extreme injuries may result in the need for physical therapy or could even require surgery.

Contact Colorado Springs Orthopaedic Group for Jammed Finger & Finger Injury Treatment

Colorado Springs Orthopaedic Group’s Hand and Nerve Center comprised of our two fellowship-trained board-certified physicians and physician assistants can put help provide a diagnosis and custom treatment options for even the most complex hand and nerve injuries.

Visit www.CSOG.net or call us at 719-632-7669 to schedule your initial consultation today!

Physicians:

Dale Cassidy, MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.
> Dale Cassidy, MD, MBA

Jeffry T. Watson, MD

Dr. Watson’s clinical interests include adult and pediatric conditions of the upper limb, such as arthritic and post-traumatic reconstruction, microvascular surgery, and treatment of complicated fractures.
> Jeffry T. Watson, MD

Physical Therapy Exercises for Hip Pain with Cristin McGetrick

Welcome to a Medical Minute segment with Cristin McGetrick, DPT, CSCS, TSAC-F at the Colorado Springs Orthopaedic Group. Tune into the video linked below as Cristin demonstrates 5 physical therapy exercises for hip pain that can be performed in the comfort of your home.

When the hips are weak, many patients notice a significant decrease in their ability to balance as well as increased pain in their knees and feet. Therefore, when we see this type of weakness, we want to focus primarily on strengthening those hips as they provide stability throughout the entire body.

Contact Colorado Springs Orthopaedic Group for More Information About Physical Therapy Exercises for Hip Pain

To learn more, visit www.csog.net or call us today to schedule your initial evaluation. A referral may be necessary depending upon your insurance coverage.
To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Arthritis Types, Symptoms & Treatments with Dr. Tyler Bron

Welcome to a Medical Minute segment with Dr. Tyler Bron, one of four fellowship-trained Orthopaedic physicians at Colorado Springs Orthopaedic Group. The video below will cover what arthritis is and discuss the different arthritis types, symptoms & treatments available at CSOG.

Arthritis Types: Osteoarthritis vs. Rheumatoid Arthritis

Arthritis comes in several different forms including Osteoarthritis and Rheumatoid arthritis. Osteoarthritis causes the cartilage, that lies between and protects the bones, to break down. Once this cartilage wears down, the bones become exposed to each other causing them to then rub against each other. This rubbing can cause inflammation and send pain signals to the brain. This is contrasted with Rheumatoid arthritis, which is caused by your body’s own immune system degrading the cartilage.

Who does Arthritis affect?

Arthritis can affect those of any gender or age, however, is most commonly seen when people get older. Arthritis, specifically Rheumatoid Arthritis, has a strong genetic component. Osteoarthritis is the most common form of arthritis and is known as “wear and tear arthritis” where previous joint injuries, overuse injuries, or obesity can be the primary cause.

Arthritis Symptoms

The most common symptoms of arthritis include an ache or dull pain that is constant and gets worse throughout the day depending on how active you are. As it progresses, the pain becomes more debilitating. Occasionally, arthritis progresses to the point where individuals are not able to live their desired active lifestyle. We recommend seeing an orthopedic specialist prior to this point.

Arthritis Treatment Options

There are non-surgical treatment options to treat arthritis. At Colorado Springs Orthopaedic Group, our physicians believe that in most cases, non-surgical treatment is the best place to start. Non-surgical interventions include weight loss, activity modification, avoiding high-impact sports activities, physical therapy, and the prescription of anti-inflammatory medications. Depending on the severity of your case, your physician may suggest a steroid injection that acts as an anti-inflammatory treatment. Once a patient has tried the above non-surgical options without experiencing long-lasting relief, then surgery may be a recommended option.

Colorado Springs Orthopaedic Group’s board-certified and fellowship-trained joint physicians can put together a custom-tailored program for both diagnosis and treatment.

Weightlifting After Shoulder Surgery with Matthew Kudron

Welcome to a Medical Minute segment with Matthew Kudron, Physical Therapy Supervisor at the Colorado Springs Orthopaedic Group located off Briargate Parkway. The video below will cover the recommended timeframe and physical therapy needed to return to weightlifting after shoulder surgery.

Common Shoulder Surgeries

Common shoulder surgeries include rotator cuff repairs, labral repairs, and total shoulder replacements. Within these different surgeries, there are different timeframes in which a patient may return to activities such as weightlifting and high-intensity upper body activities. The progression through recovery after shoulder surgery may vary. However, a typical timeframe one can begin increasing their activity intensity, specifically with overhead weightlifting after shoulder surgery, can range between three to six months. We strongly recommend diligently following all physical therapy protocols prescribed by your physician and physical therapist to ensure proper recovery.

Recovery Milestones

Within these protocols prescribed by your physician and physical therapist, there are three main recovery milestones that need to occur before getting into weightlifting after shoulder surgery. The first is tissue healing, the second is achieving full range of motion and the third is building full strength of both the rotator cuff and the muscles that help stabilize the shoulder blade.

Weightlifting Exercises After Shoulder Surgery

Some of the exercises that are generally safe after shoulder surgery include bicep curls, triceps pulldowns, and rotator cuff exercises. However please follow your physical therapist’s instructions prior to attempting any of these exercises. Some exercises to avoid are those exercises where you cannot see your hands, such as a triceps dip exercise, or exercises where your arms are in a position extended away from your body or in a wide-grip position. These exercises may put the shoulder in a vulnerable position as demonstrated in the video above.

Contact Us to Schedule Physical Therapy to Help with Weightlifting After Shoulder Surgery

To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Physical Therapy Pain Management with Danielle White

Welcome to a Medical Minute segment with Danielle White, one of 18 physical therapists at Colorado Springs Orthopaedic Group. The video below will cover how the brain experiences pain and helps one manage such pain through physical therapy pain management.

The definition of pain is an unpleasant sensory or emotional experience. Pain is caused by a stimulus to your tissues and is personalized for everyone. Chronic pain is defined as any pain that lasts for three to six months or more. If you have chronic pain the best thing is to focus on what you can do and not what you can’t. There are four main things to focus on that can help alleviate pain is to:

Educate the nerves
Create good sleep habits
Perform aerobic exercise
Set recovery goals

To learn more about pain management visit one of Colorado Springs Orthopaedic Group’s physical therapists today.

To schedule a physical therapy appointment at our North Campus location call. (719) 867-7320
To schedule a physical therapy appointment at our South Campus location call. (719) 622-4524

Annie’s story: from debilitating pain to enjoying gardening, scuba diving, and hiking again

Dr. Roger Sung is a board-certified and fellowship-trained physician who joined The Spine Center at Colorado Springs Orthopaedic Group in 2007. He believes in ‘making it a priority to provide all his patients with education and individualized treatment so they can return to the activities they love with the least invasive options possible’. Read through the following patient testimonials and watch the video to see how much Dr. Sung’s work is impacting lives throughout Colorado Springs.

Dr. Roger Sung Specializes in:

Cervical & Lumbar Spine Surgery
Minimally Invasive Spine Surgery
Adult Scoliosis/ Degenerative Spine
Artificial Disc Replacement
Lateral Spine Surgery
Spinal Cord Stimulation
Minimally Invasive SI Joint Fusion
Spine Trauma

Here are just a few patients testimonials and what they have to say about their experience with Dr. Sung:

“Dr. Sung did a spinal fusion on my back, because of severe pain in my legs, 6 months ago. I am totally recovered, have no more pain, and can hike, bike and garden again. I am over the top pleased with this outcome! During my recovery, the PA and MA were very helpful in answering questions and adjusting medications. I highly recommend Dr. Sung and his staff.”

“Sung is a straightforward doctor and a very good surgeon. He has my utmost confidence. He’s performed four spinal procedures on me and I would wholeheartedly recommend him.”

“Absolutely blown away by the level of caring and exceptional surgery I had with dr Sung and Colorado Springs Ortho! I felt as though I was the president of the United States with how I was treated by this amazing staff! Lower back fusion and disc replacement…..and I’m not joking when I say the most pain I had was the IV the day before. Don’t be scared or worried at all with Dr. Sung! He is an absolute ROCK STAR in his field and I can’t say enough positive words about him and CoSprings Ortho!”

Our Spine Physicians:

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.
> Roger D. Sung, MD

James M. Bee, MD

Dr. Bee’s interests include the full range of spinal disorders of the cervical, thoracic, and lumbar spine. Scoliosis and the treatment of spine shrinkage and fractures from osteoporosis are a couple examples.
> James M. Bee, MD

Paul Stanton, DO

Dr. Paul Stanton is a board-certified orthopedic surgeon with surgical expertise in all aspects of spinal surgery, including minimally invasive techniques and complex reconstructive techniques for the cervical spine, adult spinal deformity, and degenerative scoliosis.
> Paul Stanton, DO

Spinal Cord Stimulators for Chronic Pain with Dr. Roger Sung

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s Dr. Roger Sung discussing chronic pain management through the use of spinal cord stimulators.

When a patient experiences chronic pain, what is the best option for them?

As every orthopaedic case is unique, if the pain begins to affect daily life we recommend scheduling an appointment with an orthopaedic doctor. With this, we recommend finding a doctor who specializes in the body region where pain is at it’s worst.

After a full evaluation to find the source of your chronic pain, our physicians at Colorado Springs Orthopaedic Group work diligently to create individualized treatment plans for every patient. From there, your physician will continue to adapt that individualized plan to best suit your specific needs as you work through the recovery process.

What is a spinal cord stimulator?

A spinal cord stimulator (SCS) is a battery-operated implant that sits along the spinal cord and aids in alleviating nerve tension by sending mild electronic pulses to the nerves. These pulses interrupt the transmission of pain signals to the brain and have shown great success in alleviating chronic pain.

The surgery for a spinal cord stimulator implant takes approximately one hour when performed in our outpatient surgery center, The Orthopaedic Spine Center of Southern Colorado (OSCSC).

Try before you buy?

The best news with this type of chronic pain treatment is that you can actually trial the stimulator before electing to have the permanent implant placed. This is a one-of-a-kind treatment option in that you and your physician can give the spinal cord stimulator trial implant a test run to see if this treatment will work for you. This trial run is typically between 5-7 days where you will have direct access to a qualified SCS representative who can help you learn the intricacies of the stimulator remote. This representative will be your direct contact if any setting adjustments need to be made moving forward.

How customizable is a spinal cord stimulator?

After meeting with your SCS representative, you are able to fully customize your device, independently choosing the intensity and schedule at which you prefer your device to operate at. With recent technological advancements, these adjustments can be made at the touch of your fingertips by utilizing an application on your phone. Patients will also receive a remote from which they can program their stimulator from as well.

What is the success rate of spinal cord stimulators?

Patients that respond well to this treatment are likely to see at least 50-75% improvement in their pain. These devices can last upwards of 10-25 years, while only requiring battery replacements as needed. Please contact your SCS representative or our office at 719-632-7669 if you are in need of a spinal cord stimulator battery replacement.

How long is the Spinal Cord Stimulator Recovery Time?

The surgical procedures for both trial and permanent stimulator implantations are performed as outpatient surgeries and can be completed within approximately one hour. Patients can expect to recover from the permanent implant procedures within 2-4 weeks. Many noticing significant chronic pain relief just days after surgery. Please note, these timelines will very case by case.

Think Spinal Cord Stimulation might be right for you?

Give us a call at 719-632-7669 to schedule an initial evaluation. Our Spine Center Doctors are ready to help get you back to living how you want to live.

Our Spine Physicians:

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.

James M. Bee, MD

Paul Stanton, DO

Most Common Mountain Bike Injuries With Dr. Michael Huang

Colorado Springs is known for beautiful mountains, parks, and reserves that are home to miles and miles of amazing trails, which attract mountain bikers from around the world. In this episode of Medical Minutes, we discuss the most common mountain bike injuries Dr. Michael Huang sees each year.

What are some of the most common mountain bike injuries that you see at Colorado Springs Orthopaedic Group?

One of the most common injuries seen at Colorado Springs Orthopaedic Group is clavicle fractures, more commonly known as collar bone fractures. These injuries generally happen when a mountain biker loses control and hits their shoulder after falling forward over their bike’s handlebars. Depending on if the break is well aligned or displaced can create a vast difference in the patient’s treatment plan. If the clavicle break is well aligned, there may not be a need for surgery. However, if the bones are displaced, surgery may be necessary to ensure proper healing.

What is the recovery time for a mountain bike clavicle bone fracture?

The recovery time may vary depending on the location as well as the severity of the fracture. For example, a fracture located in the middle of the collar bone, also known as a mid-shaft fracture, may take anywhere between 3-4 months to heal fully. Treatments plans often include the use of a sling and rehabilitation.

What is an AC Separation caused by mountain biking?

AC Separation, or Acromial Clavicular Joint Separation, is often confused with a Shoulder Dislocation. However, AC Separations occur when the Acromial Clavicular Joint (AC Joint), located at the end of the collar bone, is separated. This injury can cause pain when reaching across the body as well as cause the shoulder to droop. Recovery timelines may vary depending upon the severity of the joint separation.

What is a rotator cuff tear?

The Rotator Cuff encompasses four muscles. These muscles include the subscapularis, supraspinatus, infraspinatus, and teres minor. Tears within the Rotator Cuff tendons that attach these four muscles to the shoulder bones are typically diagnosed through an MRI and are best treated through surgery as tendon tears do not heal on their own.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

The Medial Collateral Ligament (MCL)

MCL vs ACL

ACL or MCL Injury?

Symptoms of an ACL injury differ from an MCL injury by:

1.) How the injury occurred.

2.) Location of the pain.

First, recognize ‘how‘ you injured your knee.

An ACL injury typically occurs with a sudden stop or turn or twist of the knee. ACL injuries are common in start-and-stop sports such as soccer, football, basketball, and skiing.
An MCL injury, in contrast, most often occurs with a hit to the outside of the knee. The impact causes the knee to buckle inward and strains the ligament.

Next, ‘where‘ you feel pain can be evidence of either an ACL or MCL injury. Both ligaments are on the front of the knee however, your anterior cruciate ligament (ACL) sits more towards the middle of your knee. So, you may feel a sharp pain ‘in‘ or ‘below‘ your knee cap. The medial collateral ligament (MCL) runs along the inner side of your leg thus, you will experience pain on the ‘inside‘ of your knee.

With both an ACL or MCL injury, you may hear or feel a ‘popping’ sensation, though ACL injuries traditionally having a more obvious ‘pop’ than MCL injuries.

Also, know that it is possible to injure your MCL and ACL at the same time. In that case, you could experience most or all the above symptoms.

Symptoms

MCL Injury Symptoms

Symptoms of a less severe MCL sprain or tear may include:

Tenderness, aching
Swelling
Stiffness
Bruising

Symptoms of a more severe MCL tear may include:

Significant to unbearable pain
Instability or looseness of the joint
Excessive swelling
Excessive Bruising
Reduced range of motion

Recovery Time

Recovery time depends upon the severity of your MCL injury and whether you have surgery or not:

MCL Injury Recovery (No Surgery)

A mild to moderate MCL injury heals in a few days to several weeks. This is without surgery but is recommended to include rest, self-care such as ice and elevation, bracing or wrapping the knee, and physical therapy.

MCL Injury Recovery (With Surgery)

The sports medicine orthopedic physicians at Colorado Springs Orthopaedic Group believe in exhausting all conservative treatment options prior to discussing surgery. Some of the non-surgical options include physical therapy, cortisone injections, viscosupplementation, or PRP therapy.

If surgery is deemed necessary, then recovery could take four to six weeks after surgery to heal. At that time, you should be able to return to the majority of your normal activities as designated by your physician. However, it may take 6 to 12 months for the injury to heal to full health and integrity. We recommend that you follow your physician’s post-operative recovery and therapy protocols attentively. Once the MCL has fully healed, most experience successful long-term results including a full return to sports.

If you experience pain and stiffness on the inner side of your knee, it may be a medial collateral ligament (MCL) injury. The pain could be mild to severe, and the injury could be the result of an impact that caused the knee to violently bend or twist inward. Many MCL injuries occur during sports or rigorous physical activity. The ligament can also become injured through repeated stress such as running or jumping.

Your MCL (medial collateral ligament) is a thick band of tissue that runs from your thigh (femur) to your shinbone (tibia) about 4-6 inches from the knee. Its job is to keep the leg from bending too far inward. It also works with your ACL and PCL to stabilize your knee and allows rotation.

When strained too much, the ligament can sprain or tear. In some cases, the MCL can heal on its own and not even be that painful. But in severe cases, the pain can be excruciating, and surgery may be required to repair it.

If you suspect an MCL injury, visit our Express Care clinic to be seen the same day or call us at (719) 632-7669 to schedule with one of our Orthopedic sports specialized orthopedic physicians who specialize in MCL injuries to discuss the best treatment options for your specific situation. Contact our office today to schedule a medical consultation at:

CSOG: (719) 632-7669

Express Care- (719) 622-4550

Walk-in Clinic where you will be seen the same day by one of our board-certified Physician Assistants and scheduled with a fellowship-trained physician for a follow-up visit.

Types of MCL Injury

Grade 1: you have a ligament sprain, but not a tear. You likely do not need surgery.
Grade 2: you have a partial ligament tear. You may or may not need surgery.
Grade 3: you have a complete ligament tear. You are more likely to need surgery.

MCL Injury Testing

Assessment of an MCL injury should include:

Physical exam
MRI
X-rays

MCL Injury Home Therapy

Home therapy for an MCL injury may include:

Icing/cold packs
Elevating the leg while resting
Crutches
Knee brace
Anti-inflammatory medication
Specific stretches and therapy exercises

If MCL Injury Requires Surgery:

Generally, surgery is not required for an MCL injury unless it is a Grade 3 injury or does not heal with home care and therapy. You may also need surgery if you have other combined knee complications.

Cost for MCL Injury Surgery

Please contact your insurance carrier to discuss your specific cost estimates. You can reach our office at (719) 632-7669 to further discuss payment options.

Procedures

Surgery might be your best option to repair and/or reconstruct the knee:

MCL Repair

To repair the MCL, your surgeon will identify the torn portion of the ligament and reattach it to itself or the bone where it tore away from.

MCL Reconstruction

To reconstruct the MCL, your surgeon replaces the damaged ligament with a healthy tendon graft which will then become a new ligament.

Your surgeon may use minimally invasive surgery methods to complete your MCL surgery. This allows for faster recovery time and reduces the chance of infection and excessive scarring.

Benefits

The advantages and benefits of MCL surgery include:

Pain reduction
Improved mobility
Faster recovery
Reduced muscle atrophy
High patient satisfaction rates

Risks

The disadvantages and risks of MCL surgery include:

Infection
Scarring
Re-tear of the ligament

Preparing for an MCL Surgery

To prepare for your MCL surgery, your doctor will give you instructions for the following:

Medical Exam: This is to make sure you are healthy enough for surgery. A medical clearance form will need to be filled out before surgery.
Pre-op Appointment: Before surgery, a pre-op appointment will be scheduled to answer any questions you may have and understand the surgery in more detail.
Medications: You may need to stop taking medications and supplements.
Diet: You may need to limit certain foods and drink. You will also likely need to fast before surgery and stop consuming all tobacco products.
Transportation: Arrange to have someone drive you home from the surgery center. This should be a close friend or relative you know well. The vehicle should be easy to get in and out of.
Clothing: Wear comfortable clothing and shoes that are easy to take off and put on.
Home: Prepare your home with safety and comfort features. This may include grab bars, ramps, and furniture to help you rest and move about.

Postoperative Care

What to Expect After MCL Injury

Your postoperative care and instructions may include:

Medications: CSOG will prescribe a variety of medications to help the recovery go smoothly. Remember that most of these medications are as needed.
Knee brace: Most knee arthroscopy procedures don’t require a brace however, if you are required one, it will be placed on you before leaving the operating room.
Control swelling: Elevate your leg and keep using cold compression/ ice packs
Suggested early rehabilitation exercises
Pain and anti-inflammatory medications
Follow up physical exams

MCL Injury Therapy Rehab Exercises

Your physician will tell you when you are ready to return to normal activity. For your rehabilitation, your physician will prescribe specific rehabilitative exercises and stretches. This may include:

Hamstring stretches
Calf stretches
Quadriceps isometric strengthening
Straight leg raises
Ankle flexing and rotations
Knee flexion and sitting knee flexion

With these exercises, you do not need to stand or put weight on the surgery leg. As you progress throughout recovery, your physician will request for you to meet with a physical therapist to carry out your physician-prescribed rehabilitation protocols.

During rehabilitation, your exercises will progress with intensity. Be sure to listen to your body. If an exercise becomes painful, stop.

If You Suffer Pain from an MCL Injury

An MCL injury can heal on its own or with therapy; however, if you still have pain and discomfort after proper rest and at-home treatment, call us at (719) 632-7669 to consult with any one of our Fellowship Trained Knee Specialists to see what treatment options are available to restore pain-free knee function.

o Physical Therapy for the Knee
o Meniscus Repair Therapy
o Hip & Knee Replacement Testimonials

Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

VIEW BIO

Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

VIEW BIO

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

VIEW BIO

John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

VIEW BIO

Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

VIEW BIO

Meniscus Repair Surgery

Symptoms

Localized pain, stiffness, and swelling in the knee are common symptoms of a torn meniscus. The pain may worsen with movement or bending of the joint. You might also feel a ‘catching’ sensation, giving way or buckling, or your knee might feel like it “locks up”. These can all be potential signs of a meniscus tear.

Your doctor will most likely use the following tests to confirm a meniscus tear:

Physical exam
MRI
X-ray
Arthroscopy

Recovery

Typically after a meniscus repair surgery, you can return to non-strenuous everyday activity within a few weeks however, it can take 3 to 6 months to fully recover. At that time, you should be able to return to your active lifestyle.

Of course, your total recovery time will depend upon your health and the severity of the injury. Diligent compliance with your post-operative Physical therapy program will also help reduce the time to full recovery.

Procedures

Meniscus repair surgery is a common and highly successful procedure in the US. There are more than 750,000 orthopedic knee arthroscopy procedures performed each year and it has a better than 90 percent patient satisfaction rate.

The surgery to repair a meniscus tear is primarily arthroscopic or minimally invasive. The surgeon makes small incisions introduce the arthroscope (camera). He or she can then see and do the entire surgery ‘inside’ your leg. This reduces the chance of infection. It also reduces your recovery time. Your surgeon will insert sutures or fixation devices to mend the meniscus tear. Sometimes, the repair will require incisions as well.

Meniscus Tears

What is a meniscus? The knee has a specialized soft tissue structure called a meniscus. It is made mostly of collagen. It sits between the bottom of the femur (thigh bone) and the top of the tibia (shin bone) and acts as a cushion or pad. A torn meniscus is a tear of this specialized structure. Unfortunately, when a meniscus tears, it does not heal due to its poor blood supply. If you have a meniscus tear, depending on the severity of your tear, you may be a candidate for meniscus repair surgery. Meniscus repairs are typically an outpatient surgical procedure that aims to restore the full function of the knee through a variety of minimally invasive techniques. If conservative treatments have been exhausted to heal a meniscus tear, surgery may be the next best treatment to help you return to your active lifestyle.

The meniscus can be injured in various ways; however, the most common occur from rapid turning or twisting or applying high amounts of vertical load (weight) without proper activation of supporting muscles, such as squatting heavy weight without properly warming up or activating the appropriate muscles. Meniscus injuries may result from sudden trauma to the knee or can occur as a result of chronic wear and tear of the joint.

The meniscus tear will not heal on its own; however, the pain and inflammation can and often will decrease on its own with proper rest and cautious exercise. If you’re still experiencing pain after taking proper precautions, it’s recommended to speak with your orthopedic physician. A torn meniscus needs immediate care when the knee “locks” or isn’t able to complexly bend or straighten. Contact our office today to schedule an initial consultation and learn if meniscus repair surgery is right for you:

Call (719) 632-7669

Meniscectomy vs. Meniscus Repair

Meniscectomy is another surgical treatment for injured meniscus. Rather than ‘repair,” the surgeon fully or partially ‘removes‘ or ‘trims‘ the meniscus. This is typically performed when the torn portion of the meniscus is small, or the tear pattern will not benefit from “repair” stitches. Remember that the majority of the meniscus does not have a blood supply, so its ability to heal is severely diminished.

A meniscectomy may be your best treatment option if:

The meniscus has significantly deteriorated tissue
Parts of the meniscus are almost completely torn already

Types of Meniscus Repair

There are four basic types of meniscus repair:

Open technique
Inside-out technique
Outside-in technique
All-inside technique

The technique used will depend upon the severity and location of the meniscus tear.

What Types of Meniscus Repair Require Surgery?

You will likely need surgery to repair your meniscus if:

You have multiple tears
Your knee is ‘locked up’
You have advanced tissue deterioration
You have also damaged the MCL

What Is The Meniscus Tear Recovery Time Without Surgery?

You may recover from a meniscus tear without surgery within 4 to 8 weeks. Recovery times will vary upon your health, resting appropriately, and the severity of your injury.

Treatments

Surgery is just one treatment option to repair a torn meniscus. Other treatment options include:

Exercise and physical therapy
Anti-inflammatory medications
Joint aspiration and injection
Knee braces

Benefits

The benefits and advantages of meniscus repair surgery include:

Faster recovery
Pain reduction
Restored function and mobility of the knee
Mitigates further degeneration of the knee

Risks

The risks and disadvantages of meniscus repair surgery include:

Anesthesia
Infection
Scarring
Further medical complications and pain
Re-tear of the meniscus

Preparing for Meniscus Repair Surgery

Preparation for your meniscus repair surgery includes:

Medications: You may be required to stop taking specific medicines and supplements prior to surgery. Cutting down or stopping smoking will decrease the risk of infection and blood clots and improve healing.
Diet: Your physician may recommend a weight loss program and you will likely be required to fast for several hours before surgery.
Transportation: be sure to arrange your post-surgery transportation plan prior to surgery day.
Home: we also recommend making home arrangements for the first several days post-surgery since mobility will be impaired.

Post-Operative Care

What to Expect After Meniscus Repair

You may or may not have a hospital stay after your surgery. Your doctor will give you post-operative care instructions. This may include:

Wound and bandage cleaning
Pain and anti-inflammatory medications
Diet and supplements
Therapy and exercises

You will also need a follow-up appointment to check progress and remove sutures. Contact your doctor immediately if you experience increased pain or other medical problems.

Physical Therapy Post Meniscus Repair

Your doctor will likely refer you to a physical therapist for post-surgery rehabilitation. Dependent upon your knee and overall health, your physical therapy program may last several weeks to a year.

Physical therapy aims to safely restore knee strength and mobility. Physical therapists receive special movement training to best provide you with exercises and stretches and work directly with your physicians to ensure you receive the best overall treatment. To help you recover from your meniscus repair surgery, CSOG offers on-site physical and occupational therapy.

Cost of Meniscus Repair Surgery

Please contact your insurance provider to discuss coverage details.

To make an appointment at our North Campus location call. (719) 867-7320

To make an appointment at our South Campus location call. (719) 622-4524

Our Orthopaedic Doctors

At Colorado Springs Orthopaedic Group, you have access to top knee repair surgeons. Our doctors are board-certified and committed to delivering the highest quality of care.

Michael Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

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Jamie Friedman, MD

Dr. Friedman’s interests include treating a full range of sports injuries and specializes in complex injuries involving the shoulder and knee.

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Christopher Jones, MD

Dr. Jones is fellowship-trained in the treatment of sports medicine injuries and disorders of the shoulder.

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John Redfern, MD

In addition to general orthopedic care, Dr. Redfern has a particular interest in arthroscopic and open techniques for shoulder and knee disorders.

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Richard Stockelman, MD

Dr. Stockelman’s professional interests include simple and complex problems of the shoulder and the knee.

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Is a Meniscus Repair Surgery Right for You?

Surgery is a significant medical treatment option, and it is not for everyone. Call our office to schedule a consultation and learn if meniscus repair surgery is right for you.

o Physical Therapy for the Knee
o MCL Repair Surgery
o Hip & Knee Replacement Testimonials

xvision™ with Dr. Roger Sung

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s Dr. Roger Sung as we discuss xvision™ Spine System and using augmented reality in the operating room.

What is xvision™ Spine System?

xvision™ Spine System provides surgeons the ability to see the patient’s anatomy in real-time through the use of an augmented reality headset. This technology allows surgeons the ability to perform complex surgeries with increased accuracy and speed.

How is the xvision™ Spine System Utilized?

At Colorado Springs Orthopaedic Group, the xvision™ Spine System is currently used during spinal fusions, Scoliosis, and Kyphosis procedures. We anticipate seeing augmented reality surgery systems becoming available for additional spine procedures and subspecialties in the foreseeable future.

How Does xvision™ Spine System’s Augmented Reality Technology Improve the Outcome for the Patient?

xvision™ allows surgeons to perform one- and two-layer spine fusions as outpatient surgeries, so many patients are able to go home the same day as surgery. When in the operating room, xvision™ provides surgeons the ability to work within smaller incisions, which helps lessen the damage to any surrounding musculature. Less damage to the surrounding musculature allows for a much quicker recovery time. Typical recovery time for procedures such as a lumbar fusion can vary. However through the use of xvision™, patients can return to their daily much quicker than with traditional lumbar fusion methods.

“At the risk of sounding too positive, [recovery] has been just outstanding. The day after surgery, my leg pain was gone and it hasn’t been back.” – xvision™ patient of Dr. Sung’s

The Spine Center Physician

LEARN MORE ABOUT DR. SUNG

Minimally Invasive Spine Surgery with Dr. Paul Stanton

Welcome to a Medical Minute segment with Dr. Paul Stanton, Orthopaedic Spine Surgeon at Colorado Springs Orthopaedic Group as he discusses minimally invasive spine surgery for Anterior and Posterior Lumbar Fusions.

What is the difference between Anterior and Posterior Lumbar Fusions?

There are multiple avenues in which a surgeon can perform lumbar spine surgery. Which procedure type is to be utilized is dependent on:

the type of procedure being done
complexity of the case
the patients current health status
the patient’s surgical history

These factors also help the surgeon determine which angle (anterior, posterior, lateral, etc.) to utilize during the procedure as well.

What is Minimally Invasive Spine Surgery?

The goal of any minimally invasive surgery is to achieve the best possible outcome with the least amount of damage to the surrounding musculature. Preserving the surrounding musculature is key to optimizing a patient’s recovery, and getting them back to their normal range of function. Minimally Invasive Surgical techniques, help us achieve this function in an accelerated and less invasive manner.

What type of injuries is an Anterior or Posterior Lumbar Fusion commonly used for?

Anterior and Posterior surgery methods can be used for many cases including spinal instability, spinal deformity, collapse, fractures, and trauma.

The spine physicians at Colorado Springs Orthopaedic Group believe in customizing treatment plans specific to each patient and their individual case. For those appropriate candidates, conservative care options such as physical therapy, manipulation, or injections may be recommended. In the event a patient has exhausted conservative treatment options, with little to no progress in pain relief, then surgery may be needed to help achieve full recovery.

What is the Average Recovery Time for an Anterior and Posterior Lumbar Fusion?

Recovery time varies depending on each case, however the recovery time for lumbar reconstruction, using minimally invasive techniques, averages a few months to a year. These timelines are estimated to achieve full recovery. With most minimally invasive spine surgery, Anterior and Posterior Lumbar Fusions specifically, patients will often be required get up and walk around on the day of surgery. This reduces the chance for complications that can arise from immobility post-surgery.

What is the Average Hospital Stay after a Minimally Invasive Anterior and Posterior Lumbar Fusion?

It is typical for this surgery to require a hospital stay of one to two nights. This is significantly less than more invasive surgery techniques which typically require between 5-7 days in the hospital.

How does Recovery Differ Between Traditional Open Spine Surgery and Minimally Invasive Spine Surgery?

There is a significant difference in the recovery experience between minimally invasive surgery and traditional surgery methods. Because minimally invasive surgery techniques reduce the damage of the surrounding musculatures, patients can return to normal function much quicker than patients that undergo traditional open surgery methods.

What Age Range can Undergo Anterior or Posterior Lumbar Fusion Surgery?

Minimally invasive anterior and posterior surgery techniques can be used for individuals of any age. There are a few exceptions depending on a patient’s prior surgical history however, most can benefit from a minimally invasive surgery techniques.

What do your patients say after receiving this type of surgery?

Patients are incredibly excited to get back to their daily routines and be pain free again. Check out Annie’s story and her experience with the CSOG Spine Center here.

Call us today at 719-632-7669 to schedule your appointment with one of the Physicians at Colorado Springs Orthopaedic Group! Visit us at www.csog.net to learn more.

The Spine Center Physicians

Paul Stanton, DO

Dr. Paul Stanton is a board-certified orthopedic surgeon with surgical expertise in all aspects of spinal surgery. Some of his most commonly utilized techniques include minimally invasive techniques and complex reconstructive techniques. These techniques are used often to help those with conditions of the cervical spine, adult spinal deformity, and degenerative scoliosis.

James M. Bee, MD

Dr. Bee’s interests include the full range of spinal disorders of the cervical, thoracic, and lumbar spine.

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery.

Physical Therapy for The Knee

Knee Pain and Common Knee Injuries

There are numerous reasons why you might be experiencing knee pain such as an acute traumatic injury, degenerative disease such as Osteoarthritis or Rheumatoid Arthritis, or natural deterioration of muscle, bone, nerves, and connective tissue. Other common reasons you may benefit from physical therapy for the knee include:

Knee surgery or replacement Post-Operative Rehabilitation
Runner’s knee
Knee sprain
Dislocated knee
Knee bursitis
Above-knee amputation
Torn meniscus
Knock knees or bow-legged knees
Muscular Imbalance Corrective Exercise
Knee arthritis

How Long Is Physical Therapy?

How Long Does Physical Therapy Take?

Depending on the severity of an injury, most patients can recover and return to normal activities within a few weeks to a few months when compliant with their prescribed recovery plan. The total length and frequency of your sessions will depend upon the severity of your injury. However, most range from one to three days per week, anywhere between 45 to 60 minutes per session.

Physical Therapy Cost

Relative to surgical treatments, physical therapy is much less expensive. Depending on the medical necessity deemed by your insurance provider in conjunction with a recommendation from your initial Physical Therapy evaluation and/or an orthopedic physician referral, a typical patient may only need upwards of 10 to 20 treatments in total.

Physical Therapy Costs with Insurance

Fortunately, most insurances cover the cost of medically necessary physical therapy treatment however, you may be required to pay a deductible or copay with each visit. Contact your insurance provider to discuss physical therapy out-of-pocket costs associated with your benefit plan. Depending on your insurance cost, some practices offer a cash pay rate that may be an alternative option as well. Call us at 719-632-7669 for more information.

Physical Therapy Costs without Insurance

Out-of-pocket costs depend on your physical therapy plan however, some practices offer a cash pay rate that may be an alternative option. Call us at 719-632-7669 to discuss self-pay options.

Musculoskeletal and Joint pain typically stem from either a lack of strength or lack of mobility within a joint and its surrounding structures. These structures can include your skeletal muscles, tendons, and ligaments. Physical Therapy is one of, if not the most recommended conservative treatments by orthopedic physicians and aims to restore full function from various conditions and injuries. Through proper evaluation and exercise prescription by a licensed physical therapist, you could be back to living your pain-free life within a few weeks or a few months depending on the severity of your pain.

Call (719) 632-7669 to schedule a consultation with one of our physical therapists today or visit us at Colorado Springs Orthopaedic Group.

Types of Physical Therapy Exercises for Knee

The following physical therapy exercises for knee pain are just some of the exercises that can help strengthen the knee after experiencing an injury or surgical procedure. During your first Physical Therapy visit, your Physical Therapist will prescribe additional exercises to address your specific symptoms.

Warmup:

Walk or bike for 5 to 10 minutes.
Raise your knee and grab it with your hands. Hug your knee towards you and balance in place for 10 to 20 seconds on each leg. Repeat 3 to 4 times with each leg.
Do 5 to 10 bodyweight squats to a pain free depth or depth designated by your physical therapy protocols. During each bend, think about pushing the floor away from you through with your weight evenly distributed between your heels and your toes. Use supportive assistance as needed.

Wall Squats:

Stand with your back to a smooth wall and your feet set just slightly in front of you. Cross your arms or have your hands on your hips. Next, slowly bend your knees allowing your upper body to lower down the wall in a controlled and stabilized manner. If you need to, hold on to a chair placed either in front or to one side of you for balance.
Lower yourself until your knees are bent at a 90-degree angle or at an angle prescribed by your physical therapist. A few notes to keep in mind:
- Try not bend your knees further than 90 degrees and prevent your your knees from going over your toes.
- Keep your feet flat to the ground and your weight evenly distributed between your heels and toes.
- Try not to lift your heels or toes as you squat down.
- Keep your head in a neutral position looking straight in front of you.
- It might help to have a mirror in front of you to watch your form as you perform the exercise.
Hold the squat for 3 to 5 seconds, then push evenly through your feet to stand back up. Immediately stop the exercise if you experience any sharp pains that escalate over a 3 out of 10 on the pain scale or pain that lingers after you perform the exercise.
- You should experience a slight burn in your quadricep, hamstring, and glute muscles. You may experience some mild pain in your knee with these. So long as it is not above a 3 out of 10 on the pain scale and the pain does not linger afterward, some discomfort is ok.
Repeat for 2 to 3 sets, 5 to 10 reps each set or as prescribed by your physical therapist.

Additional Wall Squat Tips:

The goal is to see an increase in strength and exercise endurance over a period of time, this is also referred to as progressive overload. A modification for this exercise would be to place a stability ball between your back and the wall and carefully squat down while keeping tension on the ball. This modification will allow for greater range of motion and add fluidity to the movement for those learning initial squat mechanics.

Lateral Walks:

With a small resistance band placed just above your ankles, stand with your feet shoulder-width apart. Place your hands on your hips as you keep your head in a neutral position looking straight ahead.
Keeping your legs straight with just a slight bend in your knees, press your knees slightly outwards to put tension on the band and activate your gluteal muscles. Now, take a step to your left to create additional tension on the band. Now, move your right foot in towards the left so that your feet are once again shoulder width apart and the band is stretched to a moderate tension. We want to keep constant tension on the band and your glutes engaged throughout the entire movement.
The resistance band should make it a bit difficult to take the step. If it is too tight, lengthen the resistance band or move to a band with less tension. If it is too easy, shorten the resistance band between your feet or move to a band with higher tension. Hold on to a chair if you are having trouble balancing. It might also help to have a wall mirror in front of you to watch your form as you perform the exercise.
Repeat 5 to 10 times stepping in the same direction, pause and then repeat going the opposite direction, i.e., leading with the right foot to return to your starting position.
You will feel this movement primarily in your gluteal region which will help strengthen the muscles that help you move side to side. Immediately stop the exercise if you feel any sharp pain above a 3 out of 10 on the pain scale or if the pain lingers after you perform the exercise.

As you become stronger, aim to increase the tension on the restriction band.

What to Expect at Your First Physical Therapy Session

Your first visit to any physical therapy clinic will include an evaluation of your injury condition. PTs are also trained to assess the cause of your pain, not just in the treatment of symptoms.

Before your first visit, it might be beneficial to create a list of questions that you would like to discuss with your PT. We also recommend informing your PT of any past medical history, previous treatments, and current medications during your initial evaluation. If you are scheduled to be seen with one of our highly trained physical therapists here at Colorado Springs Orthopaedic Group, please complete your patient intake form found within your patient portal prior to your initial appointment.

During your first visit, your PT may perform tests and certain movements to determine your condition as well as ask detailed questions about your mobility, current movement and activity restrictions, and your level of pain associated with such movements or activities. From there, they will discuss a recommended treatment plan specific to your injury, pain, and associated symptoms.

Benefits

The primary benefits of physical therapy to treat knee issues can include:

Faster recovery
Safer recovery
Less expensive
High patient satisfaction rates
Eliminates or reduces the need for surgery.
Eliminates or reduces the need for medications.
Promotes muscle strengthening that can carry over into your daily life and hopefully promote life-long exercise and activity habits.

Patient Advantages

Much to the patient’s advantage, Colorado is a Direct Access state, which means you can see a physical therapist for the first line of care without a doctor’s referral. However, some insurances require an insurance authorization or physician referral prior to seeing a physical therapist. Contact your insurance provider to discuss your benefit requirements and procedures.

For those patients who are referred to Physical Therapy by an orthopedic physician post-surgery, diligent compliance with your physical therapy plan will be crucial to optimizing your post-operative recovery. Repair or Reconstruction procedures addressing the MCL, ACL, PCL, LCL or Meniscus are just some of the types of procedures performed on the knee that will require post-operative rehabilitation.

Specialized Care

Physical therapists (or PTs) are movement specialists trained in kinesiology and have their Doctoral Degree in Physical Therapy education. This education is also known as a Doctorate in Physical Therapy (DPT). These specialists are trained to diagnose an injury based on specific evaluation criteria and will prescribe strength and mobility treatment plans as applicable to each case. They are also trained to know when physical therapy is not your best treatment option. In the event your pain cannot be treated by way of physical therapy, you may be referred to an orthopedic physician for proper diagnosis and to discuss further treatment options.

Our Physical & Occupational Therapists

At Colorado Springs Orthopaedic Group, we work with some of the most highly trained and highly skilled physical therapists. Contact our office at 719-632-7669 to schedule an appointment with either our north or south physical therapy locations.

North Location

4110 Briargate Parkway, Suite 145,

Colorado Springs, CO 80920

(719) 867-7320

South Location

1259 Lake Plaza Drive, Suite 100,

Colorado Springs, CO 80906

(719) 622-4524

Woman walking with crutches during physiotherapy

Is Physical Therapy Right for You?

If you are tired of living in pain, let us help! Physical therapy for the knee is one of the common treatment options available at Colorado Springs Orthopaedic Group.

o Minimally Invasive Surgery
o Top Docs of Colorado Springs
o Doctors With X-Ray Vision Technology

Hip Labral Reconstruction: “Pull-Through” Technique

There is a new hip labral reconstruction technique, developed by Colorado Springs Orthopaedic Group’s Sports Medicine expert, Michael J. Huang, MD. that is revolutionizing the field of sports medicine. Learn more about his new “pull-through” technique and how it is being used to treat sports injuries.

New Hip Labral Reconstruction Technique leads to increased accuracy and efficiency

Pioneered by Dr. Michael Huang of Colorado Springs Orthopaedic Group, a new “pull-through” technique for Arthroscopic Labral Reconstruction in the hip has been shown to lead to better outcomes in hip preservation due to the more efficient use of the graft. Alternative Arthroscopic techniques require the surgeon to manipulate the surgical graft significantly, leaving the graft vulnerable to fraying. With this innovative “pull-through” technique, there is minimal manipulation of the surgical graft, eliminating the potential for fraying and providing additional longevity to the procedure.

Further, Nakashima et al. reported significant improvements in postoperative outcomes for patients who underwent this modified technique after two years post-surgery. In addition to this, Domb et al. found significant improvements to patient outcomes five years after surgery if they underwent this modified technique.

To read the full article, please see below:
Pull Through Technique.PDF

Michael J. Huang, MD

Dr. Huang specializes in treating orthopedic sports medicine injuries. His treatments involve both surgical and non-surgical options.

> Michael J. Huang, MD

MRI Scan With Colorado Orthopaedic Group’s Lead MRI Technician

Welcome to a Medical Minute segment with Colorado Springs Orthopaedic Group’s lead MRI technologist, Adolfo Trevino. In this segment, we will discuss what to expect during an MRI scan.

What is an MRI Tesla?

An MRI Tesla is the strength rating for the magnet that is within the MRI Machine. At Colorado Springs Orthopedic Group, our magnet strength rates at a 1.5 Tesla, which is the industry standard for MRI scans.

What can you expect when receiving an MRI Scan?

At Colorado Springs Orthopedic Group, you can rest easy knowing that we will make you feel comfortable during your MRI experience. Each patient is provided with a button that allows you to communicate with your MRI Technician at any point during your MRI scan. Your technician will also check in with you frequently to make sure you are doing well, check if you need a quick break, or answer any questions you may have throughout the session.

Why is it important to tell your MRI technician if you have any metal implants?

For your own health and safety, it is crucial to disclose any metal implants you have to your technician prior to entering the machine as any MRI machine uses high-powered magnets to take the imaging. With this, certain metals can pose a safety concern if not disclosed and addressed prior to your MRI session.

What is a C-Arm?

A C-Arm is an x-ray machine that is used by certified health professionals to help increase accuracy when administering injection therapies to the appropriate patients.

Why chose Colorado Springs Orthopedic Group to perform your next MRI Scan?

Most patients can expect to receive their MRI results within 1-2 business days when seen at Colorado Springs Orthopedic Group. Our mission is to ensure every patient is provided with the highest quality imaging quickly and efficiently.

Hours: 6:00 am – 8:00 pm Mon.- Sat.
MRI Direct Phone: (719) 867-7315
Direct Fax: (719) 633-9912
Email: [email protected]

Cubital Tunnel Syndrome Symptoms & Treatment with Dr. Jeffry T. Watson

Welcome to a Medical Minute segment with Dr. Jeffry Watson, Orthopaedic Hand Surgeon at Colorado Springs Orthopaedic Group as he discusses Cubital Tunnel Syndrome and the treatment options available.

What is the difference between Cubital Tunnel Syndrome and Carpal Tunnel Syndrome?

Both Cubital Tunnel Syndrome and Carpal Tunnel Syndrome involve nerve compression. Carpal Tunnel Syndrome is median nerve compression and can occur where the median nerve goes through the ‘Carpal Tunnel’ in the wrist. Cubital Tunnel Syndrome is when the ulnar nerve—commonly known as the “funny bone”—is compressed. The ulnar nerve is one of the three main nerves in your arm and can be constricted in many places between your neck to your hand. However, the most commonplace for nerve compression is by your elbow. Pressure on the ulnar nerve causes symptoms of numbness, and tingling in the hand, specifically on the pinky and part of the ring finger. Other symptoms including aching and a weak grip.

What are the treatment options for Cubital Tunnel Syndrome?

Often, there is not a specific cause of Cubital Tunnel Syndrome and many patients will develop it naturally. Patients can develop symptoms from sleeping with their elbows flexed. Often Cubital Tunnel Syndrome can go away with the conservative treatment option of wearing a night splint. However, if a patient is getting and staying numb or having any muscle changes, then surgery may be required to relieve the pressure on the nerve.

What surgery options are available for Cubital Tunnel syndrome?

Ulnar nerve decompression (also known as ulnar nerve transposition) is a surgical treatment option for Cubital Tunnel Syndrome. This surgery relieves the pressure on the ulnar nerve. To do this, an incision is made on the backside of your elbow and the nerve is moved from the back to the front of your elbow. This new nerve placement takes the external compression and tension off the nerve and allows for better local blood flow to the nerve.

What is the recovery time for an ulnar nerve decompression?

After ulnar nerve decompression surgery, a patient may have some swelling, soreness, and bruising around the elbow that may limit the movement and use of the arm. A patient will be able to perform basic daily household activities such as cooking or getting dressed but will be limited from performing any strenuous activities for about a month after surgery. This includes any activities that involve vigorous pushing, pulling, or throwing.

What happens if you do not treat Cubital Tunnel Syndrome?

If a patient does not treat Cubital Tunnel Syndrome and the nerve is under enough pressure for a long period, it can undergo scarring on the inside of the nerve. This can cause long-term numbness or can weaken the muscles in the hand that the nerve controls. If too much time has passed, even with surgical treatment to remove the pressure, the numbness may not go away, therefore we recommend seeking professional advise sooner rather than later.

Our Hand & Upper Extremity Physicians

Jeffry T. Watson MD

> Jeffry T. Watson

Dale Cassidy
MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.

>Dale Cassidy, MD, MBA

How to fit and use Crutches, Canes, and Walkers

Welcome to another Medical Minute segment. Here, Haeleigh Little, a certified orthotic fitter from Colorado Springs Orthopaedic Group reviews how to properly fit and use crutches, canes, and walkers.

WHAT IS THE #1 THING PATIENTS STRUGGLE WITH WHEN FITTING WALKING ASSISTANCE DEVICES?

The number one thing patients struggle with is getting the height correct. The height for all of these devices will depend on body type. Most crutches will have markers that will allow for adjustments, but each body is different. Fit can change depending on each individual’s body length, leg length, and arm length.

WHAT HAPPENS IF ANY PIECE OF EQUIPMENT IS NOT FITTED PROPERLY?

If a piece of equipment is not fitted properly, then the ultimate concern is the risk of injury. If the crutch or cane is not properly fitted to a patient’s particular height, you risk injury to the shoulders, elbows, and wrists because you are now relying on those parts of the body to walk.

HOW TO FIT CRUTCHES

Typically, you will want your crutches to sit approximately two or three finger widths below the armpit. If the crutches are too short, you can risk putting excessive pressure on internal structures and muscles within the armpit. Next, you will want to ensure the crutch allows for a slight bend in the elbow, that way in the case of a fall, you do not hyperextend your arm, potentially causing injury.

HOW TO FIT CANES AND WALKERS

When fitting a cane, hold your arm down at your side, the top of the cane should hit at your wrist. You can do the same for measuring walkers, however you will want it to hit a bit above your wrist to compensate for slight bend your elbows as you walk with the device.

ANY OTHER TIPS?

The biggest tip we recommend for all patients to follow is: go slow, listen to your body, and be aware of your surroundings when using any form of walking assistance equipment.

HOW CAN SOMEONE SCHEDULE AN APPOINTMENT?

To schedule an appointment, please call the office at 719-632-7669. Colorado Springs Orthopaedic Group does require a prescription for walking assistance devices so you will want to make sure you have talked to either your orthopedic physician or family physician prior to scheduling your appointment.
With these tips, you can safely fit crutches, canes, and walkers, and be on the path toward healing.

All About Arthritis with Dr. Jepson

Welcome to a Medical Minute segment with Dr. Eric Jepson, a fellowship-trained Joint Replacement physician at the Colorado Springs Orthopaedic Group.

The video below will cover what arthritis is, particularly arthritis in the knee, the symptoms, and treatment options available.

What is arthritis in the knee?

Arthritis in the knee is when the cartilage in the knee wears down. This lack of padding causes the primary symptom, which is pain within the joint. Over time this affects the alignment and mechanics of your joints, as well as your range of motion.

How does arthritis of the knee differ from other parts of the body?

The biggest difference between arthritis in the knee versus other parts of the body is that the knee is a weight-bearing joint. This pain in the knee impacts people performing day-to-day activities. When arthritis starts to impact someone’s daily activities, that is when they usually call the experts at Colorado Springs Orthopaedic Group to find out what their options are.

How do you treat arthritis in the knee?

Dr. Jepson’s philosophy for arthritis is to start with conservative treatment options first. Conservative treatment options include activity modification, physical therapy, cortisone or gel injections, or the use of anti-inflammatory and over-the-counter medications. While these conservative treatments do not treat the underlining condition of arthritis, they change the symptoms and help avoid having to go on to surgical treatment.

The last treatment option for arthritis in the knee is knee replacement surgery. Knee replacement surgery is often very successful and predictable; however, it is still surgery, so Dr. Jepson uses this as the last treatment option.

How do you determine which procedure to use for knee arthritis?

Dr. Jepson determines which procedure and treatment options are right for each patient after consulting with them. Treatment options often depend on how much they impact the patient’s quality of life. Dr. Jepson utilizes conservative methods first, such as physical therapy, or even simple steps such as encouraging and maintaining an ideal body weight. If these simple, conservative options are not helping, then Dr. Jepson will try injections or anti-inflammatory medications as the next step and progress along the treatment cascade from there.

What is the average recovery time for knee replacement surgery?

Knee replacement surgeries are incredibly predictable procedures that have improved greatly over the last ten years. Typically, the patients can stay in the hospital or surgery center overnight; however, now offered through Colorado Springs Orthopaedic Group, many can now go home the same day as surgery! After surgery, patients are up and moving right away. The physicians at Colorado Springs Orthopaedic Group get patients involved in physical therapy immediately after a knee replacement surgery, and after two weeks patients can expect to be able to tell a significant difference from before the surgery. By six weeks, Dr. Jepson expects that patients are starting to return to normal activities.

What is the average recovery time for partial knee replacement surgery?

To perform a partial knee replacement surgery, a patient must have arthritis in only one part of the knee. If a patient has this particular unique circumstance, then a partial knee replacement surgery is an excellent procedure. For most patients, a partial knee replacement surgery has a quicker recovery time and is less invasive.

Colorado Springs Orthopaedic Group’s fellowship-trained joint replacement physicians can put together a custom-tailored program for both diagnosis and treatment. Call to schedule an appointment today at 719-632-7669.

Carpal Tunnel Syndrome
with Dr. Watson

Welcome to a Medical Minute segment with Dr. Jeffry Watson, Orthopaedic Hand Surgeon at Colorado Springs Orthopaedic Group as he discusses Carpal Tunnel Syndrome and the treatment options available.

Carpal tunnel syndrome is when the median nerve is compressed and is one of the most common injuries the hand physicians at Colorado Springs Orthopaedic Group see. The median nerve goes through a passage in your wrist called the ‘Carpal Tunnel’ to give the medial half of your ring finger, your thumb, index and middle fingers the ability to move. The carpal tunnel also controls most of your thumb muscles.

Often there is not a specific cause of carpal tunnel syndrome and many patients will develop it naturally, however, in some instances, it may be the result of a traumatic injury. When swelling occurs on the median nerve, it results in less blood flow to that area. The oxygen deprivation causes symptoms such as numbness or painful tingling primarily in those three aforementioned fingers. The symptoms can worsen at night when most people sleep with their wrist in a flexed position, which puts pressure on the median nerve.

Initial conservative at-home treatment options include wearing a carpal tunnel splint at night, making sure that it is worn tight enough that your wrist doesn’t flex as you sleep but still allows for proper blood flow to the wrist and hand structures. If after diligent compliance with conservative treatment options, you still notice symptoms, we recommend seeing one of our Fellowship-trained Orthopaedic Hand Physicians at Colorado Springs Orthopaedic Group to discuss additional conservative and operative treatment options.

Our Hand & Upper Extremity Physicians

Jeffry T. Watson MD

>Jeffry T. Watson

Dale Cassidy
MD, MBA

Dr. Cassidy is a fellowship-trained orthopedic surgeon specializing in conditions affecting the hand and upper extremity, and in orthopedic trauma.

>Dale Cassidy, MD, MBA

Hip and Knee Replacement Testimonials

Get back to doing the things you enjoy and find out if a hip or knee replacement is right for you with Colorado Springs Orthopaedic Physician, Dr. Tyler Bron. Dr. Bron specializes in complex hip and knee replacement surgery. He is one of the few surgeons in Colorado who uses the Mako Robotic Arm to assist in total knee replacements which allows him to be more precise in preparing existing bones and placing the implants.

Dr. Bron strives to be available to his patients to provide as much information as needed to ensure they are comfortable with any decisions made regarding treatment. As a general principle, he believes in conservative measures when appropriate and proceed to surgery only when necessary.

Dr. Bron believes that life is too short to live in pain and shares that “advances in surgical procedures for both hip and knee replacements can get you up on your feet and enjoying life”. Here are just a few of his patients and what they have to say about their experience.

The SI joint is the joint that links the spine and the pelvis. Pain in this area can often be difficult to diagnose and most patients have a difficult time locating exactly what joint is giving them trouble – whether it is the hip, back, or the Sacroiliac (Si) Joint. If you are not able to find pain relief through conservative treatments at home, we recommend visiting one of our spine surgeons at Colorado Springs Orthopaedic Group to properly diagnose your condition through physical examination, imagining, injury history assessment and diagnostic injections.

Treatment options for the Sacroiliac (Si) Joint will vary dependent on the severity of your case however may include, physical therapy, injections, pain management, or manual manipulation. If those options fail and do not provide long-lasting relief, then surgery may be the recommended option.

Colorado Springs Orthopaedic Group’s board-certified spine surgeons will put together a customized program specific for your diagnosis and recommended treatment.

Our Spine Physicians

Paul Stanton, DO

> Paul Stanton, DO

James M. Bee, MD

> James M. Bee, MD

Roger D. Sung, MD

Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery. He also performs complex spine reconstruction via minimally invasive techniques.

> Roger D. Sung, MD

The First Xvision Augmented Reality Spine System in Colorado

Colorado Springs Orthopaedic Group’s Dr. Roger Sung, MD is the first in Colorado to pilot the
innovative xvision Augmented Reality Spine System

Augmented reality headset gives surgeons “x-ray vision” during procedures for accurate and
personalized implant placement while keeping their eyes on their patients

Colorado Springs, CO, December 2020 – Dr. Roger Sung, MD and his Physician Assistant Kelsey Chrane with Colorado Springs Orthopaedic Group are now offering spine surgery with the Augmedics xvision Spine System, a groundbreaking augmented reality (AR) guidance system that allows surgeons to “see through” a patient’s anatomy as if they have “x-ray vision.” The xvision Spine System is the first AR guidance system to be used in surgery and is currently approved for use in open and minimally invasive spine implant procedures.

Similar to a real-time GPS, this “see-through” surgery lets surgeons know exactly where to place implants in a patient’s unique anatomy, and is bringing a new standard of personalization and care to the operating room. The xvision Spine System is different from other image guidance systems, as it allows surgeons to maintain their focus directly on the patient, rather than on a distant screen displaying the patient’s anatomy.

“Augmented reality is a way to look at a patient’s anatomy in three dimensions “live” in the operating room through a headset. It’s like having x-ray vision as it allows us to peek inside. We can take complicated complex spine anatomy and simplify it to allow for better precision and accuracy in surgery. This lets us work through smaller incisions with less trauma to the tissues. Patients can have a quicker recovery and better long term outcome.” – Dr. Roger Sung, MD First Physician in Colorado to use and offer xvision Augmented Reality.

The xvision Spine System consists of a transparent near-eye-display headset and all elements of a traditional navigation system. It accurately determines the position of surgical tools, in real-time, and superimposes them on the patient’s CT data. The navigation data is then projected onto the surgeon’s retina using the headset, allowing him or her to simultaneously look at both the patient and the navigation data. The xvision Spine System is designed to revolutionize how surgery is done by giving the surgeon better control and visualization, which may lead to easier, faster and safer surgeries.

“Moving here to Colorado Springs, I never dreamed that I would have the opportunity to use Augmented reality and the technology that’s brand new in surgery; that I would be the first woman and the first physician assistant in the world to be able to use this technology, and that we would be the first facility in Colorado to use this technology. Having the opportunity to be involved with a technology that is so new and cutting edge has been incredibly rewarding and also has been really gratifying to know that even here in Colorado Springs I am still able to be involved in the most cutting edge technology and medicine that is available.”- Kelsey Chrane, PA-C First Woman and First Physician Assistant in U.S to use and offer xvision Augmented Reality.

About Dr. Roger Sung, MD
Dr. Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery. He also performs complex spine reconstruction via minimally invasive techniques. Dr. Sung also offers spine surgery with local or spinal anesthesia as an alternative to general anesthesia. These options allow many patients to have complex surgeries in an outpatient setting. Dr. Sung’s expertise with minimally invasive techniques allows for quicker recovery and quicker return to lifestyle.
For more information on Dr. Sung, visit https://www.csog.net/our providers/roger-d-sung-md/

About Kelsey Chrane, PA-C
Kelsey is a Physician Assistant specializing in Orthopaedic surgery and spine surgery. She works with Dr.Sung in The Spine Center. Prior to joining the CSOG team, she worked in a multi-disciplinary Orthopaedic practice at a Level I trauma center in Houston, Texas. She primarily worked in Orthopaedic trauma surgery as well as spine, sports, hand, and pediatric care.
For more information on Kelsey, visithttps://www.csog.net/new-providers-page/roger-d-sung-md/

About Colorado Springs Orthopaedic Group
Colorado Springs Orthopaedic Group is the largest independent orthopedic practice in Southern Colorado and has been providing care to the Colorado Springs community and Pikes Peak region since 1994. We are dedicated to improving the quality of life for the people we serve. We do this by making
orthopedic care as efficient as possible, offering a broad scope of services all in one practice – X-Rays, MRI, Physical and Occupational Therapy, Outpatient Surgery Center, Orthotics and Prosthetics. No matter your need, our 15 Fellowship Trained Board Certified physicians, subspecializing in all aspects of orthopedics – ranging from Orthopaedic Sports Medicine, Hand and Upper Extremity, Spine, and Joint Replacement – have your entire Road to Recovery journey, under one roof.
For more information, visit www.csog.net

About Augmedics
With Augmedics, the future of surgery is within sight. The Chicago-based company aims to improve healthcare by augmenting surgery with cutting edge technologies that solve unmet clinical needs and instill technological confidence in the surgical workflow. Its pioneering xvision system, the first augmented reality guidance system for surgery, allows surgeons to “see” the patient’s anatomy through skin and tissue as if they have “x-ray vision,” and to accurately navigate instruments and implants during spine procedures. Augmedics is backed by Terra Venture Partners and AO Invest, a venture arm of the AO Foundation. The AO is a medically guided, not-for-profit organization, a global network of surgeons,
and the world’s leading education, innovation, and research organization for the surgical treatment of trauma and musculoskeletal disorders.
For more information, visitwww.augmedics.com.

MEDIA CONTACT:
Chelsey Valerio
Colorado Springs Orthopaedic Group
[email protected]
719-867-7329

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Hand Surgery in Colorado Springs

Hand surgery may be recommended for an injury, deficiency, or ailment that causes frequent pain, limited range of motion, loss of feeling, or deformation. The condition may affect your fingers, hand, wrist, and forearm. As a result, even basic life tasks may become difficult. It can be challenging to eat, dress, exercise, lift objects, or you may simply dislike how your hands look.

Hand surgery may be an optimal solution for damaged or infected tendons, muscles, nerves, or bones, especially if therapy and medications are not enough. Thankfully, hand surgery is a successful and safe procedure with high satisfaction rates that aims to permanently restore hand, finger, wrist function, and appearance.

Call (719) 632-7669 to schedule a consultation with one of our hand surgeons today or visit us at Colorado Springs Orthopaedic Group.

Types of Hand Surgery

Types of hand surgery include the following:

Bone Fixation
Joint Replacement
Tendon and Muscle Repair
Fasciotomy
Replantation
Drainage
Skin Graft and Skin Flaps

Recovery Time

Hand surgery recovery time can take several weeks to several months. Although the recovery time for hand surgeries completed with a minimally invasive technique is typically three times faster than traditional open surgery. Recovery time depends upon:

The complexity of the hand surgery
Total number of procedures needed
The health of the patient

Hospital Stay

Most hand surgeries are outpatient and do not require an overnight stay at the hospital.

Cost

Hand surgery in the United States costs $7,000 to $15,000. At CSOG, we accept cash or credit card payments and accept all major insurances.

Costs with Insurance

Your insurance may cover part or the entire cost of your hand surgery. Know that insurance may not cover elective or cosmetic procedures. Contact your insurance provider for coverage details.

Hand Surgery with Modern Technology

If we were to compare modern hand surgery of today with the technology of several years ago the difference would be astounding. Surgery has improved so dramatically over the past decade with modern technologies and advancements.

10 Years Ago: A patient who may have received hand surgery several years ago would have had to frequently change out her bandages. She also would have received a lot of physical therapy and had noticeable scarring.

Today: If that same patient were to receive surgery on her hand utilizing minimally invasive techniques, her recovery would be three times faster, her incisions would be so small that the doctors could use glue instead of bandages to close them (so there would be no need to change out bandages), and she would also experience minimal scarring. In fact, the scarring might not even be visible.

Causes for Hand Surgery

There are many reasons a person may elect to have hand surgery including injury, infection, a degenerative issue such as trigger finger or carpal tunnel syndrome, or a pre-existing defect or deformity.

Hand Injury or Infection

Hand injuries include fractures, sprains, and dislocations. Symptoms include sharp pain, swelling, and limited range of motion. Common causes include falling, sports injury, or an automobile accident.

Signs of infection: swelling, tenderness, stiffness, discoloration, numbness or lack of feeling, or oozing from the injured area.

Degenerative
Disease

Degenerative diseases of the hand include:

Carpal tunnel syndrome
Tennis elbow
Trigger finger
Osteoarthritis
Rheumatoid arthritis

Patients with degenerative diseases typically experience chronic, nagging pain and swelling. Common causes include genetics, aging, and prolonged aggravation of the joints.

Hand Defect or Deformity

A hand defect or deformity can include:

Cysts or lumps
Unnatural growths or shape
Crooked or bent fingers
Partially or fully missing fingers

A hand defect or deformity may not be a painful or debilitating condition but may simply be cosmetic. Such deformities may have naturally occurred at birth or developed over time.

Hand Surgery Ortho vs. Plastics

In some countries, hand surgery is its own medical specialty. In the U.S., both orthopaedic surgeons and plastic surgeons can perform hand surgeries. Both receive added certified medical training to perform hand surgeries.

Plastic surgeons tend to specialize in skin and soft tissue repair. This includes reconstructive and replants operations to treat amputations, burns, and cosmetic deformities.

Orthopaedic surgeons treat all facets of hand injury and disease. This includes issues affecting bone, nerves, and tendons in the hand, wrist, and forearm.

Procedures

Hand surgery is more involved than other reconstructive procedures since the hand and wrist are small, complex joints; hand surgery requires surgeons to receive adequate medical training and refine medical techniques to perform hand operations.

Bone Fixation:

The orthopaedic surgeon can repair bone fractures and breaks with open or microsurgery. The surgeon first aligns the bones. Then, the surgeon inserts pins, wires, and screws to hold the bones together. The aim is to mend the bones together to restore integrity and function.

Joint Replacement:

A surgeon can replace a damaged or deteriorated joint with an artificial joint. The replaced joint could be a knuckle or wrist. The surgeon may use minimally invasive surgery to complete the replacement. Fewer incisions reduce the chance of infection and speed up recovery time. Artificial joints may be metal, plastic, rubber, or other body tissue. The aim is to reduce joint pain and restore full function and integrity.

Drainage:

If a sore or infection develops, the surgeon can drain and clean pus from infected areas. The surgeon may also use debridement to clean and decontaminate a hand infection. The aim is to remove infection and allow full healing.

Tendon and Muscle Repair:

Your surgeon can repair torn or severed tendons and muscles. The procedure is difficult due to small and intricate structures. Often, the surgeon will use microsurgery or open surgery to complete the repair. The aim is to restore full strength, integrity, and motion to the fingers, hand, or wrist.

Nerve Repair:

Your surgeon can repair and reattach damaged or severed nerves. This is a complex procedure. Often, the surgeon will use microsurgery to mend the nerves together. In some cases, the surgeon may use a nerve from another area of the body as a replacement. The aim is to restore hand function and feeling to the hand.

Skin Graft and Skin Flaps:

A skin graft or skin flap involves taking skin from another body part to repair hand skin. The surgeon first removes damaged skin. Replacement skin is then attached to form healthy skin. The aim is to restore hand function, appearance, and allow routine healing.

Fasciotomy:

Fasciotomy is the relief of painful compartmental pressure in hand. The surgeon can cut and scrape damaged tissue, causing the pressure. The aim is to reduce pain and improve the function of the hand or wrist.

Replantation:

Replantation is the reattachment of a severed finger or full hand. Microsurgery allows the surgeon to reattach ligaments, tissue, and nerves. The aim is to restore as much normal function as possible.

Treatment

Hand surgery is often not the first option of treatment for hand injury or disease. Your doctor (or doctors) may first prescribe medications, injections, splints, or therapy. But if medicine and therapy are not enough, surgery is a standard permanent treatment option for:

Sports-related injuries
Carpal tunnel syndrome
Wrist pain
Cuts and severs
Creating or extending fingers from other joints
Degenerative diseases
Defective and deformed fingers and joints

Benefits

The primary benefits of hand surgery are:

Permanent treatment
Reduce pain
Restore hand function

Commonly Used To:

Reattach and repair torn tendons and muscle
Repair damaged nerves
Realign and mend broken or fractured bones
Replace joints
Remove or scrape diseased or deteriorated tissue
Reattach severed fingers

Disadvantages

The disadvantages of hand surgery are:

Higher cost than non-surgical procedures
Chance of complications from surgery
Longer recovery time

Postoperative Care
Risks

Postoperative Care

Your hand doctor will give you detailed at-home care instructions. Follow the instructions carefully to best assure optimal outcomes and avoid other complications. Your hand doctor will also let you know when you can expect to return to regular activity. In the meantime, protect your surgical wound and avoid strenuous activity. If you experience increased pain or other medical symptoms, get medical help immediately.

Risks

All surgeries have risks. Likewise, hand surgery can introduce the chance of complications, to include:

Bleeding
Clotting
Pain or discomfort
Infection
Nerve or tissue damage

Always consult with a board-certified hand doctor about likely outcomes and risks.

Our Orthopaedic Hand Doctors

At Colorado Springs Orthopaedic Group, we strive to provide the highest quality care. Our board-certified hand doctors receive extensive hand surgery training and they are some of the most practiced surgeons in Colorado.

Our Specialists for Hand Surgery

We are so fortunate to have some of the most talented and caring hand doctors. Please take a moment to get to know them:

Jeffrey T. Watson, MD

Dr. Watson is a board-certified orthopaedic hand surgeon. He specializes in adult and pediatric reconstructive and microvascular hand surgery.

>Jeffry T. Watson, MD

Dale Cassidy, MD, MBA

Dr. Cassidy is a board-certified orthopaedic hand surgeon. He specializes in hand trauma, arthritis, carpal tunnel syndrome, and tendon repair.

> Dale Cassidy, MD, MBA

Is Hand Surgery Right for You?

Hand surgery is a severe medical treatment consideration. Find out if hand surgery is your best treatment option. Schedule your Colorado Springs Orthopaedic Group consultation today. Call (719) 632-7669 now to schedule your appointment.

o Minimally Invasive Surgery
o Top Docs of Colorado Springs
o Doctors With X-Ray Vision Technology

Doctors With X-Ray Vision: Augmented Reality for Spine Surgery

Advanced Medical Technology | xvision™ Spine system

Colorado Springs Orthopaedic Group is now offering a new standard of care in surgery, giving our doctors x-ray vision during surgery! Dr. Roger Sung, MD and his Physician Assistant, Kelsey Chrane with Colorado Springs Orthopaedic Group, are now offering spine surgery with the Augmedics xvision Spine System, a groundbreaking augmented reality (AR) guidance system that allows surgeons to “see-through” a patient’s anatomy as if they have “x-ray vision.”

We Are Proud To Announce XVS Image Guiding System for Spine Surgery

Colorado Springs Orthopaedic Group introduces xvision™ Spine system (or XVS) as our newest technology equipped with an image guiding system for spine surgery. xvision™ equipped with this groundbreaking technology, allows for better accuracy and efficiency within the operating room.

Dr. Roger Sung is the first to use xvision™ in Colorado for surgery.
Kelsey Chrane is the first PA and the first woman in the world to utilize this technology.
Colorado Springs Orthopaedic Group is the 4th practice in the nation to offer this technology.

As we continue to invest in innovative surgical technologies and techniques, providing our patients with the best there is in healthcare, please contact us at (719) 632-7669 to learn more about the xvision™ Augmented Reality Spine System and to schedule your personal consultation today.

X-ray Vision Achieved with New Cutting-Edge Technology

xvision™ Spine system is a cutting-edge technology that allows our surgeons to ‘see-through’ a patient’s body as if they have X-ray vision. The surgeon can focus directly on the patient and not have to look away to a digital screen. This allows the surgeon to place implants with greater precision for the best minimally invasive spine procedure outcomes possible.

The Future of Surgery

At Colorado Springs Orthopaedic Group, we constantly invest in the latest orthopaedic techniques and technology. We feel the XVS technology from Augmedics is the future of surgery. XVS is designed to give our surgeons better control and visualization resulting in more efficient, less invasive, and safer surgeries.

“Moving here to Colorado Springs, I never dreamed that I would have the opportunity to use Augmented reality and the technology that’s brand new in surgery; that I would be the first woman and the first physician assistant in the world to be able to use this technology, and that we would be the first facility in Colorado to use this technology. Having the opportunity to be involved with a technology that is so new and cutting edge has been incredibly rewarding and also has been really gratifying to know that even here in Colorado Springs, I am still able to be involved in the most cutting edge technology and medicine that is available.”

– Kelsey Chrane, PA-C
First Woman and First Physician Assistant in the U.S to use and offer xvision Augmented Reality.

Groundbreaking Augmented Reality | xvision™ Spine System (XVS)

The spine is a complex part of the body. It is an intricate structure of bones, muscles, tendons, ligaments, nerves, and discs which makes spine surgery, specifically multi-level complex surgery a more difficult and delicate procedure. Now, with the XVS augmented reality technology we can better navigate these complex procedures. The primary advantages of XVS over other image-guided systems include:

Personalized procedures
More accurate spinal implant placement
Faster
Safer
Less radiation exposure for the physician during the procedure

Benefits
How xvision™ Works

Benefits

Benefits of X-ray Vision with Surgery

With XVS, surgeons can:

Meet 98.9% implant placement accuracy
Move small muscles aside instead of detaching them
Minimize incisions
Operate faster
Operate safer
Better align anatomy for more successful outcomes
Reduce patient recovery time

How xvision™ Works

How xvision™ Augmented Reality Headsets Work

Augmedics’ xvision™ Spine system is an augmented reality (AR) surgical guidance system. It is the first AR system to be utilized in spine surgeries. The surgeon can look directly at the patient and ‘virtually’ see the anatomy through the skin. It is as if the surgeon has ‘X-ray vision.’

Here’s how XVS works …

Instead of looking up or to the side at monitors displaying the patient’s anatomy, the surgeon sees everything through the AR headset, allowing surgeons to maintain their focus directly on the patient. They can likewise move freely around the operating room due to the wireless system. This gives the surgeon better control and visualization, which may lead to surgeries that are easier, faster, and safer to perform.

The headset includes a transparent near-eye-display that determines the position of tools utilized in surgery. It then projects the patient’s CT data in real-time onto the surgeon’s retina, allowing them to look at both the patient while seeing the navigation data.

The AR Guidance System consists of several technology components:

Transparent AR display: all 3D anatomical and instrument data projects on a heads-up display. Thus, the operating field is not obstructed.
Built-in surgical tracking system: the surgeon sees accurate, real-time tool positioning.
Integrated headlight: shines a light on the focus surgery area.
Personalized headset: the headset is custom-fit for each user.
Powerful high-speed processor: eliminates data lag for instant visual tracking.
Wireless system: allows free movement about the operating room.

Our Featured Doctor

Roger D. Sung, MD

Dr. Roger Sung is a board-certified orthopaedic surgeon at Colorado Springs Orthopaedic Group. He specializes in complex spine reconstruction and minimally invasive techniques. He is also the first in Colorado Springs to use the xvision™ Spine system. This technique allows for faster, easier, and more accurate surgery.

“Augmented reality is a way to look at a patient’s anatomy in three dimensions ‘live’ in the operating room through a headset. It’s like having x-ray vision as it allows us to peek inside. We can take complicated, complex spine anatomy and simplify it to allow for better precision and accuracy in surgery. This lets us work through smaller incisions with less trauma to the tissues. Patients can have a quicker recovery and better long-term outcome.”

– Dr. Roger Sung, MD, First Physician in Colorado to use and offer xvision AR.

> Roger D. Sung, MD

Will My Surgery Qualify for XVS?

Not all patients are a candidate for the xvision™ as each patient’s diagnosis will vary however, to learn if xvision™ is right for you, give us a call today at (719) 632-7669 to schedule an appointment with Dr. Sung.

Minimally Invasive Surgery

For patients, ‘minimally invasive surgery’ means ‘smaller incisions than traditional surgery.’ Minimally invasive surgery is also known as a laparoscopic surgery, band-aid surgery, or keyhole surgery. At Colorado Springs Orthopaedic Group, our doctors prefer to use minimally invasive surgery whenever possible, as it is more beneficial for our patients’ overall success and recovery time.

Procedure

The procedure for minimally invasive surgery consists of several small incisions (only a few millimeters long). Next, your surgeon will insert a small endoscope (a long, thin tube with a camera and light on the end) through one of the incisions. The endoscope displays the entire procedure on a large video screen to help your surgeon clearly ‘see inside your body.’ Once the endoscope is in place, your surgeon inserts small surgical tools through the other incisions. The instruments are so small that the surgeon operates the tools by remote control. When complete, the surgeon removes all the devices. Your incisions often do not require more than bandages to heal, and the risk of infection is minimal.

Recovery Time

Recovery time after minimally invasive surgery is typically three times faster than traditional open surgery.

The recovery time for each patient can vary as it depends on the size and complexity of the procedure; however, it is often much shorter than traditional surgery.

Hospital Stay

The average hospital stay for minimally invasive surgery is substantially less than traditional surgery. For instance, the average hospital stay for someone who has recently had a minimally invasive spine surgery is less than 2 days compared to open spine surgery of 3 to 4 days. Depending on the type of surgery, for many, minimally invasive procedures are out-patient surgery where patients can return home the same day.

Cost

Minimally invasive surgery can cost thousands less than traditional surgery due to reduced hospital time, medications, and follow-up care. For most, surgery costs depend upon the complexity and severity of your medical condition. Additional fees may include anesthesia, hospitalization, physical therapy, and medications.

Costs with Insurance

Although your insurance provider likely covers the cost of most rehabilitative procedures, most elective procedures are not covered by insurance. Contact your insurance provider for coverage details. Please ask our office administration about financing and payment options.

Traditional Surgery vs. Minimally Invasive Surgery

With traditional surgery (or open surgery), the incisions are more extensive and take longer to heal. Stitches or staples are used to close the incisions and will have to be removed via a follow-up appointment. There is a higher risk of infection with traditional surgery because the incisions are much larger. Since traditional surgery requires larger incisions, the patient may experience more discomfort for a longer period. Thus, due to higher risks and longer recovery time, more and more surgeons opt for less invasive options if they can achieve the desired outcomes. At Colorado Springs Orthopaedic Group, our doctors choose minimally invasive surgery for our patients unless the procedure or patient is not the right candidate for minimally invasive surgery.

Advantages of Minimally Invasive Surgery

The primary benefit of minimally invasive surgery is that a patient can achieve the same results but with a lower chance of infection, less pain, minimal scarring, and faster recovery time.

At Colorado Springs Orthopaedic Group, we’re committed to optimal patient outcomes and safety. Our doctors have extensive experience, world-class training and are considered elite specialists in their field. (See Top Doc Awards)

To learn whether you would be the right candidate, speak with your orthopaedic surgeon.

Call (719) 632-7669 now to schedule your appointment.

Treatments

Minimally invasive surgery can be done on any joint, including shoulder, elbow, wrist, hip, knee, and ankle. Labrum surgery can even be used to repair torn tendons and is commonly used for total joint replacement surgery for sports injuries or arthritis. At Colorado Springs Orthopaedic Group, we may elect minimally invasive surgery for:

Spine or back surgery
Scoliosis surgery
Hip surgery
Bunion surgery
Knee surgery
Bone spurs
Sports injuries
Meniscus rotator cuff
Knee meniscus

Benefits

Minimally invasive surgery has advantages over traditional surgery. The notable benefits are:

Small incisions (5 to 10 millimeters)
Less pain
Less scarring
Faster recovery
Less blood loss
Lower rate of complications
Shorter or no hospital stay (outpatient procedure)

Commonly Used To:

Repair torn tendons
Replace total joints

Disadvantages

Some disadvantages of minimally invasive surgery are:

It is a more complex procedure; therefore, it takes longer to perform than traditional surgery.
There is a risk of trocar injuries caused by the insertion of the endoscopic and surgery tools. A trocar is a surgical instrument with a three-sided cutting point enclosed in a tube, used for withdrawing fluid from a body cavity.

Despite some disadvantages, minimally invasive surgery has high patient satisfaction rates, and many doctors recommend it over traditional surgery. Thus, when possible, more and more patients and doctors opt for minimally invasive procedures.

Types of Minimally Invasive Surgery

This technique was quickly adopted by specialists in varying medical fields. Orthopedic surgeons use the method to diagnose and treat joint injuries and diseases. There are two main procedure types, arthroscopic and laparoscopic surgery.

Arthroscopic Surgery:

Arthroscopic surgery, coming from the Greek word “artho” meaning “joint”, is a type of surgery for the joints and spine. Arthroscopic procedures may include surgeries of the hip, foot, ankle, knee, shoulder, elbow, and wrist. During the procedure, the surgeon inserts an arthroscope through a small incision, which allows them to see the joint area on a video screen. A small remote-control surgical device is then used to operate.

Laparoscopic Surgery:

“Laparo” means “flank, side” in Greek. With laparoscopic surgery, the surgeon uses an endoscopic tool called a laparoscope. It’s generally used for operations in the spine, abdomen or pelvis. Laparoscopic surgery may include treatment of wound infections, muscle tears, or hernia repair. Again, the surgeon uses a robot to perform the operation with small surgical tools.

Postoperative Care
Risks

Postoperative Care

You may experience discomfort post-surgery. Therefore, your surgeon will give you detailed recovery and self-care instructions. Prescribed medications and physical therapy may also aid in recovery.

One of the benefits of minimally invasive surgery is that it is usually an outpatient procedure, so you will likely not need to stay overnight. Though, you should always have a friend or relative to help you home after the procedure. Also, avoid strenuous activity for several days. Be sure to rest your body, drink plenty of fluids, and stay comfortable. Your doctor will let you know when you can resume full routine activities.

If you experience unusual pain or have complications, contact your doctor. Likewise, get immediate medical help for dizziness, nausea, or irregular heartbeat.

Risks

Risks exist with any type of surgery; however, the risks associated with minimally invasive surgery are significantly reduced because of the smaller surgical incisions. Lower risk and faster recovery rates are why doctors prefer this type of surgery to traditional open surgery. Although minimally invasive surgery is typically less risky than conventional surgery, there can still be complications with anesthesia, infection, bleeding, and minimal scarring.

Surgery is a serious medical consideration. Be sure to talk to your doctor about patient safety. It is always important to clarify the risks, beneficial outcomes, and complete medical history before opting for any surgery type.

Our Certified Doctors

At Colorado Springs Orthopaedic Group, we are one of Colorado’s largest and most respected orthopaedic practices. Our doctors are highly recommended, and we are known as one of the best centers for minimally invasive surgery. Our doctors have extensive experience in spine and various sports injuries, including total joint, knee scopes, sports injuries, and rotator cuff reconstruction.

Our Specialists for Minimally Invasive Surgery

Michael J. Huang, MD

Doctor Huang is a board-certified orthopaedic surgeon. He is also a Colorado Springs Top Doc 2018. He specializes in sports injuries and total hips.

>Michael J. Huang, MD

Tyler R. Bron, MD

Doctor Bron is a board-certified orthopaedic surgeon. He specializes in total knees and hips. Dr. Bron has additional training for using the unique CT-guided Mako Robotic Arm for knee replacements.

> Tyler R. Bron, MD

Is Minimally Invasive Surgery Right for You?

If you’ve been injured or suffer from pain, see a specialist as soon as possible. Sometimes ignoring pain or an injury can make it worse. Call to schedule an appointment with one of our specialists at Colorado Springs Orthopaedic Group. During your initial consultation, our board-certified orthopaedic surgeons work with you to devise the best medical plan.

As every patient and situation is different, surgery may or may not be the best answer.

To learn whether you would be the right candidate for minimally invasive surgery, speak with your orthopaedic surgeon.

Call (719) 632-7669 now to schedule your appointment.

Spinal Fusion Surgery

Senior couple discussing X-ray with doctor.

Procedure

Many Americans suffer from a number of back issues. Spine and back issues can include a spine deformity, instability, and weakness of the back, or a herniated disk. Moreover, many have exhausted other medical treatments to fix the issue. If this applies to you, you may be a candidate for spinal fusion surgery.

What Is Spinal Fusion?

With spinal fusion surgery, spine vertebrae are ‘welded’ together. They connect and heal together. This then corrects and stabilizes your back and reduces pain. There are always risks to surgery, but satisfaction and success rates are high. Spinal fusion surgery is a permanent and common procedure. More than 30 million Americans undergo surgery each year and the procedure has been a successful and safe treatment option for decades.

Again, the aim of spinal fusion is to reduce pain-causing movement between vertebrae. There are two primary parts to the surgery:

Bone Graft: The first goal is to decompress the pain-causing spinal cord and nerves. The surgeon then packs real or artificial bone graft between the vertebrae. This is how they fuse together – much like the healing of broken bones.
Hardware: Screws, plates, and rods are next inserted to better hold the fusion together. This is called internal fixation.

How Long Does Spinal Fusion Surgery Take?

The length of surgery for spinal fusion can take 2 to 7 hours. It depends upon the severity and complexity of the procedure. It also depends upon the health of the patient and the number of vertebrae fused.

Recovery Time

Physical therapy often starts 6 to 12 weeks after surgery.
Your doctor may also prescribe medication to manage your pain. Talk to your doctor if you have concerns about prescription pain medicines.

Hospital Stay

It is likely you will spend a few days recovering in the hospital. After that, be patient. Do not try to return to life as normal too soon. You will receive at-home care instructions. Follow them best you can! You will also likely begin a physical rehabilitation plan.

Cost

In all, a spinal fusion procedure can cost $14,000 to $30,000. In most cases, spinal fusion is covered by insurance. Talk to your insurance provider for coverage details. Do know that with most surgeries, there can be several bills of charges. This includes the surgeon, surgery center, hospital, anesthesiologist, and pharmacy.

Costs With Insurance

Contact your insurance provider for coverage details. If you are unsure about your coverage details, give us a call. We are happy to guide you through the process.

Why Spinal Fusion?

Your spine is literally the ‘backbone’ of your orthopaedic health. Aging, disease, and deformities can deteriorate your back over time. Weak or deformed vertebrae can cause chronic back pain. As a result, you may also have limited physical ability and range of motion. You might also be inhibited from living your desired active lifestyle. Spinal fusion could be your solution.

At Colorado Springs Orthopaedic Group, our doctors are committed to restoring our patients’ health and overall wellbeing. (See Top Doc Awards)

Talk to one of our back and spine doctors at Colorado Springs Orthopaedic Group (CSOG) to discuss if a spinal fusion surgical procedure is right for you.

Call (719) 632-7669 now to schedule your appointment.

Treatments

Spinal fusion can help with:

Deformed neck or back
Spinal stenosis
Spondylolisthesis
Scoliosis
Tumor
Infection
Degenerative disk disease
Weakness or instability
Fractured vertebra
Herniated disk

Benefits

The benefits and advantages of spinal fusion surgery include:

Pain relief
Pressure relief
Back stability
Improved vertebra integrity

Longterm Results:

Spinal fusion is a permanent treatment to help alleviate pain and improve daily routine.

Disadvantages

Immobilizing vertebrae can limit or change how your back moves and rotates, but with reduced pain, your range of motion should improve.

Also, it is important that you are in optimal health. You should not smoke and you should maintain a healthy body weight. Follow post-surgery instructions without exception and do not engage in sports or physical activity that puts undue stress on your back.

Always consult with your surgeon about your risks for any medical procedure.

Advanced Surgical Techniques

Spinal fusion surgery is open surgery. Although, more and more surgeons are using a minimally invasive surgery technique. The technique used will depend upon the complexity of your medical condition. Post-surgery rehabilitation may also include wearing a brace, physical therapy, exercise, and stretches.

cervical, thoracic, and lumber spine image sectioning out each

Regions of Your Spine:

There are three regions of your spine for a spinal fusion procedure:

Cervical spine
Thoracic spine
Lumbar spine

Types of Spinal Fusion Surgery:

Anterior cervical discectomy and fusion
Anterior lumbar interbody fusion
Lateral lumbar interbody fusion
Posterior lumbar interbody fusion
Scoliosis fusion surgery
Transforaminal lumbar interbody fusion

Life After Spinal Fusion Surgery
Risks

Life After Spinal Fusion Surgery

Ah, the big question … can I go back to doing all the things I love to do again? Again, talk to your doctor about safe and realistic lifestyle expectations. Certainly, the goal is to return you to as-close-to-normal orthopaedic health as possible, but post-surgery life may have some limitations. You are still susceptible to further injury or disease. This might be the time to find alternative lifestyle activities. Find something that doesn’t threaten your spine health. You don’t want to risk further back injury or degeneration.

Risks

Like any surgery, spinal fusion has risks and disadvantages, including infection, blood loss, blood clots, pain at the graft site, nerve damage, change of/restricted motion, recurring symptoms, pseudarthrosis (not enough bone formation), post-surgery recovery time, and pain.

Our Certified Orthopaedic Doctors

CSOG strives to provide nothing but the best possible care for our patients. To do that, we insist on putting together the best possible healthcare team.

Our Spine Specialists

James M. Bee, MD

Doctor Bee is a board-certified orthopaedic surgeon who specializes in spine surgeries. Dr. Bee’s medical expertise includes a full range of spinal disorders of the cervical, thoracic, and lumbar spine. Scoliosis and the treatment of spine shrinkage and fractures from osteoporosis.

> James M. Bee, MD

Roger D. Sung, MD

We are so fortunate to have Roger D. Sung, MD, on our physician staff! Dr. Sung is regularly recognized as a Top Doc in his medical peers in Colorado Springs. His surgical expertise is in spinal fusion and spine stimulators. He also specializes in microsurgery and minimally invasive spine surgery. Dr. Sung was the first doctor to use the new xvision™ system at CSOG. He has been in practice with us since 2000.

> Roger D. Sung, MD

Paul Stanton, DO

> Paul Stanton, DO

Is Spinal Fusion Right for You?

You do not have to live with chronic back pain, but surgery is a considerable choice to make. Give us a call at Colorado Springs Orthopaedics Group. We will get you scheduled for your first consultation with a board-certified orthopaedic surgeon. During your consultation, we will discuss your treatment options, along with risks, and likely outcomes. But rest assured that at CSOG, your care is in the best hands possible!

Call (719) 632-7669 now to schedule your appointment.

Helpful Orthopedic Self-Care Tips

Your body’s musculoskeletal system is a complex masterwork made up of thousands of moving parts that performs like a well-oiled machine and with orthopedic self-care, you can maintain this process. Whatever movements you make — walking, stretching, reaching, bending, flexing, grasping — are dependent upon the smooth interaction of bones, muscles, and joints. That’s why avoiding injury and the wear and tear of repetitive motions over the course of a lifetime is so important. Here are some orthopedic self-care tips you can use to keep your body in top shape for years to come.

How to Build Your Bone Strength

Flex those joints. Spend a few minutes every day slowly stretching and moving each of your joints through their full range of motion without hyperextending.
Stay active. Avoid allowing your joints to remain in the same position for an extended period of time, commonly from standing, sitting, leaning, bending over, etc. Stay active, taking breaks often, by moving around and stretching to prevent your joints from stiffening.

How to Keep Your Muscles Healthy

Exercise regularly. Any physical activity is better than none, but strength training is most beneficial for maintaining muscle mass and tone. Not only does it prevent muscle atrophy (losing muscle mass) over time, but it also strengthens your bones.
Drink plenty of water. Muscle function is dependent on hydration. Drinking water prevents muscles from cramping. Avoid alcohol and caffeinated beverages if you can, as these can lead to dehydration.

We’re here to provide total care and help you stay active and fit. If you have any questions about our Express Bone & Joint Injury Care services, please call our office at (719) 622-4550.

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Prevention Tips: Avoid Orthopaedic Disorders and Injuries.

According to the old adage, an ounce of prevention is worth a pound of cure. That’s certainly true when it comes to orthopedic disorders and injuries. One of the best ways to deal with them is to avoid them in the first place.

Here are several simple ways you can avoid serious orthopedic disorders and injuries:

Watch your weight. Did you know that for every 10 pounds you gain, there is a 36% increased risk that you will eventually develop osteoarthritis? Imagine the stress that an additional 20, 30, 40 pounds or more would put on your muscles and joints! Simply maintaining the normal weight for your height will greatly reduce that risk.
Never stop exercising. Regardless of your age, regular exercise increases muscle mass and helps keep your joints functioning properly. The best routines include walking, swimming, stretching, and biking on level ground. However, limit or avoid exercises that place extreme stress on your joints, such as long-distance running and deep knee bends. Also, be sure to stretch before you exercise to maintain flexibility, enhance performance, and reduce the risk of stress injuries such as sprains and strains.
Focus on developing strong core muscles. These help you balance your body weight, rather than putting too much stress on specific joints. You can strengthen your core muscles by practicing yoga and/or pilates.
Wear supportive yet comfortable footwear. The right shoes promote proper alignment and reduce the risk of developing back or knee pain.
Make sure your home and workplace are safe. Most injuries occur in the home and in work environments. Household safeguards may include handrails on stairs and hallways, proper flooring, and the installation of bathmats and grips in bathtubs to avoid slips and falls. At home or on the job, be conscious of repetitive movements that can cause strains. If you must do some heavy lifting, be sure to stretch first, then lift using your legs and core muscles. Also, be sure your workstation is ergonomically friendly, especially if you need to sit for long hours or work at a computer. Take frequent breaks to avoid repetitive stress conditions such as carpal tunnel syndrome.

At CSOG Express Bone & Joint Injury Care, not only can we treat your pain – we can show you how to prevent and avoid orthopedic disorders and injuries. If you have any questions about our express care services, please call our office at
(719)622-4550.

CALL (719) 632-7669

Should I Visit Urgent Care or the ER?

We’ve all had to ask the question, “should I visit the urgent care or the ER.” It’s late at night, and you’ve rushed to the emergency room where you are placed last on the list. You’re in a crowded, noisy waiting room amidst heart conditions, strokes, uncontrollable coughing, and other ailments considered more catastrophic than yours. It is one scenario that’s all too common. While many had hoped the Affordable Care Act would have reduced ER wait times,- they appear to be worse than ever. A 2014 study done by The Centers for Disease Control reported that the average total time in the ER was two hours. A director at one major hospital compared the balancing of patient needs to a “stock exchange,” – in that someone is always coming in with a direr problem than the last. Orthopedic injuries such as fractures, joint issues, and muscle strains don’t always make the cut.

History of Urgent Care & ER

During the 1970s, urgent care came on the scene, revolutionizing the healthcare landscape and offering a less burdensome alternative to the ER, without sacrificing the quality of doctors. According to the Urgent Care Association of America, there are currently 7,000 of these centers within the United States. Specialized centers are popping up for different types of medicine, including orthopedic care. Unlike run-of-the-mill urgent care centers – which primarily treat colds, coughs, and minor cuts, facilities such as Colorado Springs Orthopedic Group’s Express Bone & Joint Injury Care offer on-the-spot bone and joint treatment by experts in the field of orthopedics at a significantly lower cost than the ER.

How do you know when an orthopedic injury requires a trip to the ER, or to Express Bone & Joint Injury Care?

The question is: how do you know when an orthopedic injury requires a trip to the ER, or to Express Bone & Joint Injury Care? Consider the severity of your injury. If you are suffering from a life-threatening problem, severe blood loss, deep lacerations, or a fracture with the bone visible – it’s best to head toward the ER. Most urgent care facilities don’t have the necessary tools to handle an injury of this magnitude. However, if you’ve suffered from a broken bone, joint injury, dislocation, or sports injury, visiting an orthopedic urgent care can help you to cut out the middle man, allowing access to an expert right from the start. Oftentimes, this will save you both time and money.

Employee Experience

The employees who work at these facilities typically have years of surgical as well as clinical diagnosis and treatment experience in orthopedics. Obvious deformities of the elbow, knee, or ankle are better treated in the ER, as they may require more intense pain control than is available at an urgent care facility. Once you’ve been treated in an orthopedic care center, their staff will refer you to a specialist for ongoing follow-up treatments. One benefit of going to an urgent care center affiliated with a regular orthopedic group, is that they will already be familiar with your condition.

Extended Hours

Musculoskeletal injuries aren’t scheduled; and sometimes a sprain, strain, or fracture can leave you feeling helpless. Urgent care centers offer extended hours for people to accommodate before and after work schedules and don’t require an appointment to be seen the same day. However, they aren’t open 24/7 like the ER is. In some cases, the inevitable occurs and time just isn’t on your side.

Express Bone & Joint Injury Care

Thanks to the advent of Express Bone & Joint Injury Care, you no longer need to make the choice between lengthy visits at the ER or waiting weeks for an appointment with that in-demand specialist. Whether it’s our society’s obsession with instant gratification, or simply a need in the market that has finally been met – the introduction of these specialized facilities is a welcome change. For more information, contact Colorado Springs Orthopedic Group Express Bone & Joint Injury Care at (719) 622-4550.

CALL (719) 632-7669

Does Positive Thinking Help with Recovery Time After Surgery?

There is solid evidence that having a positive attitude about your surgery and recovery process will help increase your healing rate. According to researchers who reviewed 16 different studies about positive mental attitude and healing, the right frame of mind can make a huge difference. The studies covered over 30 years and different types of surgery, but they all came to this conclusion. So if you’re wondering “Does positive thinking help?” The answer is a resounding, “Yes!”

How does positive thinking help?

The exact reason positive thinkers tend to have better surgical healing outcomes is still not completely understood. Scientists do however, have a few theories to explain the benefit of positive thinking:

Thanks to the body’s primary stress hormone Cortisol, when we are stressed, the body reacts by increasing inflammation. Positive thinking however, allows you to have a more optimistic outlook on a stressful situation thus, allows you to feel less stress. In turn, this optimistic outlook can help lower inflammation. With less inflammation, the body is able to heal in a more efficient manner.
People who are more positive in general tend to choose more beneficial life decisions. These decisions typically stem from having a vision and plan focused on achieving long-term goals. They understand the road will not be easy or painless, but instead of focusing on the pain, they choose to focus on the end result. For those in post-operative stages, plans for achieving their long-term goals will often include following post-operative orders or physical therapy recommendations with upmost integrity.
Negative thoughts and emotions weaken your immune system’s responses. This goes back to the increase in inflammation as stress increases that we discussed in number one above. Chronic elevations of Cortisol that are derived from negative emotions, can lead to a ‘resistant’ immune system and more inflammation.

While the precise reason why positive thinking helps may elude scientists, the benefits of choosing an optimistic psyche through any adversity are very real.

How can you become a positive thinker?

Now that we have answered the question, “Does positive thinking help with recovery after surgery?” you may be left wondering how to get this benefit in your own life. There are some simple steps you can take to shift your frame of mind for a more positive outlook on surgery and life in general.

Smile more! Studies have show that smiling, even fake smiling, improves your outlook. This simple act reduces both stress levels and your blood pressure.
Practice re-framing stressful situations. When something has you stressed or anxious, try to find something to be grateful for in the situation or a way to see what the lessons to learned within the situation could be. There is almost always a silver lining to every dark cloud in your day.
Work on becoming a resilient person. You can do this by fostering positive relationships with friends and family, learning that change is just a part of life, and working to resolve stressors in your life instead of ignoring them.
Work on your Environment. The environment you create around you and in your head is shown to be one of the biggest catalysts with the way you perceive each day. Examples of ways to adjust your environment can include: doing what you can to keep an organized home, remaining positive in stressful situations, working on strengthening your personal relationships, staying as mobile as possible, and staying hydrated.

Another way to reduce the stress associated with an upcoming surgical procedure is to have complete trust in the expertise of your surgical team. At Colorado Springs Orthopaedic Group our team of specialists will walk you through the surgery and recovery process step by step. If you need anything throughout your journey, we are here for you. Give us a call today to schedule a consultation with one of our caring and competent physicians.

CALL (719) 632-7669

Activities and Essential Nutrients for Better Bone Health

One of the most important things you can do to enhance your life is to maintain strong, healthy bones. Your bones deteriorate as you age, and most bone mass is created by the age of 30. So how can you attain better bone health? Here are some key steps you can take.

1. Eat a balanced diet.

This should include plenty of fresh fruits and vegetables as well as a balance of proteins and fats. Consuming large quantities of vegetables in particular helps children grow strong bones and helps older adults maintain their bone density.

2. Do strength training exercises.

Weight-bearing exercises not only build muscle, but also help to increase bone mass. This holds true both for the young and the old. You can work with a personal trainer to discover the best weight lifting plan for you.

3. Get the right vitamins

If you are eating a healthy diet, you should not need to take an additional vitamin supplement. The key nutrients for better bone health are Calcium, Vitamin K, Vitamin D, Magnesium, and Zinc. When you eat a wide variety of foods, your body will get all of these key nutrients.

4. Consume the right amount of calories

Both over and under-eating are not good for your bones. Very low calorie diets can cause you to lose bone mass, while being overweight can produce the same result. Strive to maintain a stable, healthy weight for better bone health.

Why better bone health?

The most common bone disease of older adults is osteoporosis. This disease causes your bones to become thin and brittle. It is more common in women, but men also suffer from osteoporosis. For this reason, you can never start too early when thinking about better bone health. Some of the symptoms of osteoporosis are:

A bone that breaks very easily
A stooped posture
Back pain due to a collapsed or fractured vertebra
Loss of height over time

At the Bone Health Clinic at Colorado Springs Orthopaedic Group, our providers address bone health through comprehensive care including risk assessments, dietary information, lab and pharmacy services, and specialized treatment. Our mission is to promote better bone health, reduce fracture risks, accelerate healing, and prevent re-fractures, ultimately detecting the disease at its earliest stage and taking measures to prevent its advancement. Schedule an appointment today for a bone health screening.

CALL (719) 632-7669

Safety Tips for Kids Playing Sports

Your young athlete is learning valuable skills, having fun and staying fit. Most parents encourage their children to engage in sports for all of these benefits. You may also be concerned about how to keep your child injury free this season. Follow these safety tips for kids playing sports, and your child will get the most our of their sports activities.

Kids playing sports need protective gear

Protective gear is the first line of defense in preventing injury for kids playing sports. Of course that gear will be different depending on what sport your child plays. Protective gear may include:

Helmet
Cleats
Pads
Eye protection
Athletic cup (for boys)

Your child’s coach should let you know what protective gear you will need.

Always warm up

It’s never a good idea to hit the field or court without warming up first. Your child should start with a light jog and then do some stretching before every practice and game. In team sports, most coaches will have the kids warm up together. For individual sports, you may need to lead your child in a warm-up routine.

Know how to play the game

When all the players know and follow the rules of the game, fewer injuries occur. This is where practice comes in. The more children practice their chosen sport, the better they will be at following the rules, staying in the game and off the sidelines with an injury.

Kids playing sports must look out for others

It’s important for your child to be aware of his or her teammates while playing. This can be accomplished by being courteous of the other players, listening to the coach, and being aware of surroundings. It is also important for kids playing sports to communicate with their teammates. For example, yelling “I got it!” when going in to catch a baseball can prevent a collision with the other players.

Never play while injured

Unfortunately, even when you follow the above tips, injuries can still happen. Kids playing sports may be tempted to push through and keep playing with an injury. Be sure to give your child time to heal before returning to their sports activities or the injury may become worse. This can end a fun season for your child.

Specialists in sports injuries

When the unthinkable happens, and your child is injured while playing sports Colorado Springs Orthopaedic Group is here to help. With an onsite x-ray machine, our Express Care Clinic is available for your urgent care needs. Our specialists in the sports medicine clinic will also treat your child and get him or her back to the sports they love.

CALL (719) 632-7669

The Best Sleeping Positions for Neck and Back Pain Relief

When you sleep your body is doing much more than resting. This time allows your body to regenerate and enable you to feel refreshed and rejuvenated when you wake up. In order to get the optimum benefits from sleeping, it is important for you to consider the best sleeping positions for neck and back. Whether you are already suffering from neck and back pain or your pain results from your sleeping position, follow these helpful tips to get the best out of your night’s sleep.

Best Sleeping Positions for Neck and Back

Keeping your spine in a neutral position while sleeping is the key to relieving neck and back pain. This means that your spine is straight and your hips are aligned.

Sleeping on your back provides the best overall sleeping position to keep a neutral spine. Use a small pillow to support your head while still keeping your neck aligned with your spine.
Sleeping on your side with your legs stretched out is the next best option, especially if you snore while sleeping on your back. You can place a pillow between your knees to keep your hips aligned.

Sleeping Positions to Avoid

With the goal being sleeping with a neutral spine, there are some sleeping positions to avoid in order to prevent neck and back pain.

Sleeping on your side with your legs curled is not an ideal position as your neck and shoulders cannot align properly. Your weight distribution is also uneven in this sleeping position which can lead to back pain.
Sleeping on your stomach may be the worst position of all if you are trying to avoid neck and back pain. Your spine is not aligned in this position, it puts pressure on your joints, and your neck must twist to one side.

When to See a Specialist

If you have been using the best sleeping positions for neck and back but are still experiencing chronic pain, it may be time to see a specialist. The trained physicians at the spine clinic at Colorado Springs Orthopaedic Group can help. Our services range from treating conditions such as herniated discs and low back or neck pain, to more complex problems such as spinal tumors, scoliosis, and stress fractures. The majority of spine problems can be treated without surgery. In most cases, our doctors will refer you to our in-house physical therapy department to try conservative treatment first. Give us a call today to schedule your appointment.

CALL (719) 632-7669

Finding Meaning in Daily Rituals

We all have our own routines: the way we prepare a meal, get ready in the morning, or wind down before bed. Our daily choices create our future. But what makes the difference between a daily routine and a daily ritual? It’s all about mindfulness.

Daily Rituals Versus Routines

Your daily routine may feel like it’s controlling you. It’s the long list of tasks you must complete every day from getting the kids to school, to going to work, then making dinner and getting everyone to bed. If you are mindful about the simple steps in this process, you can turn your routine into a ritual that you control. When you create daily rituals, you allow the small steps in your day to take on greater significance. This can add happiness and meaning to your daily life.

Creating Positive Rituals

The same tasks performed every day in the same order can be considered either daily routines or daily rituals, it all depends on your frame of mind. How can you give those things the meaning needed to make the transition into becoming a pleasing ritual?

First you need the right perspective and attitude. Instead of negative self-talk, change your inner dialogue to something positive that you can repeat daily.
Instead of mindlessly completing your tasks, really focus your attention on your actions. Involve all of your senses in whatever you are doing.
Focus on the bigger picture of why your daily rituals are important to your life. Every action you complete in a day has a benefit somehow.

By being intentional about these steps, you can bring meaning to your day and enjoy greater productivity and an elevated mood.

Daily Rituals with Physical Therapy

If you have an injury or are recovery from surgery, physical therapy may be part of your daily routine. Turning your prescribed exercises into a daily ritual can not only bring you more satisfaction, but also speed the healing process. Whey you are more invested in physical therapy, you get better results. The specialists at Colorado Springs Orthopaedic Group can get you connected with someone in our physical therapy clinic to help you on your healing journey.

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How to Improve Balance and Prevent Falls

Every year, one in four older adults will experience a fall. This can often lead to painful injuries such as hip fractures. In fact, falls are the leading cause of death in this age group, but if you are 65 or older, you don’t need to consider falls to be a natural part of the aging process. Improving your balance will greatly decrease your risk of experiencing a fall.

Tips for how to improve balance through exercise

As you age, the systems that prevent falls are also aging. Your vision, muscles, and central nervous system are all losing a small amount of function the older you become. Your reaction time to trip hazards is increasing as well. All of these factors combine to create a great risk of falling as you age. Here are some ways on how improve balance through exercise:

Aerobic exercise such as walking, swimming, or bicycling. This helps serve as gait training as well as increasing your stamina.
Lift weights to help strengthen your muscles. You can use hand weights, resistance bands, or weight machines.
Flexibility training such as stretching or yoga. Find a local class with other seniors who are interested in maintaining a healthy lifestyle.
Tai Chi for muscle strength and balance. This ancient Chinese practice has been shown to decrease the incidence of falls in older adults.

Before starting any exercise program for how to improve balance, you should consult your doctor. If you experience pain or dizziness after a new activity, stop and rest.

Tips for how to improve balance through training

Exercise is not the only way to improve your balance and avoid falls. This can also be accomplished through balance training activities that you can do as you go about your day. Some examples are:

Alternate balancing on one foot while waiting in line
Practice sitting and standing without using your hands for assistance
After you are used to taking walks, try switching to an uneven surface.

By combining exercise and balance training, you can help condition your body to avoid a nasty fall. If you are looking for help with getting started on a plan for how to improve balance, contact the physical and occupational therapy office at Colorado Springs Orthopaedic Group. We can help develop a plan to keep you on your feet. If you do experience a fall, the physicians at Colorado Springs Orthopaedic Group can help as well. Give us a call today.

CALL (719) 632-7669

Is Wide Awake Hand Surgery for the right option for you?

If you are in need of surgery for your hand or wrist, you may be concerned about the side effects of general anesthesia which can include:

temporary memory loss or confusion
nausea and vomiting
chills and dizziness
breathing problems

Fortunately, another surgical option exists for your hand or wrist condition.

What is Wide Awake Hand Surgery?

Wide awake hand surgery, in essence, is surgery where a local anesthetic is used instead of a sedative or general anesthetic during treatment of various hand and wrist conditions. This allows you to be comfortably awake for the whole procedure. Your surgeon is better able to control bleeding and can safely extend the surgical time. Further, it provides an option for people who cannot undergo traditional general anesthesia due to an underlying medical condition. You are also able to interact with your surgeon and fully comprehend your post-operative instructions.

Benefits over General Anesthesia

The biggest benefit of wide hand awake surgery is being able to test the surgical results while modifications can still be made to the procedure. This can be helpful for conditions such as:

In addition to improved surgical outcomes, this method also avoids both the preoperative testing and the post-operative grogginess. This surgery also does not require preoperative fasting and there is less swelling and pain after the surgery. Overall, it allows you to get the best results possible with the least amount of stress, anxiety, and discomfort.

Wide Awake Hand Surgery Physician

Dr. Dale Cassidy is part of the Hand and Upper Extremity Center at Colorado Springs Orthopaedic Group. He is a pioneer in the field of wide awake hand surgery with a goal of minimizing patient exposure to anesthesia in order to optimize patient recovery time, while still providing completely comfortable care. Dr. Cassidy’s additional training makes him extraordinarily well qualified to render care for traumatic injuries as well as chronic and degenerative disorders of the hand and wrist. He is a member of several highly respected medical organizations including the Orthopaedic Trauma Association, American Academy of Orthopedic Surgeons, American Association of Hand Surgery, and El Paso County Medical Society. Call today to schedule your initial evaluation.

CALL (719) 632-7669

Safety Tips for Bike to Work Day Colorado Springs

While the weather in Colorado can sometimes be unpredictable, our 300 days of sunshine offers the opportunity to bike to work. Biking to work benefits you in many ways including:

Saving money on gas
Getting a daily workout
Reducing air pollution
Avoiding traffic
Getting fresh air and sunshine
Increasing positive mood

Whether you are a seasoned bike enthusiast or just getting started, you’ll want to keep some safety precautions in mind if you plan to participate in Bike to Work Day Colorado Springs.

Tips for Biking to Work Safely

Bicycles are considered vehicles in most states, and rules apply for safely operating bikes in the same way they do to cars. In order to avoid accidents or injuries follow these tips.

The first thing to take care of when you decide to bike to work is a good helmet. This one simple step can reduce your risk of injury by as much as 85 percent.
Wear bright or reflective clothing, especially if you need to ride your bike in the dark. It’s important to stay visible to those around you.
Keep your bike properly maintained. Check your tire pressure, gears, brakes and chain regularly.
Know the rules of the road. Use proper hand signals and stay in bike lanes or on approved roadways.
Watch for hazards in your path such as rocks, glass or sand, and pay special attention at intersections.
Don’t wear earbuds while riding to work. You need to be fully aware of your surroundings in order to react quickly.

Follow these six tips, and Bike to Work Day Colorado Springs will be safe and fun!

Bike to Work Day Colorado Springs

In the state of Colorado, June is bike to work month, with an official “bike to work day” that is normally scheduled in the month of June. For 2020 the date has been postponed to September 22, 2020. The number of participants in Bike to Work Day Colorado Springs has risen dramatically since it’s start in 1995. Biking is especially popular in Colorado, so that trend is likely to continue.

If you are an inexperienced biker and find yourself sore or injured after biking to work, contact the specialists at Colorado Springs Orthopaedic Group to help get you healthy and back on your bicycle enjoying all the benefits of riding your bike to work.

CALL (719) 632-7669

How Screen Time Affects Your Health & What You Can Do About It

Most parents are concerned with the amount of time their children spend on screens, but the average adult spends 11 hours per day on a screen of some sort. All of this technology can be a life-saver in business and productivity, but unfortunately, it’s not so good for your health. Some negative effects of too much screen time are:

Weight gain: more time in front of a screen translates into less physical activity
Depression: significant time spent watching TV or playing videos games correlates to higher depression rates
Vision problems: this can include blurred vision, headaches, and dry, strained eyes
Sleep disruption: the blue light emitted from cell phones and computers hinders melatonin production, the hormone necessary to help you fall asleep
Other health conditions: screen time can even increase the likelihood of conditions such as diabetes, heart disease, and some types of cancer

What you can do about how screen time affects your health

In this digital age, not one is asking you to give up screens entirely. Most people need to use an electronic device for work or school, staying in touch with friends and family, or simply for entertainment. The key here is being conscious of your screen time usage and practicing moderation. Here are some tips for healthier screen time habits:

Use the settings on your phone to set limits on certain apps or on phone usage overall
Schedule quality time with your family and friends
Make time for exercise
Turn off all screens at least 30 minutes before bedtime
Seek help if you are experiencing depression
Take breaks from sitting at your computer at least every hour

When you start paying closer attention to your screen time habits, you will be able to change how screen time affects your health.

Colorado Springs Orthopaedic Group cares about how screen time affects your health

At Colorado Springs Orthopaedic Group, we provide a holistic care model. How you spend your time each day affects your physical health as well as your mental health. If you are experiencing negative effects from excessive cell phone usage, check out our article on how to prevent smartphone hand pain. Our specialists are also available to help if you are feeling pain in your back, legs, or joints due to sitting for long periods of time in front of a screen. Give us a call today to schedule an appointment!

CALL (719) 632-7669

Valuable tips for training for a marathon

People participate in marathons for a variety of reasons. You may want to get in shape, lose weight, or support a worthy cause. Whatever your “why,” training for your first marathon can seem like a daunting task. Running 26.2 miles is no small feat! With plenty of preparation and planning, you can be successful in your fitness endeavor.

Preparation when training for a marathon

Choosing a Marathon. One of the first things you will have to decide is which marathon you would like to participate in. Some important things to consider are:

Terrain: Marathons can be run on anything from crow-lined city streets to hilly country roads.
Participants: Would you prefer a race with thousands of other runners or something a little more low key?
Location: You can sign up for a destination marathon or find one in your home town.

To figure out which marathon is right for you, go as a spectator to several and cheer on the runners. This will give you the best feel for the race and help you chose the marathon that’s right for you.

Getting Started. Many trainers advise you to start training for a marathon one full year before the race. This will give your body and mind time to adjust to running longer and longer distances.

Consult with your doctor before you start training
Build up your distance gradually to avoid injury
Participate in smaller races first
Get to a point of running 20-30 miles per week
Do one long run every 7-10 days

With these steps in place, you can be successful in your training for a marathon.

Preventing injury when training for a marathon

Running long distances puts you at greater risk for injury. It is important to take certain precautions in order to keep you safe, healthy, and injury-free.

Stretch before and after runs
Hydrate well before, during, and after your run
Eat carbohydrates to keep your energy up
Take a rest day to give your body time to recover

Pain and injury while training for a marathon

Even if you have used proper preparation and prevention techniques, you may find yourself in pain or injured while training for a marathon. If this happens, the specialists at Colorado Springs Orthopaedic Group can help. Our Express Care Clinic is there for urgent treatment needs. Our Sports Medicine Clinic is also available to help you get back on the road to meet your marathon goal.

What are the signs of needing a hip replacement?

Living with chronic hip pain can be exhausting and frustrating. The hip is one of the most commonly replaced joints, and osteoarthritis is the main reason for hip replacement surgery. A bad hip can limit your ability to do the things you enjoy as well as complete simple activities of daily living. But how do you know what are the signs of needing a hip replacement? The specialists at Colorado Springs Orthopaedic Group have seven tips to answer this question.

Do you have hip pain when you are active? Does the pain lessen when you rest?
Do you have delayed hip pain that comes on after an activity and lasts for a few days?
Does your hip pain wake you at night?
Do you have bone on bone arthritis in your hip joint as shown by X-ray?
Do you have swelling and inflammation in your hip?
Do you have stiffness in your hip that inhibits your ability to do basic daily activities?
Do you avoid activities you enjoy because you know it will lead to pain?

If you answered yes to many or all of these questions, it could be time for a hip replacement.

The specialists who can answer what are the signs of needing a hip replacement

In general, doctors will start with the least invasive approach before deciding on surgery as the method of treating your hip pain. This can involve weight loss, steroid injections, pain medication, or physical therapy. Once you have tried all of the non-invasive options, the specialists at Colorado Springs Orthopaedic Group can find the surgery that best suits your needs. There are two types of total hip replacements: traditional and anterior approach. In both procedures, the ball (top part of the femur, or leg bone) and hip socket are replaced. What differs between these two procedures is the placement of the incision, which can be on the side or front (anterior) of your hip. Using computer-assisted surgery, our total joint experts can ensure the proper positioning of your hip implant.

When you need a hip replacement, you are in good hands at Colorado Springs Orthopaedic Group. Living with constant hip pain can lead you to become withdrawn and depressed. If you are a candidate for hip replacement, our joint reconstruction specialists are here to help.

5 Tips To Start Lifting Weights Safely

If you’re like most Americans right now, you are looking forward to getting into the gym. If you haven’t done a weightlifting program before, you may wonder how to start lifting weights safely. It’s an important thing to consider, especially if you are unfamiliar with using weights to stay fit and healthy. Here are some tips to help get you started.

1. Warm up your muscles

Before doing any sort of strength training, you need to get your muscles warmed up. You can accomplish this through stretching or using a foam roller to wake up your muscles. Another great option is 5-15 minutes of cardio to get your blood flowing. Now your muscles are ready for a workout.

2. Learn proper technique

You must lift weights properly to avoid injury. Most gyms have trainers available to help you with the correct form when weightlifting. If you do not have access to a trainer other great resources are online videos, Facebook groups or fitness apps. Don’t just wing it when trying something new. This is definitely not how to start lifting weights safely.

3. Choose the right weight

When you first start lifting, you’re better off having slightly too little weight rather than too much. Experiment when doing your workout and see what weight size feels comfortable. It should be somewhat difficult to complete the last few reps of your final set of lifts. Your arms or legs may shake with the effort, but you should not feel sharp pain.

4. Rest between workouts

When starting a new lifting routine, your body will need rest to recover from the strain on your body. Weightlifting causes tiny tears in your muscles. This is how the body grows new muscle mass, but you need 1-2 days between weightlifting sessions to let this process happen. How do you feel the day after your workout? Soreness is to be expected, but you should not be in pain. If you are, give yourself another day of rest.

5. Gradually increase your time lifting

If you are new to weightlifting, give your muscles a little time to adjust to this new routine. Start out with just two days per week for the first 1-2 weeks, then add in a third day. You don’t want to shock your muscles and get hurt. Ideally you will work your way up to 3-5 lifting sessions each week.

Follow these tips for how to start lifting weights safely and you should avoid an injury. If you find you over did it at the gym, visit the Express Care Clinic at Colorado Springs Orthopaedic Group. We can help with all of your acute orthopedic needs.

CALL (719) 632-7669

Orthopedics & Prosthetics Colorado Springs: Caring for our Military

The Colorado Springs area is home to several military installations. At Colorado Springs Orthopaedic Group, we are proud to be of service to these men and women just as they have been to our country. For years our doctors have provided these soldiers, veterans, and their families with orthopedic care and specialty services such as high-quality prosthetics for amputees. Whether troops just returning from war or veterans of wars long past, at Colorado Springs Orthopaedic Group, we treat all types of acute and chronic orthopedic injuries, from complex combat injuries and loss of limbs, to back pain, sprains, and everything in between.

Orthopedics Colorado Springs

A military career is a rewarding one that may bring with it different injuries and chronic conditions. From jumping out of planes to running with heavy packs, the life of a serviceman or servicewoman is hard on a body. At Colorado Springs Orthopaedic Group we have specialists to help. These include:

Our trained physicians will treat you with compassion and respect and can offer the highest quality of care for orthopedics Colorado Springs.

Prosthetics Colorado Springs

Audubon Orthotic & Prosthetic Services has been providing quality care to the residents of Colorado Springs since 2000. The staff is highly qualified and ready to serve our military veterans with personalized care in a timely manner and in a comfortable environment. The specialists at Audubon understand how devastating it is to lose a limb. They are able to help patients regain their function and self-confidence with a high quality, durable prosthesis. Within their expansive state-of-the-art lab, they can design, fit, and fabricate custom prostheses for the lower extremity (leg) and upper extremity (arm). For prosthetics Colorado Springs, Audubon is the the leader in this field.

Caring for our Military

At Colorado Springs Orthopaedic Group, our care goes even further than simply treating injured troops. We know that a debilitating injury affects the whole family, and we work with all family members – even extended relatives who may be caregivers – to help everyone adjust after a loved one comes home with these types of injuries. To help restore function, mobility, and independence, we also provide world-class rehabilitation. Our physical and occupational therapy programs are tailored for each individual to meet his or her goals. Give us a call today so we can get you back on the road to recovery, and thank you for your service!

CALL (719) 632-7669

Heel Pain in the Morning with Dr. Dresher

Do you have chronic heel pain in the morning? This may be due to plantar fasciitis. Plantar fasciitis is one of the most common causes of heel pain. It involves inflammation of the thick band of tissue (plantar fascia) that runs across the bottom of your foot and connects the heel bone to your toes. This painful condition can inhibit your daily life and activities. Thankfully, plantar fasciitis treatment can usually be accomplished at home.

What is causing my heel pain in the morning?

Plantar fasciitis occurs when small tears accrue in the tissue band from any of the following issues:

Wearing shoes that are too hard
Bad habits when running
Flat feet
High arch without proper support in shoes
Being overweight
Standing for long periods

While some cases of plantar fasciitis are due to genetics, many can be prevented or treated with good home care.

How can I prevent heel pain in the morning from plantar fasciitis?

There are many things you can do to prevent pain from plantar fasciitis including:

Wear shoes with good support
Replace tennis shoes often
Avoid walking on hard surfaces barefoot
Keep a healthy weight
Low-impact exercises like swimming or walking
Avoid high-impact exercise such as running
Stretch your legs and feet

Whether you lead an active lifestyle or spend much of your time at home, these things can help prevent plantar fasciitis from developing.

How can I get treatment for plantar fasciitis?

If you know your heel pain in the morning is caused by plantar fasciitis, there are non-invasive ways to treat it. These include:

Rest
Ice the bottom of the foot
Stretching
Physical therapy
Orthotics
Night braces

We always suggest you start with home care and other minimally invasive plantar fasciitis treatments before seeking the help of a doctor.

When should I see a doctor?

If the pain persists after several months you should schedule a visit with Dr. Dresher, our trained foot and ankle specialist. You may have underlying issues such as a bone spur rubbing on the tissue or a stress fracture. At that time Dr. Dresher may request an x-ray or an MRI to better understand what is causing your heel pain in the morning. Surgery should be the last resort for plantar fasciitis treatment unless there is a secondary condition like a bone spur. The specialists at the foot and ankle clinic at Colorado Springs Orthopaedic Group can assess your condition and make a plantar fasciitis treatment plan that will work for you.

CALL (719) 632-7669

Tips for Preventing Smartphone Hand Pain

Let’s face it, most of us have our phones in hand more often than not. Holding and using your device for several hours each day can lead to pain in your hands and wrists. You can even develop a repetitive stress injury in your thumb from typing too much. Follow these simple tips for preventing smartphone hand pain.

Hold your phone correctly

Most of the positions you can hold your phone in are not good for your muscles. This is why developing smartphone hand pain is so common in today’s times. When using your phone, try to keep your wrist straight as much as possible. You can do this by texting with once hand rather than using both thumbs. Another method would be setting your phone on a flat surface while you type.

Relieving smartphone hand pain

When you are experiencing pain due to excessive use of your phone, there are things you can do to alleviate this discomfort. Some of the best ways to do this are:

Take breaks to stretch your hands, fingers and wrists
Apply heat to relax sore muscles
Apply cold to calm more acute muscle spasms
Massage your hands to increase blood flow and relieve tight muscles
Use your fingers instead of your thumbs when typing to prevent developing a serious condition in this digit
Use the voice activated features of your phone

All of these techniques will help you recover from smartphone hand pain and help to prevent damage to your hands, fingers, or wrists. Making lifestyle adjustments to use your phone less will also go a long way in preventing pain and injury.

When to see a professional for smartphone hand pain

Most symptoms related to using your smartphone can be relieved with home treatment. If you are experiencing numbness, tingling, cramping, or stiffness long after you put down your phone, it may be time to see a professional. You may have developed a repetitive stress injury such as carpal tunnel syndrome, tendinitis or nerve damage. The hand specialists at Colorado Springs Orthopaedic Group can help. Our skilled doctors will assess your condition and make recommendations for treatment options so that you can get back to your activities of daily living.

CALL (719) 632-7669

5 Tips for How to Choose the Right Doctor

Choosing a doctor that you are comfortable with and confident in is a very important decision for your health. Like most important life decisions, making an informed choice can take some investigation and effort. Your time will be well spent when you follow these five tips on how to choose the right doctor for you.

1. Talk to family and friends

Finding the right doctor can be as simple as asking people you trust for their recommendations. Your friends and family members may have experience with the type of doctor you are looking for. Remember though that all people are different, and the perfect doctor for your best friend may not be the perfect fit for you as well.

2. Check on insurance coverage

Once you have a few names on your list, check with the providers to be sure their office accepts your insurance plan. This can easily be accomplished by calling the doctor’s office or your insurance carrier. Leaving out this important step can put an unexpected bill in your mailbox.

3. Consider location

While you may be willing to travel farther for a renowned specialist, you should still consider driving time when looking for a new doctor. If you will have frequent appointments, you may not want to make a long commute to visit your doctor’s office. You’re also much more likely to keep appointments with a provider that is conveniently located near where you live or work.

4. Research the quality of care

The most important question to answer when deciding how to choose the right doctor is how confident are you in their quality of care. You can use the website Certification Matters to find out if the doctor you are considering is board certified. Board-certified physicians must pass comprehensive exams as well as stay up to date on advancements in their field of expertise. This ensures your doctor is on the cutting edge of recent studies and technology and can provide you the best care possible.

5. Call the doctor’s office

Now that you’ve narrowed down your search to a few providers, give each office a call. Is the receptionist friendly and attentive? Did you experience a long hold time? Are they booked out very far in advance? These are important things to consider when deciding on a new provider.

We can help you with how to choose the right doctor

Colorado Springs Orthopaedic Group has specialists to meet all of your orthopedic needs. Our orthopedic physicians are board-certified or board-eligible and fellowship-trained in many subspecialties including sports medicine, foot & ankle, spine, hand & upper extremity, trauma, and joint replacement. With this breadth of knowledge and expertise, we have you covered from head to toe.

CALL (719) 632-7669

How Wearable Technology Can Help with Physical Therapy

Sometimes when you leave the physical therapist’s office, the best laid plans to follow through on your PT goals fall apart. So many of us have smart watches and fitness trackers like the Apple Watch and Fitbit. These amazing gadgets can keep track of your activity levels as you go about your day, but they can also help with physical therapy when you leave your physical therapist’s office.

Using your smart watch to help with physical therapy

Whether you have an Apple Watch or some other variety of smart watch, this piece of wearable technology can help with physical therapy tracking and goals. Some fitness features included in a smart watch might be:

Recording workouts
Step tracking
Heart rate tracking
Goal setting
Long term trend data

A smart watch provides a great way to help with physical therapy. It will often include software that tracks session-based tasks that would be assigned by your physical therapist. When you’re completing these activities on your own at home, this information can be invaluable to meeting your physical therapy goals.

Using your Fitbit to help with physical therapy

Wearable fitness trackers like the Fitbit can also help with physical therapy. Many of the features of this wearable technology are similar to those of the smart watch, and they can include:

Heart rate tracking
Activity tracking
GPS tracking

Depending on which version you own, fitness trackers tend to be smaller and lighter than a smart watch. They are also more likely to be waterproof which can be helpful if swimming is part of your physical therapy routine.

No matter what type of wearable technology you choose, these handy gadgets can keep you on track with your physical therapy plan. The better you are at sticking to your goals, the quicker you will heal from your injury or surgery. The physical therapy office at Colorado Springs Orthopaedic Group is here to help with your physical therapy needs. Give us a call today!

CALL (719) 632-7669

6 Ways to Help Chronic Shoulder Pain

Many conditions can lead to chronic shoulder pain including:

arthritis
bursitis
shoulder strain
injury
tendonitis

This common ailment affects people of all ages and activity levels. No one likes dealing with pain that can affect your quality of life and your ability to maintain your current activity level. What can you do when you’re experiencing shoulder pain that won’t go away?

1. Ice

When you have to manage chronic shoulder pain, you can start with icing the affected area. Apply a cold pack for up to 20 minutes as often as five times daily. This process will help calm inflammation in your shoulder and help alleviate your pain.

2. Compression

Another technique you can try at home for shoulder pain is compression. Wrap your shoulder in an ACE bandage or regular bandage. The wrap should be snug, but not too tight. If you begin to feel tingling or numbness in your fingers or arm, release some of the pressure from the bandage.

3. Medication for chronic shoulder pain

When you are experiencing shoulder pain, your first choice of medication should be an over-the-counter anti-inflammatory such as Ibuprofen, Naproxen, or aspirin. If this type of medicine is ineffective, you can talk to your doctor about a stronger pain medication or a muscle relaxant. Both of these require a prescription.

4. Rest

Your shoulder pain may be due to over exertion. Take some time to rest your shoulder. This can be accomplished by changing your activity level or by wearing a sling to support your shoulder while it heals. Continue to move your shoulder gently until the pain subsides.

5. Exercises and stretches for chronic shoulder pain

Stretching and exercising your shoulder can help speed healing and prevent further injury when done properly. It is best to consult a physical therapist when rehabilitating from a shoulder injury. The physical therapists at Colorado Springs Orthopaedic Group can help.

6. Specialists for chronic shoulder pain

When home treatment for your chronic shoulder pain hasn’t worked, it’s time to see a specialist. You should visit a doctor right away if you experience any of the following:

Inability to raise your arm
Severe pain that doesn’t subside with home treatment
Persistent weakness in your shoulder, arm or hand

The Express Care Clinic at Colorado Springs Orthopaedic Group is there when you need immediate treatment. We are also available for regular office visits. Call today to schedule an appointment for help with your shoulder pain.

CALL (719) 632-7669

Dr. Sung Answers Questions About Management of Severe Pain

Dr. Roger Sung is a fellowship-trained and board-certified orthopedic surgeon who specializes in cervical and lumbar surgery, microsurgery, and minimally invasive surgery. He also performs complex spine reconstruction via minimally invasive techniques. With his experience in this specialty, he has helped many patients manage severe pain.

Dr. Sung offers spine surgery with local or spinal anesthesia as an alternative to general anesthesia. These options allow many patients to have complex surgeries in an outpatient setting. Dr. Sung’s expertise with minimally invasive techniques allows for quicker recovery and faster return to normal function.

Should I only take pain medication when I’m having severe pain?

No. You should take your pain medication just as it is prescribed. It is much easier to keep mild pain under control rather than wait until it becomes severe pain. There may be times you take your medication when you are not experiencing any pain at all. This is the best method of managing your pain.

What should I do when my pain level increases to unmanageable pain?

If your pain level has become unmanageable, you should contact your doctor. There may be certain activities or certain times of day when you will experience more severe pain. If your current pain management plan is no longer effective, your doctor can help make adjustments to make you more comfortable.

What are some ways to manage severe pain on my own?

You can always try:

Relaxation techniques like meditation or deep breathing
Reducing stress
Staying physically active

All of these methods can help you deal with chronic and severe pain.

Are narcotics the only way to manage severe pain?

No. I make it a priority to provide all my patients with comprehensive and individualized treatment so they can return to the activities they love. If narcotic pain medication is not the best treatment for you, we can look into other options like physical therapy, occupational therapy, or in some cases surgery.

Will I always be in severe pain?

Hopefully not. Chronic pain is very difficult to live with. I work with my patients on the best treatment plan so that you will be able to live the life you were used to before being slowed down by severe pain.

If you are in chronic or severe pain, you can contact Colorado Springs Orthopaedic Group to make an appointment with Dr. Sung for a consultation.

Spring into Fitness Without Getting a Sore Ankle

The birds are chirping, the sun is shining, the weather is getting warmer, and most Coloradans are ready to get back outside for some Spring fitness. No matter how you like to experience the great outdoors, it’s important to do so safely. No one wants to end up with a sore ankle. Just a little preparation can keep you pain and injury-free this Spring.

Preventing a sore ankle

It’s very common to experience a sore ankle when you get back into running, jogging, biking, or other fitness routines. Your ankles take a lot of the force when you are doing physical activity. The soreness you experience may be from stress on the joint, ligaments, tendons, or muscles. A few simple steps can prevent a sore ankle.

Warm up before exercising
Stretch your legs and ankles
Wear proper shoes
Avoid uneven surfaces
Wrap your ankle if you’ve had a previous injury

If you do end up with a sore ankle, try RICE: rest, ice, compression, and elevation. You can also use an anti-inflammatory medication such as Ibuprofen.

Sore ankle or sprained ankle?

A sprained ankle can happen to anyone. According to some estimates, at least 25,000 Americans suffer from a sprained ankle each day. It is usually caused by rolling, twisting, and turning your ankle past its normal range of motion. Most sprained ankles involve the outer ligaments. In extreme cases, these ligaments may tear. If your sore ankle does not respond to home treatment and you experience any of the following:

Severe pain that cannot be controlled with an anti-inflammatory
Severe swelling
Inability to bear weight on the injured foot

It is time to seek professional help. Depending on the severity of the sprain you may be on crutches for a few days or put into a boot or a splint to restrain the movement of your ankle. In rare cases surgery may be required. After the resting period is over, you may be referred to a physical therapist for specific exercises to rehabilitate your ankle. The Express Care Clinic and the specialists at Colorado Springs Orthopaedic Group, such as Dr. Brad Dresher, can assess your injury and help with your sore ankle. We can also provide physical therapy to help you recover and get back to your spring fitness routine.

Tips For Travel After Knee Replacement Surgery

If you have a surgery scheduled for knee replacement, you may be wondering how soon you will be able to get back to normal life. For many, this includes travel after knee replacement surgery either by car or by airplane. Both of these will require you to sit for longer periods of time in a cramped position. We will discuss some precautions you can take to make travel after knee replacement more comfortable after your initial healing period of 6-10 weeks.

Air travel after knee replacement surgery

Will you be able to make your daughter’s wedding the summer after your surgery? Questions like this may weigh on your mind as you schedule your knee replacement. Air travel poses some unique challenges. It often involves lots of walking to and from your gate, sitting in a small seat for several hours, and the added concern of developing a blood clot. Here are some precautions you can take to have a safe and comfortable flight:

Wear compression socks to prevent a potential blood clot
Get up and walk around as often as possible
Stay hydrated by drinking water and avoiding alcohol and coffee
Stretch and flex your muscles

By following these recommendations you will be able to enjoy your flight and arrive at your destination with minimal discomfort.

Car travel after knee replacement

Ready for that next road trip? Once your initial recovery period ends, you can make plans to hit the open road. Aside from the cries of “Are we there yet?” from the back seat, car travel after knee replacement shouldn’t cause you too much anguish if you follow these simple tips:

Take frequent breaks and walk around
If possible, switch from driver to passenger to give your driving leg a break
Stretch out your legs and flex your muscles as often as you can

Even if you haven’t used any assistive devices during your recovery period, you may want to consider using a cane, walker, or crutch while you are traveling to relieve some of the stress on your knee joint.

The specialists at Colorado Springs Orthopaedic Group are your best choice for your knee replacement surgery. We can also provide physical therapy services as well as support during the healing process. Give us a call today if you have any questions about travel after knee replacement.

CALL (719) 632-7669

How Does a Flexible Spending Account Work with Coinsurance?

Health insurance has become a complicated enterprise. Some commonly used terms like copay, deductible, coinsurance, and flexible spending account may not be so common to the typical consumer. We will explore how does a flexible spending account work, and what is coinsurance.

How does a flexible spending account work?

A Flexible Spending Account, or FSA, lets you set aside money for medical expenses. Since your employer removes the funds from your paycheck before taxes, you realize the tax savings. You and your employer can add money to the account up to the limits outlined by the IRS. It is important to note that the money in a Flexible Spending Account must be used by the end of the year, otherwise your employer can keep the unused funds. Some employers may let you to pay expenses for the previous two months or roll over $500 to the next year. Each year you must re-enroll in the FSA program. You will also need to:

Find out what your employer’s contribution will be
Estimate how much you will spend on medical care this year
Decide on the amount you want deducted from your paycheck each month for your FSA

You can use the funds in your flexible spending account one of two ways. You can either use the provided debit or credit card or use your own money and send in receipts for reimbursement.

How does a flexible spending account work with coinsurance?

Many people confuse copay with coinsurance. They are very different things in the health insurance industry. A copay is a flat rate you pay when you see a doctor or receive other medical treatment. Coinsurance is the amount you are responsible for after you have met the deductible. There are three phases in health insurance:

Deductible phase: you have not yet met your deductible
Coinsurance phase: you pay a certain percentage for your care
Out-of-pocket maximum phase: your insurance company covers all the charges

Once you are in the coinsurance phase, you and your health insurance company are now sharing the cost of treatment at a set percentage rate. You can use your FSA to cover this additional cost for your health care needs.

How does a flexible spending account work at Colorado Springs Orthopaedic Group?

At Colorado Springs Orthopaedic Group, we accept all major insurance carriers as well as Flexible Spending Account payments. You can visit our offices for all of your orthopedic needs. When you require urgent orthopedic care, come to our Express Care Clinic for immediate help for your injury.

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What is a Spinal Stimulator?

If you are among the 100 million Americans who struggle with chronic pain, you may be looking for alternatives to pain medication. So, what is a spinal stimulator? A spinal cord stimulator (SCS) is one promising source of relief. The SCS is a small device that delivers electrical signals to the spinal cord thereby masking the pain signals to the brain. The device is similar to a pacemaker and is surgically placed under the skin. Once in place, the spinal cord stimulator sends mild electrical signals to the spinal cord. It does not remove the source of pain, but it does disrupt the pain signal thereby reducing the pain experienced.

Is spinal cord stimulation right for me?

Now that you know what is a spinal stimulator, you may also wonder how it can help your condition. If you are suffering from chronic pain, an SCS may be right for you. There are several factors that can indicate the use of an SCS.

Medication is not an option or is ineffective
Surgery is not an option
The side effects of medications and/or surgery are undesirable
Your current method of pain relief is impacting your life in a negative way

What is a spinal stimulator supposed to do?

Some intended outcomes of placing a spinal cord stimulator are:

Pain reduction of 50-70%
Better able to sleep at night and relax during the day
Reduced need for pain medication
Better able to accomplish activities of daily living

You can adjust the SCS manually with a remote control. It can be turned off or on, and the strength of the stimulation can be increased or decreased. For more details about a spinal cord stimulator, see this Johns Hopkins Medicine article.

Who can provide spinal cord stimulation treatment?

Only a specialist can perform SCS surgery. If you have exhausted your options for pain relief through medication, surgery, or other treatments, this procedure may provide the relief you are seeking. The spine clinic at Colorado Springs Orthopaedic Group can help. Give us a call to set up a consultation with one of our trained physicians.

CALL (719) 632-7669

What is the Difference Between Physical Therapy and Occupational Therapy?

Many patients are confused when it comes to the difference between occupational therapy and physical therapy. Both can be helpful to you after an injury or surgery or if you are struggling with the activities of daily living.

What does an Occupational Therapist do?

Well, we don’t help people find jobs. That’s a common misconception. No, we actually help patients with injuries, illnesses, or disabilities function in day-to-day life. An occupational therapist focuses on rehabilitating people to live normal lives after an accident or other situation that causes their body to function differently from the norm. This can include people who have experienced an injury or those who have a developmental or intellectual disability.

Difference Between Physical Therapy and Occupational Therapy

The main difference between occupational and physical therapy is the focus of treatment. PT primarily focuses on rehabilitating the body part that was injured while OT works holistically to help the patient perform activities of daily living. Occupational therapists still help to improve range of motion and strength, but we do this so patients are better able to perform daily tasks. Occupational therapists treat the whole person rather than just the injury or impairment. In some cases a patient may start with a physical therapist and then continue working with an occupational therapist.

How are OT and PT similar?

While there is a difference between occupational and physical therapy, the fields do have some overlapping areas of treatment including:

Educating on the prevention of injury
Educating on the healing process
Delivering hands-on rehabilitative care

What makes the OTs at Colorado Springs Orthopaedic Group unique?

At Colorado Springs Orthopaedic Group, we specialize in occupational therapy for the upper extremities. This means we help people who are struggling with hand, wrist, arm, and elbow issues.

We teach you how to get as much use out of these limbs as possible
We help you increase mobility and dexterity
We help you recover to full health after an injury
We work in conjunction with the CSOG hand, elbow, and nerve doctors to improve results after surgery
We specialize in custom splinting

You can find more information on our website, csog.net, or check out otpotential.com for information, resources, and tips.

Click here to find Physical Therapy Near Me and Occupational Therapy Near Me

CALL (719) 632-7669

X-ray Shielding May No Longer Be Necessary

According to a recent New York Times article, using a lead apron during X-Ray procedures may not actually be necessary. X-ray shielding has been common practice for decades and is a law in many states, but new research is showing that there may be no benefit at all to using the lead drape. In fact it could have negative effects. The purpose of shielding during an X-Ray is to protect other areas of the body, especially reproductive organs, during a scan. Unfortunately, the lead drapes can:

Reduce the quality of the scan
Increase radiation exposure
Create the need for a second scan

Resistance to Ending X-ray Shielding

Doctors and patients alike are hesitant to give up the age-old practice of shielding during an X-Ray. Most people fear radiation, and wearing a lead apron gives the patient peace of mind during the scan. However, the following factors show why it is no longer necessary:

The amount of radiation in a scan today is a slim 5% of what was used during the 1950s
It is difficult to place the lead drape in a precise position
Using shielding during an X-Ray can make the machine to emit more radiation
Such shielding cannot protect against X-ray scatter inside the body

Professional organizations, including the American College of Radiology, are now endorsing the idea that routine X-ray shielding should be discontinued as a general practice.

On the Cutting Edge

The radiology department at Colorado Springs Orthopaedic Group is ahead of the trend with ending X-ray shielding. We have been practicing this way for the past two years. We have made it our priority to educate our patients on the safety of X-ray scans when performed without shielding. For all of your orthopedic X-ray scanning needs, you can trust the professionals at Colorado Springs Orthopaedic Group.

CALL (719) 632-7669

Hip Bursitis Symptoms & Treatment

Bursa are fluid-filled sacs that provide cushioning and reduce friction between bone and soft tissue in different areas of the body including the hips, shoulders, heels, and elbows. There are two main bursa in the hip that generally become irritated or inflamed. When this happens, you will experience pain each time the tendon moves across the bone. Since this motion occurs every time you take a step, hip bursitis can be quite painful.

Hip Bursitis Symptoms

Hip bursitis is a common condition that can occur in athletes and the general population. It is more common in women, the middle-aged, and the elderly. Hip bursitis can be brought on by overuse, a hip injury, spine disease, a difference in leg lengths, rheumatoid arthritis, previous surgery, or bone spurs or calcium deposits. Some of the symptoms of hip bursitis are:

Tenderness on the upper/outer thigh
Sharp pain in hip or groin area
Swelling
Aching pain at the hip extending down the outer thigh
Pain typically worse at night
Pain worse when walking or rising from a chair
Difficulty sleeping on the affected hip

Hip Bursitis Treatment

Many people can experience pain relief from hip bursitis through small changes to their day-to-day routines. Some of these changes include:

Rest: As with most injuries, rest is key to recovery. You should avoid the activities that bring on pain or modify the movements of the activity. If you are an athlete, you can consult with a physical therapist or trainer to be sure you are performing exercises appropriately to not further aggravate the bursa.
Anti-inflammatory medication: Over the counter medications such as Ibuprofen can help control the inflammation and pain associated with hip bursitis.
Ice the affected area
Use a walker, cane, or crutches when the pain is most intense
Stretching
Physical therapy to increase hip strength
Steroid injection

With hip bursitis treatment, usually one or a combination of the above is enough to help most patients.

Preventing Hip Bursitis

Hip bursitis can’t necessarily be prevented, but it can be minimized by avoiding repetitive activities that stress the hips. Some potential ways to minimize the likelihood of hip bursitis are:

Losing weight if you’re overweight
Using a shoe insert if there is a difference in length between your legs
Maintaining muscle strength and flexibility in your hips

Seeking Help

If you have a fever in addition to the above symptoms, you should visit the Colorado Springs Orthopaedic Group Express Care Clinic to be treated right away and rule out an infection. Otherwise, if your symptoms do not improve within two weeks, it’s time to seek professional help for hip bursitis treatment. The doctors at Colorado Springs Orthopaedic Group are specialists who can help diagnose your problem and recommend an appropriate treatment plan for your specific situation.

CALL (719) 632-7669

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Colorado Springs Orthopaedic Group Is Among First in the U.S. to Offer Next-Generation Senza Omnia Spinal Cord Stimulation System to Treat Chronic Pain

Roger D. Sung, MD, Implanted Omnia, the Only System Designed to Deliver Nevro’s Proprietary HF10 Therapy, Expanding Patient Treatment Solutions through a Minimally Invasive Procedure

Colorado Springs, CO—January 20, 2020— Colorado Springs Orthopaedic Group (CSOG) is the first practice in Colorado and among the first pain management practices in the United States to offer the Senza^® Omnia™ system, a new spinal cord stimulation (SCS) therapy to treat chronic pain. Omnia™ was recently approved by the U.S. Food and Drug Administration (FDA) and is the first and only SCS system designed to deliver Nevro’s proprietary HF10^® therapy and all other available frequencies, providing chronic pain patients with the most versatile SCS treatment solution available. The Omnia system battery is designed to last 10 or more years, with continuous 10 kHz settings.

Spinal cord stimulation involves the delivery of electrical signals to the spinal cord to alter pain signals to the brain. The electrical pulses are delivered by small electrodes on leads that are placed near the spinal cord and connected to a compact, battery-powered generator implanted under the skin during a minimally invasive procedure. SCS is a reversible therapy that has helped hundreds of thousands of people experience relief from chronic pain – most commonly, severe pain in the low back and lower extremities.

“I am thrilled to offer my patients one system that includes all frequencies and the most waveforms of any spinal cord stimulator.” said Dr. Sung, spine specialist with CSOG. “Chronic pain often requires versatility to manage effectively. With the introduction of Omnia into our practice, we can now offer patients the proven advantages of HF10 therapy while still having access to all other SCS frequencies.”

“Given our community’s active lifestyle and home to military families, CSOG has invested in providing the best orthopaedic care possible,” said Nicole Banning, CSOG president. “It’s one of the reasons we pursued this new SCS system for our patients as an addition to our end-to-end care that includes Express Care, imaging, physical therapy, orthotics and prosthetics, surgery, and complete orthopaedic care.”

Other SCS systems on the market are limited to a frequency below 1500 hertz. Omnia delivers the widest range of frequencies of any SCS system, between 2 and 10,000 hertz. In addition to HF10, Omnia offers the most waveforms in a single product and can be programmed to provide waveforms independently or paired with HF10. The pairing of waveforms across frequency ranges enables dual mechanisms of action that no other system can offer.

“I took special interest in being trained to conduct this type of pain management because chronic pain is the most common reason for physician visits in the U.S.,” said Dr. Sung. “I make it a priority to provide all my patients with comprehensive and individualized treatment so they can return to the activities they love.”

More than 50 million Americans suffer from chronic pain, which is the primary cause of adult disability in the U.S.[1] and is a costly public health issue. Combined loss of productivity and healthcare costs related to chronic pain exceed $560 billion annually in the U.S.[2] There are a variety of treatment options for chronic pain that range from medications to surgical interventions.

To help support Colorado Springs’ active community, CSOG’s Dr. Sung is hosting a lecture on spine stimulators and other pain management options on March 11 at 5:30pm at CSOG’s north office located at 4110 Briargate Parkway, Suite 300, Colorado Springs, CO 80920.

About CSOG

Colorado Springs Orthopaedic Group is the largest independent orthopedic practice in Southern Colorado and has been providing care to the Colorado Springs community and Pikes Peak region since 1994. Our physicians are board-certified or board eligible and fellowship trained in many subspecialties including not only the accuracy of robot assisted surgery, but also sports medicine, foot, ankle, spine, hand, upper extremity, trauma, and joint replacement. With this breadth of knowledge and expertise, we have you covered from head to toe. We provide orthopedic surgical and medical services when and where you need us. Our onsite capabilities include digital X-rays and MRIs, an Express Care walk-in clinic, osteoporosis screening, physical and occupational therapy, and a state-of-the-art outpatient surgery center. Schedule an appointment today! Call (719) 632-7669. We have two convenient locations to serve you in Colorado Springs.

1.Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults —United States, 2016

2.Debono DJ, et al. Caring for patients with chronic pain: pearls and pitfalls. J Am Osteopath Assoc. 2013 Aug; 113(8):620-7.

3.https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=57

4.Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: National Academies Press; 2011

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How your 2020 Resolution Can Help your Knee Problems

Do you suffer from knee pain? It could be due to being overweight. Over 70 percent of all Americans are overweight or obese. A BMI (Body Mass Index) of 25 or higher indicates overweight, while 30 or higher indicates obesity. Losing weight can benefit your body in many ways including relieving inflammation and stress on your joints. In fact, knee pain and back pain in particular are two of the most common complaints associated with being overweight.

Causes of Knee Problems

Osteoarthritis is caused by wear and tear on a joint. Being overweight increases this wear and tear in two ways. First, the extra weight you are carrying puts greater pressure on your joints. Second, the inflammation associated with being overweight also causes problems for your joints. This can be true for joints like knees and hips, but it is also true for other joints like those in the hands.

Weight Loss Can Help Knee Problems

The good news is that losing even a few pounds can provide relief for your aching joints, knee pain, and lower back pain. One study showed that women who lose 11 pounds, or decrease their BMI by just two points, can decrease their risk of osteoarthritis by 50%. If you increase your activity level and include strength training in your weight loss regimen, this is another factor that will boost your joint health. Stronger muscles are better able to support your joints.

Helpful Tips for Weight Loss

Losing weight and then maintaining that healthy weight are essential to overall health, joint health, and less knee problems. It is important to eat a healthy diet filled with nutrient rich foods. Some other steps you can take on your weight loss journey are:

Eat smaller portions
Practice only eating when you are hungry and stopping when you are full
Take walks after meals
Join and gym and meet with a trainer
Cook meals at home rather than eating out
Park farther away from the entrance to your office or grocery store
Use a pedometer or other device to monitor your daily activity level
Keep healthy snacks on hand

Follow these 8 simple steps, and you will be on your way to healthier joints as well as a healthier lifestyle! If you have already been successful in getting to a healthy weight and still have knee problems, it may be time to see a specialist. The doctors at Colorado Springs Orthopaedic Group can assess your condition and create a treatment plan that will help alleviate your knee pain.

CALL (719) 632-7669

Avoiding an Injured Finger this Winter

The most common finger injuries we see in the clinic include lacerations, crushing injuries, fractures, and sprains. Finger sprains are quite common, especially in the sports world, and symptoms may linger for several months. In the winter, some types of injuries become more common. These can include:

Frostbite
Sprains from winter sports
Lacerations from snowblowers

Injured finger: Frostbite

You can easily get an injured finger due to frostbite. This condition can occur in as little as thirty minutes when your hands are exposed in freezing temperatures. The symptoms of frostbite include:

Cold, tingling skin
Numbness
Discolored skin
Joint and muscle stiffness
Waxy-looking skin

With frostbite, prevention is key. Always wear insulated gloves when you will be working or playing outdoors. If you will be out for long periods of time, try using hand-warmer packets, and switch to mittens as they will keep your fingers warmer.

Injured finger: Sprain

Finger sprains are very common in any winter sport. Practice helps reduce the risk of injury, but you cannot prevent them entirely. If a finger is jammed or sprained, you can buddy tape the injured digit to an adjacent non-injured one as a form of splinting. If the injured finger is swollen, discolored, misshapen, or in severe pain, it may be more than just a sprain.

Injured finger: Lacerations

Each year, around 9,000 people lose a finger to a snowblower accident. Snowblower injuries may vary from a simple cut that can be repaired with a few sutures to a more severe injury that requires finger re-implantation or amputation. You must use proper caution when operating a snowblower. Always turn the machine off before trying to clear a blockage with your hands.

When to visit the doctor?

Since finger injuries often occur after a forceful, sudden impact, they are difficult to prevent. It is best to see a doctor if you think you have broken a finger. A specialist like those of us at Colorado Springs Orthopaedic Group can help assess your situation and provide splints and other treatment as necessary. Determining if you have a sprain, fracture or potentially a tendon injury can be important to assess in the first couple of days after an injury for the optimal outcome. In many situations, you can receive treatment other than surgery.

If the injury appears more severe, it is important to see a doctor right away. That is one reason we opened our Express Care walk-in clinic. It is a more affordable alternative to the ER and provides on-site expert care for orthopedic injuries that is often not available right away in an Emergency Room. We are also happy to take care of you in the hand department whenever you need to see a physician. Same-day appointments are usually available.

CALL (719) 632-7669

What is an Ambulatory Surgery Center?

An Ambulatory Surgery Center, or ASC, is a health facility that gives patients the option of having surgeries or procedures done outside a hospital setting. Hospitals play an important role in our communities, providing care for anything from a minor injury to surgery or intensive care. An Ambulatory Surgery Center is a very convenient alternative to the traditional hospital for otherwise healthy people.

Ambulatory Surgery Center vs. Hospital

ASC’s provide the same quality care as hospitals yet have lower infection rates, quicker recovery times, and a much lower cost. While most hospitals offer outpatient surgery, doctors and patients both favor Ambulatory Surgery Centers for certain procedures due to the benefits listed above. Some surgeries you can have done at an Ambulatory Surgery Center are:

Cataract surgery
Colonoscopy and biopsy
Joint drain or injection
Routine venipuncture
Hysterectomy
Total joint replacement
Spine surgery

Inpatient vs. Outpatient Procedures

When doing outpatient treatments, following the surgery the patient moves to the post-anesthesia care unit and is released once they have recovered. A nurse will generally call the next day to check up and answer any questions there may be. Inpatient surgery on the other hand implies that the patient will be staying in a hospital for one or more nights after the procedure. The shorter stay at an Ambulatory Surgery Center makes it a very appealing option. Even complex procedures that were traditionally only performed in a hospital are now being handled at ASC’s.

Benefits of using an Ambulatory Surgery Center

Doctors first starting using ASC’s in order to provide better care for their patients. An Ambulatory Surgery Center offers a clean environment with the best equipment as well as a team of specialists to effectively carry out procedures in their area of expertise. Scheduling is also much more efficient and convenient at an ASC.

The physicians of Colorado Springs Orthopaedic Group are pleased to offer you a convenient alternative for outpatient surgery. You can be confident that you will receive the highest quality of outpatient care and friendly, attentive service. The Orthopaedic and Spine Center of Southern Colorado is our state-of-the-art outpatient surgery center, conveniently located on-site at our North Campus office. This surgery center houses six operating rooms, two procedure rooms for pain management, and a recovery center, with nine convalescent suites for patients whose surgery requires an overnight stay and round-the-clock nursing care for recovery.

Our operating rooms and recovery suites offer the most sophisticated surgical equipment and technology available for outpatient procedures. Our physicians are also supported by a professional, highly trained, and qualified staff of anesthesiologists, nurse anesthetists, registered nurses, surgical technologists, and ancillary personnel.

To make your visit as stress-free as possible for both you and those who accompany you, we offer convenient drop-off and pick-up areas, a comfortable waiting room, and efficient turn-around times. Call today to learn more about our services.

CALL (719) 632-7669

How to Prevent Common Winter Injuries & When to Go to the Hospital

Winter brings fun times celebrating the holidays with family and friends as well as participating in exhilarating sports like skiing and sledding; however, it is also critical to prevent common winter injuries. Winter also has a set of common injuries that can leave you wondering when to go to the hospital. You can enjoy all that winter has to offer while still remaining injury-free.

Common winter injuries

Because of the snow and ice, winter carries with it the risk of injury. Some of the most common ways people get hurt in wintertime are:

Slipping and falling on ice
Over-exertion while shoveling
Injuries from winter activities such as sledding, ice skating and skiing
Automobile accidents

While there are risks, you need not stay indoors to keep yourself and your family safe this season.

Preventing winter injuries

Prevention takes some prior planning, but is well worth the effort to keep you and your family healthy and happy.

Help prevent slips and falls by using ice melt and wearing appropriate foot attire for the snow. Take your time, and use handrails when available.
When shoveling snow, be sure to take breaks, wear warm clothing, and go at a slow pace. To avoid over-exerting one side of your body, alternate throwing the snow to your left or right side.
Use caution when participating in winter sports. Use the correct equipment, and do not take unnecessary risks.
If you must go out in icy conditions, most car accidents are preventable when drivers keep a safe following distance, go slowly, and minimize distractions. When in doubt, don’t go out!

When to go to the hospital

Sometimes things happen, even when you have done your best to prevent injuries. At this point you may be wondering when to go to the hospital. A visit to the Emergency Room is in order for all life-threatening injuries. For other severe or minor injuries to your bones or joints, the Colorado Springs Orthopaedic Group Express Care Clinic is the perfect option for the best possible care. Our specialists will make you comfortable and assess your injury as quickly as possible to get you on the road to healing and back to enjoying the wonderful winter festivities.

CALL (719) 632-7669

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FOR IMMEDIATE RELEASE

December 13, 2019

Colorado Springs Orthopaedic Group Partners with The Touching Hands Project for “Hand Day,” a Day of Free Hand Surgery for Local Patients

COLORADO SPRINGS – On February 29, 2020, Colorado Springs Orthopaedic Group (CSOG) will host “Hand Day”, offering a day of free hand surgery and procedures to uninsured residents in the Colorado Springs area.

For the second time, CSOG is partnering with The Touching Hands Project (THP), which provides free hand surgery and hand therapy to adults and children in underserved communities. Hand Day 2020 will take place in at least nine U.S. cities.

Through relationships with local clinics, CSOG has identified 21 patients who need hand surgery. With the help of volunteer surgeons, nurses, anesthetists, therapists, medical professionals, and translators these patients will undergo their procedures on Hand Day. Following their surgeries, they will receive free follow-up care.

“It is a way for us to come together and help the people in our back yard” said Dr. Watson.

THP, founded in 2014, began with a single international mission, expanding to 10 missions by 2016. That same year, THP added domestic missions and conducted the first Hand Day in Atlanta. THP plans to hold Hand Day in 50 cities within the next five years. The goal is for all those who suffer from a serious hand injury or deformity to have access to affordable care, specialized treatment, and rehabilitation. Among other donors, THP is funded generously by the American Foundation for Surgery of the Hand.

Learn more about THP at www.touchinghandsproject.org, or, donate today.

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Help for Your Back & Neck Pain Symptoms

Eight out of ten people will suffer back and neck pain symptoms at some point in their lives. Sudden or acute pain may indicate an injury, however many people experience constant, chronic back and neck pain symptoms. The severity of the pain can range from a dull ache to sharp pain that inhibits your activities of daily living. If you are struggling with this common condition, there is help for you.

Potential causes of back and neck pain symptoms

Sometimes it can be difficult to determine the exact cause of your symptoms. There are many different possibilities for causes of this condition including:

Over-exertion
Repetitive motion
Aging
Injury
Obesity
Weak muscles
Joint weakness
Osteoporosis

Because there are so many things that may cause back and neck pain symptoms, it is important to be evaluated by a specialist when your pain is acute or chronic.

Preventing bigger problems associated with back and neck pain symptoms

Since it is difficult to ascertain the exact cause of your symptoms, bigger problems may develop if you ignore what your body is telling you. Untreated back and neck pain could result in:

Nerve damage
Disability and loss of productivity
Depression
Further injury
Weight gain from lack of physical activity

When your body is in pain, this is a message to you that something is not right or is not working properly. It is important for you to listen to that message and take action.

Treating or minimizing back and neck pain symptoms

There are many ways you can manage your back and neck pain symptoms. The first thing you can start with is an over the counter pain medication such as Acetaminophen or Ibuprofen. Once you are certain that you are not injured, you can also try some of the following methods to alleviate your pain:

Exercise
Stretching
Physical therapy
Weight management
Assistive devices
Pain management techniques

All of these methods should be considered before introducing Opioid medications.

Finding a specialist for back and neck pain symptoms

If you have tried home care methods for alleviating your back and neck pain symptoms and you are still experiencing acute and/or chronic pain, it may be time to seek the help of a specialist. The doctors at Colorado Springs Orthopaedic Group can help. We have a team of specialists who are qualified and ready to assess your back and neck pain symptoms and help you get some relief.

CALL (719) 632-7669

Recognizing the Early Signs of Arthritis

Twenty-three percent of all Americans experience arthritis. This condition is an inflammation of the joints that often results in pain and stiffness. It breaks down the cartilage that helps joints bend and move smoothly. The effects of arthritis generally worsen with age.

Early signs of arthritis

If you experience:

pain
swelling
stiffness
redness
decreased range of motion in your joints

You may have arthritis. The best way to know for sure is to have a physical examination with an orthopedic specialist. He or she can diagnose your symptoms and order imaging like x-rays, CT scans, or an MRI to help determine the best treatment options for your situation.

Treatment for advanced arthritis

If the arthritis is significantly impairing your ability to perform day to day activities, your physician may recommend surgery to repair the damaged joint. In some cases, a joint repair may be the only thing necessary to smooth joint surfaces and increase function. This can often be done through a small incision and the use of a camera, or scope. More extreme cases may require a total joint replacement in order to reduce pain and increase mobility and range of motion. Although these procedures tend to have great outcomes, you should always ask you doctor about more conservative treatment options for your situation.

Non-surgical options for the early signs of arthritis

Pain is the driving force behind surgical and non-surgical treatment options for arthritis. There is no known cure for arthritis, but there are treatments that can reduce pain and help you function more normally. Sometimes, a simple cortisone injection can make a world of difference. Overweight patients can also reduce the pain and stress in joints by losing even a few pounds. The important thing is to speak with a specialist about your specific needs.

Time to see a specialist

Once again, pain is usually what causes people to see a doctor. If you have any questions about your joints or other orthopedic conditions, it doesn’t hurt to come see us. We can educate you on your options and work with you to determine an ideal course of action for you. Visit Colorado Springs Orthopaedic Group for more information or to book an appointment for your arthritis pain.

CALL (719) 632-7669

Achilles Tendonitis vs. Tendinopathy: Understanding Symptoms and Treatment Options

If you’re experiencing Achilles tendon pain, it’s crucial to distinguish between conditions like Achilles tendonitis and Achilles tendinopathy. Understanding these issues is essential for maintaining an active lifestyle, whether for yourself, an aging family member, or a teen athlete. This article will delve into the symptoms of Achilles tendon rupture, outline treatment options for chronic Achilles tendon pain, and provide strategies for quick recovery from Achilles tendonitis.

We will clarify the differences between Achilles tendonitis and Achilles tendinopathy, discuss Achilles tendon rupture surgery recovery, and highlight effective treatments for lasting relief from Achilles tendon pain.

What is the Achilles Tendon and Why Does It Hurt?

The Achilles tendon, the largest tendon in the human body, connects the calf muscles to the heel bone and is essential for activities such as walking, running, and jumping. However, overuse, aging, or sudden increases in physical activity can lead to Achilles tendon pain, inflammation, or even tears.

Recognizing the signs of Achilles tendonitis or rupture is vital for timely intervention and recovery.

Differentiating Achilles Tendonitis from Tendinopathy

Achilles Tendonitis (Acute Condition)

Achilles tendonitis is characterized by inflammation and usually occurs after a sudden increase in activity. Common symptoms include:

Sharp pain and swelling near the heel
Tenderness or warmth in the affected area
Stiffness, particularly in the morning or after inactivity

Who is affected:
Active individuals, particularly those returning to exercise after a break, often experience this condition.

Achilles Tendinopathy (Chronic Condition)

Achilles tendinopathy involves long-term changes in the tendon structure and arises from chronic overuse. Key symptoms include:

Thickening of the tendon
Persistent Achilles tendon pain that worsens with activity
Stiffness that does not improve with stretching
Minimal swelling but significant loss of strength

Why it matters:
Unlike tendonitis, tendinopathy requires a more comprehensive approach, including eccentric strength training and physical therapy.

Recognizing Serious Issues with Achilles Pain

Not all heel pain is benign. Failing to address persistent symptoms may lead to a complete Achilles tendon rupture, which often requires surgical treatment.

Symptoms of a Possible Achilles Rupture:

A sudden “pop” in the back of the heel or calf
A sensation of being kicked in the leg
Inability to walk or stand on tiptoes
Severe Achilles tendon pain with immediate swelling or bruising
Loss of mobility in the affected leg

If you notice these symptoms, especially after a sudden movement, see an orthopedic specialist immediately.

Achilles Tendon Rupture Surgery Explained

In cases of severe damage, surgical repair is often essential. This procedure reconnects the tendon, promoting healing and restoring strength.

Who Needs Surgery?

Anyone with a complete achilles ruptures
Individuals aiming to return to high-intensity activities
Older patients unresponsive to conservative chronic tendinopathy treatments

Recovery After Surgery:

Initial healing phase: 2–4 weeks in a cast or boot
Rehabilitation phase: Begins within 4–6 weeks with physical therapy
Return to activity: 3–6 months for moderate injuries, longer for high-level athletes

Advancements in surgical methods have improved recovery outcomes significantly.

Effective Non-Surgical Treatments

For Achilles tendon irritation without rupture, conservative treatment is usually effective, especially when initiated promptly.

Home and Clinical Treatment Options Include:

RICE Method (Rest, Ice, Compression, Elevation) post-activity
NSAIDs for short-term relief
Physical Therapy focusing on eccentric loading and mobility
Corticosteroid injections for stubborn cases
Proper footwear with good arch support

If symptoms persist or recur frequently, consulting a medical professional is recommended.

When to Seek Specialist Care

Consider consulting an orthopedic foot and ankle specialist if:

You’ve had heel or calf pain for over 10–14 days
You notice swelling, morning stiffness, or tendon thickening
You cannot jump or bear weight without pain
You’re over 40 and starting a new fitness program
A family member has Achilles-related pain or mobility issues

Act Now for Pain Relief

Whether you are experiencing Achilles tendon pain or assisting someone in need, the key to recovery lies in an accurate diagnosis and tailored treatment plan.

At Colorado Springs Orthopaedic Group, our experienced foot and ankle surgeons, Brad Dresher, MD and G. Alex Simpson, DO, are experts in treating tendonitis, tendinopathy, and ruptures with the latest non-surgical and surgical techniques.

CALL (719) 632-7669

How long does a cortisone shot last?

A cortisone shot is an injection that can help reduce pain and inflammation in a particular area in the body. They are most commonly used in joints including knees, hips, shoulders, elbow, spine, and even smaller joints in the hands and feet.

When should you consider cortisone injections?

Surgery is generally a last resort for patients with joint pain. Instead, our physicians prefer to start with non-invasive options like a cortisone injection. This treatment option can help you

minimize joint pain
increase mobility
delay surgery
get back to regular functioning and daily activities
soothe arthritis flare-ups

Cortisone shots do not work for everyone, but they are an easy and often useful option to try before more invasive treatments.

How does a cortisone shot work?

Cortisone by itself is not a pain reliever. Instead it is an anti-inflammatory. The cortisone is injected directly into the joint and prevents collagen production. This in turn prevents further inflammation and calms nerves thereby reducing pain.

How soon will I get relief after receiving an injection?

A cortisone shot is made up of a corticosteroid medication and a local anesthetic. Because of the anesthetic, your joint will probably feel numb for a few hours after the injection. The corticosteroid should kick in within 3 to 5 days of the injection, but some people experience immediate relief. Patients often wonder how long does a cortisone shot last. Pain relief and reduced swelling last for different amounts of time for different individuals. The relief may continue for months or last only a few days. People frequently see benefits from regular cortisone injections, but it is not recommended to get them too frequently. Your doctor can help determine an appropriate treatment plan during your consultation.

What are the risks of cortisone injections?

Cortisone injections are a very safe treatment for joint pain. There are minimal risks and rarely do we see any complications. The biggest difficulty is for those who have a fear of needles. Several options may be available for your specific orthopedic situation, and it is important to seek advice from a specialist to discuss cortisone shots as well as alternate treatments. The doctors at Colorado Springs Orthopaedic Group can help guide you in making this decision and with providing treatment.

Signs and Symptoms of a Sprained Wrist

To understand the signs and symptoms of a sprained wrist, we must first understand what occurs inside the body when the wrist is sprained. Ligaments are the strong tissues that connect bones to other bones and help stabilize joints. Sprains occur when these ligaments are damaged, torn, or stretched too far. A wrist sprain is usually the result of a fall or injury that causes the hand to bend forcefully. Many wrist sprains are caused by a fall during normal everyday activities. Tripping and catching yourself on an outstretched hand is the most common cause. Sports and outdoor recreation are also activities that frequently result in sprains. Since these injuries generally occur very suddenly, the best ways to avoid a sprain include using wrist guards or protective tape, and using caution when walking in wet or slippery conditions.

Signs and symptoms of a sprained wrist

Chances are, if you have a sprain, you’ll know it. Wrist sprains are painful and can show symptoms through:

swelling
bruising
tenderness to touch
warmth around injured area
popping or tearing sound in the wrist

Treating the signs of a sprained wrist

For minor strains, use RICE: rest, ice, compression, elevation. In conjunction with anti-inflammatory medications, this process should help reduce minor pain and swelling. Moderate strains may need to be immobilized for a period of time using a splint or brace. Your doctor may also advise a specific stretching routine to help you regain full mobility. Severe strains or strains involving a ligament tear may require surgery. This process involves reattaching the ligament to the bone or using a graft to reconstruct the ligament. If your doctor deems surgery necessary, he or she will talk to you about which options are best for your case.

When to see a doctor

When in doubt, it is a good idea to see an orthopedic doctor for your wrist pain. They can help you determine the severity of your sprain and whether or not it will require treatment to heal. A sprain may very well heal on its own, but even minor injuries can result in a torn ligament. These do not heal on their own but require surgery to avoid long-term problems. Also, what may seem like a sprain may actually be a fracture. If these fractures go untreated, they can result in improper healing that requires surgery down the road. If you are experiencing the signs of a sprained wrist, visit the Express Care Clinic at Colorado Springs Orthopaedic Group. Our specialists will assess your injury and create an effective treatment plan.

CALL (719) 632-7669

Shout Out to Our Military Veterans!

Veterans Day is celebrated across America on November 11. This national holiday began in 1919 to commemorate the end of Work War I. It was formerly known as Armistice Day until 1954 when President Eisenhower changed the name in order to honor all veterans. There are over 18 million veterans in the United States, and this holiday serves to applaud them for their service and accomplishments.

United States Veterans

Veterans include men and women who have served in any branch of the armed forces:

Air Force
Marines
Navy
Army
Coast Guard

Veterans are from all walks of life and many different professions. Nine percent of veterans are women. We have veterans living in every single state of the union as well, and the states with the highest number of veterans are California, Texas, and Florida.

Honor and Sacrifice

Why is it important to honor and thank our veterans each year? These men and women, and their families as well, make great sacrifices to defend and support our country. This is true during times of peace and during times of conflict. Those of us at Audubon Orthotic and Prosthetic Services would like to join the rest of our country in saying thank you to all of our veterans.

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What are the signs of scoliosis, and how is it treated?

Scoliosis is a curvature of the spine. The sideways curve is most often noticed when a child is growing significantly, such as right before puberty. Since about 3% of adolescents suffer from scoliosis, it is important to have all children evaluated to ensure their spines are developing properly. No one knows exactly what causes this condition, but it does seem to be hereditary.

Signs of Scoliosis

There are varying degrees of scoliosis from mild, to moderate, to severe. Some symptoms of this condition include:

Uneven waist
Uneven hips
One shoulder more prominent than the other
Uneven shoulders

If scoliosis goes unnoticed, the spine can begin to twist causing the ribs to stick out on one side.

Scoliosis Treatment

The treatment options for scoliosis depend on the severity of the curvature of the spine. Most cases of scoliosis are mild. In this case, the treatment is X-rays and monitoring, If the signs of scoliosis begin to worsen, a brace can assist to correct the curve while the spine continues to grow. In severe cases, scoliosis can lead to deformities that are disabling. If your child has severe scoliosis, surgery may be advised. Girls have a much higher risk of having scoliosis that requires treatment or surgery.

Finding a Specialist when you see signs of scoliosis

If treatment is necessary, your physician will guide you in the process of getting a brace to correct the problem or in severe cases, scheduling a surgery. The most common type of surgery for scoliosis is spinal fusion where the surgeon fuses two or more vertebrae together to prevent movement. A second option is placement of a spinal rod that can grow with your child. This is only used when the child is still young, the curve is developing quickly, and growth is also occurring rapidly. The first step will be to make an appointment for an evaluation with an orthopedic doctor. The specialists at Colorado Springs Orthopaedic Group can help diagnose and treat your child’s scoliosis. Give us a call to schedule an appointment today.

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What is Shoulder Dislocation?

Shoulder dislocation is when the upper arm bone pops out of the socket that is part of the shoulder blade. The shoulder is the most susceptible to dislocation because it is the body’s most mobile joint. Dislocations vary in severity based on how far the ball slips out of the socket. The bigger the dislocation, the more tendons and ligaments are stretched and damaged.

Symptoms of shoulder dislocation

When asking “What is shoulder dislocation?” the first thing you must know is that a shoulder dislocation is very painful. You may also experience:

swelling or bruising
inability to move the joint
numbness and tingling near the joint or further down the arm
muscle spasms in the shoulder

You can usually tell that the shoulder looks deformed and out of place when it is dislocated. Young men have the greatest risk of shoulder dislocation as this injury often occurs while playing sports. It can also occur during a car accident, fall, or other traumatic blow to the shoulder.

What is shoulder dislocation vs. shoulder instability?

Once a shoulder has been dislocated for the first time it may be more prone to future dislocations. In addition to injury and overuse, this can cause the upper arm bone to slip out of its socket repeatedly, thus resulting in instability. This may occur more and more frequently as the ligaments and tendons surrounding the shoulder joint are less able to hold the ball and socket together.

Treatment for shoulder dislocation

Seek medical help if you suspect you have dislocated your shoulder. A professional can help put the ball back into the socket with a procedure called closed reduction. You should feel almost immediate relief from the acute pain. Your doctor may prescribe a sling and recommend icing sore spots during the recovery period. Full function and recovery tend to follow within the next few weeks. For immediate help visit the Colorado Springs Orthopaedic Group’s Express Care Clinic.

Surgery for shoulder dislocation

Surgery is generally a last resort for orthopedic conditions like shoulder instability. If possible, your doctor should seek other treatments first and use surgery if these options have failed or are unlikely to succeed. If the damage to the joints, tendons, or ligaments is too great, surgery can be a great option to help hold the ball and socket in place. Physical therapy will play a key role in getting you back in action after this type of procedure. The specialists at Colorado Springs Orthopaedic Group can help determine the best treatment plan for your shoulder dislocation.

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Dupuytren’s Contracture of the Hand

What is Dupuytren’s contracture? This condition affects the layer of tissue under the skin in the palm of your hand. Over time, knots form in the tissue and eventually force one or more fingers into a bent position. The condition makes it impossible to fully straighten these fingers and can be a real hindrance to daily functioning.

***Symptoms of* *Dupuytren’s contracture***

Usually, the first sign of Dupuytren’s is a thickening of the skin on the palm. It takes years for the disease to progress, but can eventually manifest as a puckering or dimpling of the skin. Next a lump of tissue will start to develop that is sensitive to the touch. The lump is usually not painful. As the tissue continues to knot up and tighten it will begin to affect the fingers and pull them in toward the palm. The two fingers farthest from the thumb are most often affected.

***Can* Dupuytren’s contracture *be prevented?***

We don’t yet know the specific causes of Dupuytren’s contracture. Those who have a higher risk of developing the disease:

Use tobacco and alcohol heavily
Men over the age of 50
People of Northern European descent
People with diabetes
Have a family history of the disease

There is no indication that hand injuries or occupations involving repetitive hand movements cause this disease.

Treatment for Dupuytren’s contracture

There are a variety of treatment options ranging from minimally invasive injections to surgery to remove the affected tissue. With enzyme injections, the tight cord in your hand is weakened allowing your doctor to manipulate your fingers and break the cord holding them down. For the surgical option, the diseased tissue is removed, allowing your fingers to move freely. Both of these treatments have produced great results for our patients in many different situations with differing levels of disease severity.

When to see a doctor

If the disease is progressing slowly and does not cause pain or inhibit the daily use of your hands, you may not need treatment right away. If it is making daily life difficult, it may be time to seek some sort of treatment. Either way, it is helpful to get a professional opinion. Dr. Watson at Colorado Springs Orthopaedic Group has treated a number of patients with Dupuytren’s contracture. He prefers to start with a conservative approach. Surgery is not necessary for everyone and our goal is to work with patients on a plan that makes them comfortable.

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What is Spinal Fusion Surgery?

Spinal fusion surgery permanently connects two or more vertebrae. This process prevents movement between the individual vertebrae. Metal plates, screws, and rods are used to connect the vertebrae. Alternately, bone or a bone-like material can be used to complete the surgery.

How do I know if I need spinal fusion?

Spinal fusion sounds kind of scary! So, how do you know if this procedure is right for you? There are three main conditions that answer the question, what is spinal fusion, and do I need it?

Spine deformities: surgery corrects a condition such a scoliosis
Weak or unstable spine: corrects instability due to severe arthritis
Herniated disk: regains stability of the spine after removal of a damaged disk

While spinal fusion can be successful for these three condition, it has not been proven in situations of non-specific back pain treatment.

How does spinal fusion help?

When two vertebrae are fused together, this creates one solid bone instead of two. Since the two vertebrae can no longer move independently, the pain associated with their movement or instability is alleviated. This procedure also prevents the stretching of the nerves surrounding the vertebrae which can reduce your pain. Since only a small portion of the spine is fused, spinal fusion surgery does not usually limit your range of motion once you have healed completely.

What are the risks of spinal fusion surgery?

As with any surgery, there are always potential risks involved. It is important for you to weigh these risks against the benefits of the surgery. These may include:

Infection: you will likely receive antibiotics before, during, and sometimes after surgery to prevent infection
Persistent pain: some people will experience ongoing pain at the graft site
Continuing symptoms: in some cases, your original symptoms may return
Nerve damage: this complication is very rare
Pseudarthrosis: only occurs when there is not enough bone formation

It is important to discuss any complications you may experience with your doctor.

Who do I trust to perform this surgery?

Now that you have answered the question, what is spinal fusion, you may be asking who to see for this procedure. The qualified experts at Colorado Springs Orthopaedic Group can help. Give us a call for a consultation today. Read more about spinal fusion surgery here: Minimally Invasive Posterior Spinal Fusion.

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What is Arthroscopy & Is It Right for You?

Arthroscopy is a type of surgery that allows the physician to see inside a joint using a scope or small viewing instrument. The surgeon is able to get a useful look at the joint without making a large incision or affecting other areas of the joint

What is arthroscopy compared to traditional surgery?

Arthroscopic surgery isn’t the best solution to every joint issue, but it can help to relieve pain and repair damage in a variety of situations. Patients often appreciate this type of procedure because it helps minimize the risk of infection and lowers their recovery time after surgery. Arthroscopic surgeries are also quicker than traditional surgeries and can be performed as outpatient procedures. In some cases, you may be in surgery for just 10 minutes and able to return home soon thereafter.

When is arthroscopy necessary?

Almost any joint can be inspected using a small scope, but the joints most commonly treated with an arthroscopy are:

Knee
Shoulder
Elbow
Ankle
Hip
Wrist

Bones, cartilage, tendons, and ligaments are the main components of our joints. When these are compromised due to injury or disease, an arthroscopic surgery can often help. It allows the surgeon to smooth out the damaged parts of the joint or repair pieces that may be torn, pinched, or strained.

When is arthroscopy not appropriate?

Some physicians believe arthroscopic surgeries are not useful for those suffering from degenerative knee disease which is sometimes arthritis. In these cases, arthroscopic surgeries do not always produce a long-term benefit. It is essential to speak with a specialist and understand all your options before you agree to any type of surgery. There are often other steps you can take before resorting to surgery of any kind, even something that is less invasive, like arthroscopy.

Alternatives to arthroscopy

The most important thing is to speak with a specialist and understand all your options before you agree to any type of surgery. One of our main goals as physicians at Colorado Springs Orthopaedic Group is to educate patients so they can make the best decisions possible. We work with you one-on-one to determine the most effective plan for your condition. Every situation is different, so it is vital that your doctor not take a “cookie-cutter” approach to your treatment and recovery.

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Treatment for Hip Impingement Pain

Hip impingement pain occurs when there is abnormal wearing between the ball and socket of the hip joint. Basically, the ball and socket don’t fit together properly. This restricted motion causes friction that damages parts of the joint. It can lead to hip impingement pain and even arthritis in younger or older individuals. This condition commonly affects teens and young adults.

Symptoms of hip impingement pain

Most people who have a hip impingement suffer pain or stiffness in the groin area that is increased with exercises that stress the hips in any way. This may include:

running
jumping
flexing the hip
moving after prolonged periods of sitting

If left untreated, hip impingement can cause serious issues, even damaging or tearing of the labrum, the cartilage that helps hold your thigh bone in place in the hip socket.

Causes of hip impingement

Hip impingement is generally the result of abnormally shaped parts of the hip joint. In this case, there is no way to prevent the condition. Hip impingement may also be caused by repetitive movements beyond the normal range of motion for the hip joint. This is more common among certain athletes. The condition can also be caused by an injury to the hip.

When to see a provider

Professional diagnosis for hip impingement pain is essential for a proper treatment plan. If you have been experiencing consistent pain in the hip and groin area, the specialists at Colorado Springs Orthopaedic Group can help. First, you will receive a physical exam to assess the health of your hip joint. Further testing such as X-ray, MRI, or CT scan may also be necessary to diagnosis hip impingement.

Treatment for hip impingement pain

Physical therapy and certain stretches can help reduce pain and the potential for more damage, but surgery is the best option to correct the issue. Hip impingement surgery will reshape the hip socket and help prevent further damage to the surrounding tissues. A minimally invasive arthroscopic surgery will be most effective in most cases. However, in cases of more severe deformity, an open surgery may be recommended.

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Exploring the Benefits of Reverse Shoulder Replacement

When you have tried the non-surgical treatments for shoulder pain such as activity changes and medication, it may be time to speak to a specialist about a shoulder replacement. Each year over 53,000 people have shoulder replacement surgery. This procedure relieves pain effectively. In shoulder replacement surgery, the surgeon removes the damaged parts of the shoulder and prosthetic parts are put in to restore the joint.

Shoulder Replacement Options

There are several types of partial and total shoulder replacement. In the traditional total shoulder replacement a plastic socket and metal ball are used to create a new joint for the damaged one you already have. Instead of a total shoulder replacement, your surgeon may replace only the ball portion of the joint, leaving your own socket. He or she can also replace only the damaged socket and leave your own bone for the ball portion. The latter two options generally provide less pain relief than a total shoulder replacement surgery.

Benefits of Reverse Shoulder Replacement

In reverse shoulder replacement, the ball and socket are switched. The surgeon attaches a plastic socket to the top of the arm bone, and adds a metal ball to the shoulder bone. With a reverse shoulder replacement, you will use the deltoid muscle to raise your arm rather than the rotator cuff. You may benefit from a reverse shoulder replacement if your:

Previous total shoulder replacement failed
Rotator cuff is completely torn
Arthritis is severe with rotator cuff tearing
Arm weakness is severe

With traditional shoulder replacement, you would not be able to lift your arm fully when any of the above conditions exist. As long as the shoulder is cared for properly, the new joint should last 10-15 years.

Finding a Skilled Provider

If you experience severe shoulder pain and any of the conditions listed above, it may be time to seek the help of a professional. Only an orthopedic surgeon has the training and experience to provide you with the best outcome for this type of surgery. Call Colorado Springs Orthopaedic Group today to set up a consultation to explore the benefits of reverse shoulder replacement.

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Sports Physicals for District and Recreational Sports

CALL (719) 622-4550

Looking to get sports physicals done for your student athletes?

Back to school means the end of summer and the start of school sports. Most schools will require a specific sports physical form to be completed before your child can participate. However, depending on facility or physician availability, finding an appointment in time for the season can be troublesome. Don’t worry though, CSOG Express Care is here to help.

Where to get a sports physical

There are a few places you can get sports physicals done for your child. Each facility will vary in cost and in the time at which they can get you in for an appointment.

Primary Care Pediatrician
Pharmacy Clinic
Colorado Springs Orthopaedic Group Express Care Clinic – $25 cash pay – No Appointment Necessary

*Colorado Springs Orthopedic Group Express Care for sports physicals***

The Express Care Clinic is open Monday-Friday 9am-5pm and Saturday 8am-12pm.

Our providers will get you in and out in a timely manner and provide all of the documentation you need to get your child on the field or court. This is generally a quick exam and no appointment is necessary.

If your sports program requires a specific physical form to be completed, please be sure to bring the appropriate forms with you.

Call 719-622-4550 if you have any further questions, or visit us at 4110 Briargate Parkway, Suite 145; Conveniently located on the first floor of our Briargate office.

What is the Value & Purpose of Physical Therapy?

Physical therapists use precise exercises and specialized equipment to help rehabilitate your physical abilities. They routinely start treatment with an intake appointment. At this time your physical therapist will assess your condition and create a plan for rehabilitation. You may need physical therapy after an injury, because of aging, or due to some birth defects. Doctors also usually recommend physical therapy after orthopedic surgery.

Purpose of physical therapy after surgery

During the healing period following surgery, it is essential that you follow your physical therapy plan. This will include a combination of office visits and exercises to perform at home. When you faithfully complete your physical therapy recommendations, you give your bones, muscles, and soft tissues the best opportunity to heal properly. Disregarding the recommendations of your physical therapist can:

Limit your range of motion
Lessen your flexibility
Inhibit proper joint function
Affect your surgical outcome

The purpose of physical therapy after surgery is to give you the best possible outcome in your activities of daily living.

Is seeing a physical therapist necessary?

With the availability of information on the internet, is it really necessary to see a physical therapist? You may be tempted to figure it out on your own. Physical therapists have extensive training in the musculoskeletal system and human movement. They are able to customize a treatment plan for your precise needs and watch to ensure you are completing the exercises correctly. Failure to do so can cause your healing to progress more slowly. In a worst-case scenario, you may injure yourself by trying to work out a physical therapy plan on your own.

How often will I need to go to physical therapy?

Since the purpose of physical therapy is to rehabilitate after surgery, the frequency of your visits will vary depending on what type of surgery you have had. At first, you should expect to have office visits 1-3 times per week. These visits will be coupled with exercises for you to complete at home. Depending on what part of your body is being rehabilitated, physical therapy treatment can last 6-8 weeks. It comes to an end whenever you have reached your treatment goals. Our physical therapists at Colorado Springs Orthopaedic Group will help you in creating the best plan for healing and rehabilitation after your surgery.

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Understanding Pulled Groin Muscle Symptoms

A strained groin muscle is commonly referred to as a pulled groin muscle. It is important to understand pulled groin muscle symptoms. A strain occurs when a muscle or tendon in the body is stretched beyond its normal limit. It is sometimes simply called a pulled muscle. A groin strain occurs when any of the muscles on the inside of the thigh are stretched beyond capacity. Athletes who suffer groin pain usually have had an injury to one of these muscles. Those who play soccer, hockey, and football are especially susceptible to these and other kinds of strains. Injuries from falling, twisting, or other sudden traumas can lead to acute pain in the groin muscles. Overuse can also bring about problems for the athlete and non-athlete alike.

What does a Pulled Groin feel like?

As a physically active person, you may suffer from groin pain at some point in your life. Pulled groin symptoms may include:

Tenderness and pain on the inside of the thigh and groin area
Pain when bringing your legs together
Pain when raising your knee
A snapping or popping feeling at the time of injury that results in severe pain

If you experience any of these pulled groin symptoms, you need to know if you have a groin strain or if you have actually torn a muscle in your groin. A strained groin muscle can be prevented in several ways. Some of these include wearing proper footwear, warming up before working out, increasing exercise intensity slowly, and doing exercises to strengthen your thigh muscles.

Treating a minor strain

Many minor strains and orthopedic injuries can be treated through RICE: rest, ice, compression, and elevation. These types of injuries can heal within a couple of weeks while more intense strains may take up to a month and a half to heal completely. Occasionally, a groin injury can result in more than just a strained muscle. If a muscle is torn, the severity of the tear will dictate whether you need surgery to repair the damage. Sometimes RICE is enough to help during months of recovery, but not always. It can be challenging to diagnose a tear on your own, but these injuries are usually associated with greater pain, more swelling and bruising, and more stiffness in the area.

Treating a groin tear

If you have severe groin pain, or severe muscle pain of any kind, it never hurts to see a specialist. With a sudden and painful injury, you should visit the Express Care Clinic at Colorado Springs Orthopaedic Group. Your doctor can help diagnose the severity of your pulled groin symptoms and how best to treat the injury. He or she understands the differences between sprains and tears and will put you on the fastest road to recovery. If you have a minor injury, try RICE for a while and see if the pain decreases over the next few days. If your condition does not improve, it is time to visit one of the specialists at Colorado Springs Orthopaedic Group.

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Do I Have Runner’s Knee or Need A Total Knee Replacement?

Runner’s knee is another name for palletofemoral pain syndrome (PFPS). This condition causes pain around the front of the knee and around the kneecap, or patella. Despite the name, it can happen to people who are not runners. All types of athletes are prone to runner’s knee as well as those who sit for long periods each day. It is also more common in women and younger people. The stiffness and pain caused by PFPS can make daily activities such and climbing stairs and kneeling down difficult or even unbearable.

What causes runner’s knee, and how can I prevent it?

Runners knee is usually caused by overuse and repeated stress on the knee joint. It can also result from poor footwear and improper use of sporting equipment. In some cases, misalignment of the kneecap is the cause of the pain. The symptoms of runner’s knee are:

Pain when you perform exercises that require repeated bending of the knee such as jogging, climbing stairs, or squats
Pain after you have been sitting for a long period with your knees bent
Pain when you intensify your activity level or change walking surfaces
Cracking or popping sounds when you bend your knee

Prevention of runner’s knee is key for any athlete. Thankfully, there are steps you can take to avoid this painful condition. First, be sure to wear appropriate footwear whenever you are engaging in physical activity. Second, warm up your muscles and stretch before you exercise or play sports. Finally, maintain a healthy weight to avoid putting undue stress on your knees.

How do I treat runner’s knee?

There are several home remedies that are effective in treating runner’s knee. Start with the RICE protocol to relieve your pain

Rest: avoid bearing weight on the injured knee
Ice: apply cold packs several times each day
Compression: wrap the knee for comfort
Elevation: when resting, keep your knee higher than your heart

In addition to the RICE method, you can also use an over the counter anti-inflammatory medication. You should also decrease your activity level until the pain subsides. If these methods are not effective, you should see a specialist. They may recommend physical therapy or orthotics to help fix the problem. In some cases, surgery is necessary to remove damaged cartilage or to move the patella into proper placement. In general, runner’s knee will not require a total knee replacement. If you have experienced a sudden knee injury, visit our Express Clinic for immediate attention. If you are experiencing chronic pain, make an appointment with one of our specialists at Colorado Springs Orthopaedic Group.

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Signs of Torn Rotator Cuff & What to Do Next

A healthy, functioning rotator cuff is essential for the fluid movement of your shoulder joint. The rotator cuff consists of four muscles that stabilize the shoulder. Damage to the muscles or ligaments of the rotator cuff can lead to significant pain as well as loss of range of motion. Rotator cuff damage is most common in people who perform repetitive overhead motions either at work or at play. This type of injury is also more common as people age. In some cases, a torn rotator cuff can happen as the result of a sudden injury. It is important to recognize the signs of a torn rotator cuff and seek treatment before causing additional damage.

Types of rotator cuff injuries

When you have injured your rotator cuff, the damage can be anywhere from mild to severe. There are three grades of strains:

Grade one strains involve stretching but no tears
Grade two strains involve partial tearing of the tendons or muscles
Grade three strains involve a complete tear

If you have strained your shoulder joint, you may experience mild pain and inflammation. This type of injury can generally be treated at home with rest, ice, and anti-inflammatory medication. If you are finding that you are still in pain and have lost the use of your shoulder joint, it is important to know the signs of a torn rotator cuff.

Signs of a torn rotator cuff

Tears to the rotator cuff can either be chronic or severe. A chronic rotator cuff injury generally occurs in athletes or with those whose professions require frequent overhead movements. An acute rotator cuff tear occurs with a very sudden and forceful movement of the arm against resistance or to stop a fall. For both causes the same signs of a torn rotator cuff will be evident including:

Pain worsens at night and inhibits sleep
Weakness and decreased range of motion in the affected shoulder
Pain worsens when lifting the arm high into the air

If you are experiencing these symptoms, it is important to be seen by a professional. Some rotator cuff injuries can be treated with physical therapy, but others may require surgery.

When and where to seek help

If you are experiencing the signs of a torn rotator cuff, you will want the care of experienced specialists. The doctors at Colorado Springs Orthopaedic Group can help. If you have experienced a sudden injury, the physicians at our Express Care Clinic are available to diagnose and treat your shoulder problem. If you are experiencing the worsening of chronic pain, please made an appointment to see one of our shoulder specialists for a consultation and treatment plan.

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Broken Bones are Common Ssummer Injuries in Colorado

Summertime and broken bones may not seem to be two things that go together. Unfortunately, this is not the case. With the increase in outdoor activities, bone fractures are among the most common summertime injuries, especially in children.

Common Summertime Injuries

The warm weather, sports, and vacations of summer bring us joy and wonderful memories. This season also brings with it the risk of different types of injuries. Some of these include:

Drowning
Dehydration
Sunburn
Insect Bites
Fractures

Summertime and Broken Bones

The sports of summer such as diving, volleyball, baseball, soccer, hiking, rafting, and many others all have one thing in common; they increase your risk of bone fractures. Summer is also the time when children are outside playing, thereby increasing their risk of fractures as well. Who is most at risk of broken bones?

Smokers have an elevated risk of bone fracture
Frequent drinkers also carry this risk
Those who regularly take steroid medications
People with chronic disorders
Patients with Type 1 diabetes
Those with a family history of bone fracture

Symptoms of bone fracture

When you are injured, one of the first questions you may ask is, “Is it broken?” The following are symptoms of bone fracture:

Swelling and/or bruising
Pain that worsens when you move or apply pressure to the area
Deformity of the injured area
Loss of function of the injured body part

Where to go for these common summertime injuries

Since fractures are such common summertime injuries, it is important to know what to do when you find that you or someone you love has been injured. You need to be seen quickly. The specialists at the Express Care Clinic at Colorado Springs Orthopaedic Group can quickly and effectively assess your injury. We have on-sight X-ray available, and our Express Care Clinic is a lower cost than either an Urgent Care or Emergency Room visit. The doctors at the Express Care Clinic are all specialists and can give a higher level of care for a bone fracture.

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Grilled Food, Independence & Whiplash – 4th of July Injuries

The 4th of July is a great day to spend time with friends and family as you celebrate Independence Day. Unfortunately, it is also a day of increased emergency room visits. Some are due to burns from fireworks, however, the other causes of 4th of July injuries may surprise you.

Five most common 4th of July injuries

Face and Eye Injuries: When you are looking up at fireworks, your risk of injury is greater. Be cautious around fireworks, and seek medical attention if your face or eyes are hurt.
Hand and Finger Injuries: Again, when handling fireworks, use caution. Even sparklers can burn your hands and fingers.
Food poisoning: Proper food handling practices will help alleviate this problem. Always wash your hands when preparing food, and keep foods at safe temperatures.
Swimming accidents: Always be sure children are attended to and wearing life vests. If the adults are drinking, they should not be swimming. This is just as dangerous as drunk driving.
Car Accidents: The number one cause of 4th of July injuries is auto accidents. This is partly due to the increased number of people out on the roadways and also to those drinking and driving.

Whiplash and other auto accident-related injuries

Since car accidents are the biggest cause of 4th of July injuries, it is important to know what to do if you find yourself in an accident. Whiplash is caused by the sudden movement of the neck in a back and forth motion. It is common in rear-ending accidents. Sometimes the effects of a whiplash injury are not immediately apparent. For this reason, it is important to see a doctor after any car accident.

Bone fractures and joint damage are also common injuries that can occur in a car accident. If you are experiencing any pain after an auto accident, seek medical attention. The doctors at the Express Care Clinic at Colorado Springs Orthopaedic Group can assess your injuries and set up an effective treatment plan.

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Robot Assisted Total Knee Surgery Comes to Colorado Springs

If you are a candidate for total knee surgery, you may wonder about the accuracy of robot assisted surgery.

Tyler R. Bron, MD, Michael Feign, DO, David ‘Alex’ Forrester, MD, and Eric K. Jepson, MD, of Colorado Springs Orthopaedic Group are excited to pilot an innovative technology that will assist in total knee replacement surgery. They are among the first physicians in the Springs to use the Mako Robot. We’re thrilled to bring medical technologies to Southern Colorado that are traditionally only available in major cities. This robotic arm is specially designed to give the accuracy of robot assisted surgery and customization to total joint replacements. Patients can rest assured that the Mako Robot is safe and regulated by many safety features.

Patients frequently ask if the robot itself performs the surgery

No is the simple answer:

The surgeon sets up and controls the robotic arm during the entire procedure.
The process starts with a CT scan of the joint that helps create a 3D model of your knee.
Stryker’s Mako Software then creates a unique plan for your specific surgery.
In the operating room, the surgeon guides the robotic arm within the predefined area and marks off boundaries for the surgery.

Accuracy of robot assisted surgery

Because of the combination of a 3D model of your knee as well as the doctor’s physical assessment of its range of motion, this prosthetic is customized to each individual person’s anatomy. The physician is also able to direct the arm and make minor adjustments as the procedure continues. All of this combined with strict safety protocols makes the accuracy of robot assisted surgery a secure new way to help patients get the most out of their joint replacements.

To learn more about the Mako RoboticArm visit their website at https://patients.stryker.com/kneereplacement/options/makoroboticarmassistedtotalknee

You can also call (719) 632-7669 to schedule or to learn more about robot assisted surgery and other options available within the CSOG Joint Replacement Center

About Colorado Springs Orthopaedic Group:

Colorado Springs Orthopaedic Group is the largest independent orthopedic practice in Southern Colorado and has been providing care to the Colorado Springs community and Pikes Peak region since 1994. Our physicians are board-certified or board eligible and fellowship trained in many subspecialties including not only the accuracy of robot assisted surgery, but also sports medicine, foot, ankle, spine, hand, upper extremity, trauma, and joint replacement. With this breadth of knowledge and expertise, we have you covered from head to toe. We provide orthopedic surgical and medical services when and where you need us. Our onsite capabilities include digital X-rays and MRIs, an Express Care walk-in clinic, osteoporosis screening, physical and occupational therapy, and a state-of-the-art outpatient surgery center. Schedule an appointment today! Call (719) 6327669. We have two convenient locations to serve you in Colorado Springs.

Diagnosis & Treatment of Knee & Hip Arthritis

The term “arthritis” refers to joint pain or disease. There are over 100 different types of arthritis, and it can affect more than one joint in a person. Osteoarthritis is the most common form, and it is caused by the breakdown of cartilage. When this happens, bones in the joint rub against each other causing pain, swelling, and loss of movement. Knee arthritis and hip arthritis are both types of osteoarthritis.

Symptoms of Knee Arthritis or Hip Arthritis

How does arthritis affect the knee or hip? As the cartilage in the joint breaks down, the bones rub together causing damage to the joint. The process takes years to develop and progresses in four stages:

Stage One (Minor): Small lumps grow on the bone, and the damage to the cartilage is minor.
Stage Two (Mild): The cartilage begins to wear down slightly, and you may begin to experience pain or stiffness.
Stage Three (Moderate): Cartilage loss has occurred, and there may be signs of inflammation. You will likely experience pain when performing daily activities such as walking, running, or bending.
Stage Four (Severe): The cartilage loss is severe causing bone on bone movement in the joint. You will probably experience much more intense pain.

Prevention of Knee Arthritis or Hip Arthritis

Arthritis is not necessarily a condition that you can prevent, but you can understand the risk factors. These may include:

Family history of arthritis
Developmental diseases affecting the joints
Variations in anatomy
Dislocations of the joints or fractures of the bones
Obesity

Treatment of Knee Arthritis or Hip Arthritis

For mild and moderate arthritis you can use these treatments to find relief:

Use heat and cold on the affected area
Be sure to rest when needed
Stay active and maintain a healthy weight
Do exercises to strengthen the muscles that support the joint
Take an anti-inflammatory medication

When the joint deterioration has progressed to the moderate or severe stage, joint replacement may be an option. Joint injections can also be an effective way to deal with the pain associated with knee arthritis or hip arthritis. When you have tried home treatment and your pain is no longer manageable, it is time to see a specialist. The doctors at Colorado Springs Orthopaedic group can help with the best possible treatment plan.

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How Do Orthotics Work and Can they Improve Your Life?

Some studies estimate that upwards of 77% of Americans will suffer from foot pain at some point in their lives. Of those who live with chronic foot pain, approximately 83% say this pain affects their activities of daily living. A common question amongst this population is: ‘How do orthotics work and could they help my pain?’

Though not always to solution, for many Orthotics can help alleviate this chronic foot and ankle pain.

So How Do Orthotics Work?

Orthotics are shoe inserts that can help correct an irregular or abnormal walking pattern. They are recommended when muscles, ligaments, joints, tendons, or bones are not functioning correctly and causing pain. Orthotics work by slightly changing the angle at which the foot contacts the walking surface. In many circumstances, they can be an effective approach to alleviating foot pain.

How are custom orthotics made?

True orthotics are much more than arch supports. There are three different types of orthotics; rigid, soft, and semi-rigid.

Rigid orthotics are manufactured from a firm material such as carbon fiber or plastic. These orthotics are made from a mold of your own foot. They generally do not wear out or break.
Soft orthotics are made from compressible materials and are molded to your foot as you wear them. These orthotics help take pressure off sore areas of your foot, absorb shock as you walk or run, and increase balance.
Semi-rigid orthotics consist of layers of flexible materials reinforced with more rigid materials. These orthotics provide balance as well as allow the foot to perform more effectively.

Benefits of Using Orthotics

If you are wondering, “Do orthotics work?” the answer is, “Yes!” There are many benefits to wearing orthotics including:

Alleviating foot, low back, ankle, and leg pain
Improving balance
Provide adequate arch support
Correcting alignments of the foot and leg
Distributing pressure and absorbing shock
Allowing you to participate in activities of daily living

Orthotics let your feet function properly, and this affects many other areas of your body.

Types of Orthotics:

There are many types of orthotic insoles available in today’s market; each designed with a specific use in mind.

Custom-Made Orthotic Insoles – designed and manufactured specifically for an individual and their personal biomechanical needs. After proper evaluation, our specialists can help build these for you here in Colorado Springs, in our in-house Audubon Orthotic and Prosthetic Services shop.
Pre-Fabricated Orthotic Insoles – these insoles come ready-made and are available in standard sizes. They offer various levels of arch support and cushioning however, are not tailored to an individuals specific foot shape or condition.
Arch Support Insoles – designed to provide additional support to the arches of the feet, these orthotic insoles help distribute weight more evenly and can reduce excessive pronation (inward rolling of the foot) or supination (outward rolling of the foot) and alleviate stress on the arches.
Cushioning Insoles – primarily designed to focus on providing extra cushioning and shock absorption to the feet. These can be beneficial for those who engage in high impact activities and are a great starting orthotic for plantar fasciitis.
Heel Cups or Inserts – these insoles specifically target heel pain conditions such as plantar fasciitis, or heel spurs. They feature a contoured shape and gel padding that provides cushioning and support to the heel area.
Diabetic Insoles – designed to accommodate the specific needs of individuals with diabetes, they provide extra cushioning, pressure distribution and may protect against potential injuries.
Sport-Specific Insoles – these insoles are tailed to athletes involved in specific sporting activities. They are designed specifically for the individual to provide enhanced shock absorption, stability, and improved biomechanical alignment within their athletic shoes to optimize performance and help prevent any potential sports-related injuries. Our Audubon Orthotic and Prosthetic Services team can help if you’re in need of Sport-Specific Orthotic Insoles.
Heat Moldable Insoles – these are made from materials that can be heated and molded to an individual’s foot for a more customized fit and may provide a balance of arch support, cushioning and added comfort.
Gel or Foam Insoles – typically made from a gel or foam that aids in extra cushioning and shock absorption. They are typically used to help provide general comfort, and relieve from mild pressure points or foot pain.

It is important to note, many of these insoles may be a great starting point to relieve any foot and ankle pain, but if pain persists or becomes worse, a consultation with a foot and ankle specialist may be warranted where they can help design an orthotic insole specific to your individual needs.

Where can I get orthotics?

Many orthotics can be purchased over-the-counter at many sporting good stores or through a company specializing in orthotics for various activities. If you are experiencing a mild foot problem and are of average height and weight, these may be a great option for you. Custom orthotics designed specifically for your individual biomechanical needs, can be designed and purchased through a specialist. It may be beneficial to consult your insurance to see if your orthotic insoles are covered under your plan benefits as well.

If your pain or alignment problem does not improve, you may need to see a foot and ankle specialist for further assessment. Brad Dresher, MD or G. Alex Simpson, DO are two of Colorado Springs’ Top Orthopedic Doctors, specializing all conditions and injuries of the foot and ankle and can certainly help you localize where your pain may be coming from.

At Colorado Springs Orthopaedic Group, our team or specialists and orthotic professionals go above and beyond for every patient to help find the right orthotic for your individual needs.

To learn more about our Foot and Ankle Doctors, visit the CSOG Foot and Ankle Center. To learn more about our highly-trained and experienced orthotists, visit Audubon Orthotic and Prosthetic Services today.

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What Are Symptoms Of Nerve Damage?

With any injury or other source of pain, there is always the possibility of nerve damage. Before being able to answer this important question, you must first understand how nerves function in your body.

What role do nerves serve in the body?

Nerves communicate messages between the brain and other parts of the body through electrical signals. They are responsible for telling muscles to move and letting the brain know when something is causing pain or a change in pressure or temperature. Nerves are fragile and can be easily damaged in a variety of ways.

What causes nerve pain?

Nerve pain can be caused by a variety of factors including injuries and other health conditions. Pressure, like in carpal tunnel syndrome, can cause nerve pain in the hand and wrist. Traumatic injuries can cause nerve pain in various areas of the body. Diseases like diabetes or autoimmune diseases can also affect the nerves’ ability to function normally.

What are the symptoms of nerve damage?

Most people experience some level of pain with nerve damage. For some, it’s a stabbing pain that wakes them up in the middle of the night. For others, it manifests as a burning or tingling sensation that can last all day. Nerve damage can also interrupt critical signals between the brain and muscles, preventing the muscles from working properly or causing numbness. Some common symptoms of nerve damage are:

Pain or sensitivity
Muscle weakness or twitching
Paralysis
Tingling or burning sensation
Numbness

Whatever the symptoms, nerve pain can be debilitating and effect every aspect of daily life.

Is nerve damage permanent?

Although it may take months, non-operative recovery is possible for many nerve injuries. For nerve damage that does require surgery, nerve grafting, transfers, or muscle transfers may help to re-animate a limb. The important thing is to schedule a consultation with a trained doctor to help diagnose the symptoms of nerve damage and come up with a treatment plan. The specialists at Colorado Springs Orthopaedic Group are always happy to see patients and help them recover from injuries or nerve damage.

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How to Heal a Sprained Ankle

A sprained ankle can happen to anyone. According to some estimates, at least 25,000 Americans suffer from a sprained ankle each day. It is usually caused by rolling, twisting, and turning your ankle past its normal range of motion. Most sprained ankles involve the outer ligaments. In extreme cases, these ligaments may tear. When you experience an injury, you may wonder how to heal a sprained ankle.

Home Treatment

When you suspect a sprained ankle, the first step towards healing is the RICE protocol:

Rest
Ice
Compression
Elevation

Take these four simple steps to help alleviate pain and speed the healing process. You can also use an anti-inflammatory medication such as Ibuprofen.

Healing Time

The amount of time it will take to heal your sprained ankle depends upon the degree of the sprain. There are three degrees of ankle sprains:

First degree (the ligaments have stretched but not torn) 1-2 weeks healing time
Second degree (partial tear of the ligament) 3-6 weeks
Third degree (torn ligaments) 8-12 months

The severity of your pain and swelling as well as your ability (or inability) to walk can help you determine which type of sprain you may have.

Seeking Professional Help

If your injury does not respond to home treatment and you experience any of the following:

Severe pain that cannot be controlled with an anti-inflammatory
Severe swelling
Inability to bear weight on the injured foot

It is time to seek professional help. Depending on the severity of the sprain you may be on crutches for a few days or put into a boot or a splint to restrain the movement of your ankle. After the resting period is over, you may be referred to a physical therapist for specific exercises to rehabilitate your ankle.

If you are experiencing severe pain or if the swelling and pain have persisted for more than one week, you should see a specialist. An X-ray will show if there is a stress fracture, and an MRI will show if you have any torn ligaments. If you have a complete tear, this will require surgery. If the ankle is still unstable, it may also require surgery to tighten everything back up. The Express Care Clinic and the specialists at Colorado Springs Orthopaedic Group can assess your injury and show you how to heal a sprained ankle.

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What is an MRI Procedure & Do I Need One?

Magnetic Resonance Imaging (MRI) is a technique that uses a magnetic field and radio waves to get detailed images of the inside of your body. An MRI can even produce 3D images of the inside of the body that can be viewed from different angles.

MRI Procedure

The MRI machine is usually shaped like a large, round tube. For the MRI procedure, you will lay down on a long padded bed that will slowly move the desired body part inside the tube. During the MRI procedure, the patient:

Must stay very still for the duration of the procedure which normally lasts 20-30 minutes
Will not feel anything, but may hear a noise as the images are captured.
Wears ear protection

Why use MRI?

Before the MRI magnet or x-ray machines, there were limited ways for physicians to see what is going on inside the body without performing surgery. Now, doctors can get a good look at problem areas in the body through non-invasive methods. They can examine your organs, tissues, and skeletal system in detail without having to put you through an operation.

X-rays are helpful for looking at your bones, but an MRI procedure can give more information about your orthopedic condition. It allows us to see what’s going on with your:

cartilage
muscles
tendons
ligaments
tissues surrounding your bones and joints

This helps the doctor determine the most effective treatment options.

Do I need an MRI?

If you experience an orthopedic injury or suffer from chronic pain in your joints or back, it may be time to see a doctor. He or she can help determine the cause of your pain and whether you will need imaging in the form of an x-ray or MRI procedure. Most physicians will start with a physical exam and follow up with imaging as needed. The whole process helps paint a full picture of your orthopedic condition and give insights into the best treatment plan.

Are there any risks?

Since an MRI uses powerful magnets, the presence of metal in your body may be a safety hazard. Make sure to tell your doctor and technologist about metal in your body including:

pacemaker
cochlear implants
artificial heart valves
any other metal implants

Even tattoos can affect your MRI, so it is important to be aware of such things.

Newer magnets, like the one at the Colorado Springs Orthopaedic Group’s MRI Center, are designed with a shorter tube and larger bore to help minimize patient discomfort during a test. The bore is the opening of the MRI tube. Some people may still experience claustrophobia and sedation may be helpful to these patients.

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Shoulder Strain Symptoms & Treatment

A shoulder strain is the stretching or tearing of a muscle or tendon in the shoulder. This can happen when the shoulder stays in one position for a long period of time. For example, when someone is typing with poor posture or carrying a heavy backpack over one shoulder, a strain can occur. Playing sports, like tennis or swimming, which require repeated overhead movements of the arms also increases a person’s susceptibility to shoulder strain.

Shoulder Strain Symptoms

It is important to know the symptoms of shoulder strain so that you can seek treatment if necessary. These include:

mild to severe pain
swelling
difficulty performing tasks of daily living
bruising

Shoulder Strain Treatment

Depending on the severity of your shoulder strain symptoms, you may be able to treat the injury at home. If you suspect that you have a shoulder strain, it is very important to rest. You’ll also want to ice the painful area for 10-20 minutes at least three times a day. If the swelling has not changed in 48 to 72 hours, it’s time to go to Express Care for further diagnosis.

If your shoulder strain is more severe, you may need to see a physical therapist. Working with a physical therapist will help alleviate your shoulder strain symptoms and get you on the road to healing.

Shoulder Specialist

Sometimes, what may seem like a simple shoulder strain is actually a more severe injury like a tear. If you experience any of the following, go to Express Care immediately:

joint that appears deformed
inability to use the joint or move your arm away from your body
intense pain
sudden or severe swelling

In the case of a more intense injury, the specialists at Colorado Springs Orthopaedic Group can diagnose and treat your shoulder strain symptoms.

CALL (719) 632-7669

ACL Tear & Reconstruction

The Anterior Cruciate Ligament (ACL) is one of the most frequently injured ligaments in the knee. This is why it is critical to understand an ACL Tear It connects the femur (thigh bone) to the lower leg and gives stability to the knee. It helps to keep the leg bones aligned and discourages bone displacement.

Signs of an ACL tear

An ACL tear usually occurs when the knee is hyper-extended or when the knee is twisted harshly. Athletes are most susceptible to such injuries when they jump and land awkwardly, slow down quickly, change directions suddenly, or pivot. Football, basketball, skiing, and soccer are the sports that tend to produce the most ACL injuries. Some signs of a torn ACL are as follows:

Popping sensation or loud pop sound in the knee
Swelling
Inability to continue the activity
Severe pain
The feeling of instability in the knee

Don’t ignore the signs of an ACL tear. If you think you’ve injured your knee and feel a lot of pain, it’s probably a good idea to get checked out. A physician may use a combination of a physical exam and imaging to figure out what’s happened to your knee. An x-ray, MRI, or CT scan are standard procedure for many such injuries. Once the doctor has diagnosed your injury you and he or she can work out a treatment plan.

ACL Reconstruction

As with any orthopedic condition, we prefer to start with conservative treatment options. The problem with a torn ACL is that it will not get better on its own. Surgery is often the only option to restore function to the knee. This type of repair is usually conducted as an arthroscopy surgery. The surgeon makes small incisions to insert a lens that allows him or her to see inside the joint. Using a graft, the surgeon can then replace the damaged ligament and work to repair any other parts of the knee that may have been damaged. Sometimes this procedure can be done as an outpatient surgery so you can head home more quickly afterward.

Injury Prevention

Staying active and strengthening the muscles surrounding the knee joint can help prevent ACL injuries. For example:

Hamstring and Quadriceps strengthening exercises
Core strengthening exercises
Using proper technique when exercising

Make sure to warm up and stretch your muscles before starting a sports game, practice, or exercise routine. Balancing practice and correct form while pivoting or turning can also help you avoid an ACL tear. If you do find yourself experiencing any of the signs of a torn ACL, our specialists at Colorado Springs Orthopaedic group can help you with your treatment plan.

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What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a condition in which the Median Nerve is compressed as it travels into the hand. Compression leads to nerve dysfunction which manifests as symptoms that may include numbness, pain, tingling, weakness, and dropping things. Symptoms are often first noted at night and you may wake up and feel the need to shake your hand or hang it off the bed to try to get it to “wake up”.

Who is most likely to have it?

Typically, women are more likely to experience CTS than men. The peak age range for developing carpal tunnel is between 45-60, however it can affect people at any time throughout adulthood.

What are the causes?

Carpal tunnel syndrome can be caused by many things, but it frequently occurs in patients who overuse their wrists or experience a traumatic event where extreme pressure was placed on the wrist(s). Carpal tunnel syndrome can also be caused by:

repetitive motion
use of vibrating hand-held tools
pregnancy
arthritis
trauma to the wrist
swelling or inflammation around the tendons
work stress
diabetes
hypothyroidism
tumor or cyst in the carpal tunnel

There are many different professions and sports that expose people to the risk factors of carpal tunnel syndrome. However, most of the causes are from preexisting medical conditions.

What can prevent carpal tunnel syndrome?

It’s a common misconception that office workers who spend large amounts of time working at a computer are the most likely to have carpal tunnel syndrome. In reality, there is little statistical evidence to support this idea. The best way to help prevent the syndrome is to have frequent physical examinations. These may help to identify medical conditions that are sometimes associated with CTS, such as hypothyroidism or diabetes. Early diagnosis and treatment can also help to prevent worsening of the disease.

Is there a non-surgical treatment?

Oftentimes, early carpal tunnel syndrome can be managed without surgery. Patients who experience mild symptoms or those who have carpal tunnel syndrome due to pregnancy can often improve within a few months. This is especially true if the patient is under the age of 30. Some nonsurgical treatments are:

night splinting
steroid injections
rest and ice
anti-inflammatory medication
occupational therapy
hand exercises

When is surgery necessary?

Surgery is generally a last resort for treating CTS, but in some cases, it is required to prevent permanent nerve damage. If not addressed early enough, there can be permanent weakness and loss of sensation. The surgery is a minimally invasive procedure, and you are immediately allowed to use your hand for light activity after surgery as tolerated. Some patients who spend most of their time at a desk can go back to work the same day if they feel up to it. Your recovery may take longer if you do a lot of heavy lifting or manual labor. Contact Colorado Springs Orthopaedic Group for a consultation regarding a treatment plan that is right for you.

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Stress Fracture Treatment Options

Not all bone fractures occur as an obvious or sudden injury. If you are experiencing pain in your feet, legs or ankles, it is essential to consider the possibility of a stress fracture.

What is a stress fracture?

A stress fracture, sometimes called a hairline fracture, is a thin fracture caused by recurrent force to an area. A stress fracture can also occur if you have bones weakened by osteoporosis. This type of injury is most common in the lower extremities:

Tibia (larger inner leg bone)
Fibula (smaller outer leg bone)
Heel
Ankle
Metatarsals of the foot

Stress fractures are frequently found in runners, athletes, and dancers.

Stress fracture symptoms

The pain of a stress fracture often develops gradually and increases with any weight-bearing activity. Some additional symptoms may include:

Diminished pain when resting
Intensified pain with normal daily activities
Swelling
Tenderness to the touch
Bruising

Some stress fractures can be diagnosed with a physical examination, but most will require an X-ray.

Stress fracture treatment

For a suspected stress fracture, start with First Aid and the RICE protocol:

Rest. Avoid weight-bearing activity as much as possible
Ice. To reduce swelling, apply ice immediately after the injury followed by cold packs several times per day for 20 minutes each time.
Compression. Use a soft bandage to lightly wrap the area.
Elevation. Rest with your foot higher than your heart as often as you can.

A medication such as ibuprofen can also help with the pain and inflammation.

When to see a Doctor?

If you suspect a stress fracture, you should see a doctor before the injury gets any worse. With stress fracture treatment, your doctor may have you wear a walking boot or use crutches while the injury is healing. This can take 6-8 weeks. If you think you may have a stress fracture, visit the Colorado Springs Orthopaedic Group Express Care Clinic or schedule an appointment with one of our qualified specialists to have your injury evaluated.

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What is Spinal Cord Stimulation?

If you are among the 100 million Americans who struggle with chronic pain, you may be looking for alternatives to pain medication. A spinal cord stimulator (SCS) is one promising source of relief.

The SCS is a small device that delivers electrical signals to the spinal cord thereby masking the pain signals to the brain. The device is similar to a pacemaker and is surgically placed under the skin. Once in place, the spinal cord stimulator sends mild electrical signals to the spinal cord. It does not eliminate the source of pain, however, it does disrupt the pain signal thereby reducing the pain experienced. You are able to adjust the SCS with a remote control. It can be turned off or on, and the strength of the stimulation can be increased or decreased.

Is spinal cord stimulation right for me?

If you are suffering from chronic pain, an SCS may be right for you. There are several factors that can indicate the use of an SCS.

Medication is not an option or is ineffective
Surgery is not an option
The side effects of medications and/or surgery are undesirable
Your current method of pain relief is impacting your life in a negative way

What are the intended results of spinal cord stimulation?

Pain reduction of 50-70%
Better able to sleep at night and relax during the day
Reduced need for pain medication
Better able to accomplish activities of daily living

Who can provide this treatment?

Only a specialist can perform SCS surgery. If you have exhausted your options for pain relief through medication, surgery, or other treatments, this procedure may provide the relief you are seeking. Please contact one of the doctors at Colorado Springs Orthopaedic Group for a consultation.

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7 Plantar Fasciitis Prevention Tips

Plantar Fasciitis is one of the most common causes of heel pain. It involves inflammation of the thick band of tissue (plantar fascia) that runs across the bottom of your foot and connects the heel bone to your toes.

Causes of Plantar Fasciitis

Before discussing plantar fasciitis treatment, we must first understand what causes this painful condition. Plantar fasciitis occurs when small tears accrue in the tissue band from any of the following issues:

Wearing shoes that are too hard
Bad habits when running
Flat feet
High arch without proper support in shoes
Being overweight
Standing for long periods

Plantar Fasciitis Prevention

There are many things you can do to prevent plantar fasciitis including:

Wear shoes with good support
Replace tennis shoes often
Avoid walking on hard surfaces barefoot
Keep a healthy weight
Low-impact exercise like swimming or walking
Avoid high-impact exercise such as running
Stretch your legs and feet

Plantar Fasciitis Treatment

If you already have plantar fasciitis, there are non-invasive ways to treat it.

Rest
Ice the bottom of the foot
Stretch
Physical therapy
Orthotics
Night braces

When should you talk to a physician?

If the pain persists after several months you should schedule a visit with a doctor. You may have underlying issues such as a bone spur rubbing on the tissue or a stress fracture. At that time the physician may request an x-ray or an MRI to be done. Surgery should be a last resort for plantar fasciitis treatment unless there is another reason like a bone spur.

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Difference Between Occupational & Physical Therapy

What does an Occupational Therapist do?

Well, we don’t help people find jobs. That’s a common misconception. No, we actually help patients with injuries, illnesses, or disabilities function in day-to-day life. We focus on rehabilitating people to live normal lives after an accident or other situation that causes a person’s body to function differently from the norm. This can include people who have experienced an injury or those who have a developmental or intellectual disability. Many people then ask what is the difference between Occupational and Physical Therapy.

Difference Between Occupational and Physical Therapy

How are OT and PT similar?

While there is a difference between occupational and physical therapy, the fields do have some overlapping areas of treatment including:

Educating on the prevention of injury
Educating on the healing process
Delivering hands-on rehabilitative care

What makes OTs at Colorado Springs Orthopaedic Group unique?

At CSOG, we specialize in occupational therapy for the upper extremities. This means we help people who are struggling with hand, wrist, arm, and elbow issues.

We teach you how to get as much use out of these limbs as possible
We help you increase mobility and dexterity
We help you recover to full health after an injury
We work in conjunction with the CSOG hand, elbow, and nerve doctors to improve results after surgery
We specialize in custom splinting

You can find more information and learn about our therapists on our website, csog.net, or check out otpotential.com for info, resources, and tips.

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Hip Bursitis Treatment

Bursa are fluid-filled sacs that provide cushioning and reduce friction between bone and soft tissue in many different areas of the body including the hips, shoulders, heels, and elbows. There are two main bursa in the hip that generally become irritated or inflamed. When this happens, you will experience pain each time the tendon moves across the bone. Since this motion occurs every time you take a step, hip bursitis can be quite painful. If you believe you have any of the following symptoms, you should seek a diagnosis and and receive hip bursitis treatment.

Hip Bursitis Symptoms

Hip bursitis is a common condition that can occur in athletes and the general population. It is more common in women, the middle-aged, and the elderly. Hip bursitis can be caused by overuse, a hip injury, spine disease, a difference in leg lengths, rheumatoid arthritis, previous surgery, or bone spurs or calcium deposits. Some of the symptoms of hip bursitis are:

Tenderness on the upper/outer thigh
Sharp pain in hip or groin area
Swelling
Aching pain at the hip extending down the outer thigh
Pain typically worse at night
Pain worse when walking or rising from a chair
Difficulty sleeping on the affected hip

Hip Bursitis Treatment

Many people can experience pain relief from hip bursitis through small changes to their day-to-day routines. Some of these changes include:

Rest
As with most injuries, rest is key to recovery. You should avoid the activities that cause you pain or modify the movements of the activity. If you are an athlete, you can consult with a physical therapist or trainer to be sure you are performing exercises appropriately so as to not further aggravate the bursa.

Anti-inflammatory medication
Over-the-counter medications such as Ibuprofen can help control the inflammation and pain associated with hip bursitis.

Ice the affected area
Use a walker, cane, or crutches when the pain is most intense
Stretching
Physical therapy to increase hip strength
Steroid injection

With hip bursitis treatment, usually one or a combination of the above is enough to help most patients.

Preventing Hip Bursitis

Hip bursitis can’t necessarily be prevented. It can, however, be minimized by avoiding repetitive activities that stress the hips. Some potential ways to minimize the likelihood of hip bursitis are:

Losing weight if you’re overweight
Using a shoe insert if there is a difference in length between your legs
Maintaining muscle strength and flexibility in your hips

Seeking Help

If you have a fever in addition to the above symptoms, you should visit the Colorado Springs Orthopaedic Group Express Care Clinic to be treated immediately and rule out an infection. Otherwise, if your symptoms do not improve within two weeks, it’s time to seek professional help. The doctors at Colorado Springs Orthopaedic Group are specialists who can help diagnose your problem and recommend an appropriate treatment plan for your specific situation.

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What to Expect with Total Shoulder Replacement Surgery

Total shoulder replacement is helpful for those experiencing severe pain and stiffness due to degenerative joint disease or arthritis. When the normally smooth cartilage in the shoulder joint disappears, this creates a bone-on-bone situation causing significant pain while also limiting movement. Shoulder replacement surgery is advised when:

Your pain cannot be controlled with injections or anti-inflammatory medications.
You experiencing stiffness and loss of motion.
You experience a grinding sensation when you move your shoulder.

Tests such as a series of X-rays, an MRI, and/or a CT scan will be used to assess the condition of the shoulder. When surgery is advised, the first goal of shoulder replacement is pain relief while the secondary goal is to restore strength, function, and range of motion to the shoulder joint.

Shoulder Replacement Surgery

Total shoulder replacement surgery involves replacing the ball (humeral head) with a new metal ball and replacing the socket (glenoid) with a new plastic socket. Having metal on plastic, rather than metal on metal, allows the new joint to function smoothly and without the pain associated with the damaged joint.

Recovery from Shoulder Surgery

After surgery, your shoulder will be in a sling, but you will have the use of your hand and wrist. After about six weeks of recovery, your whole arm will be able to handle light use. During this recovery time, physical therapy will be necessary to rehabilitate your muscles and tendons. It will take several months to regain complete and pain-free use of your shoulder.

Cost of Shoulder Replacement Surgery

A total shoulder replacement surgery is a costly procedure. The bill can range anywhere from $6,000 to $22,000. The average price is $12,000. Thankfully, most insurance companies will cover a large portion of this cost.

At Colorado Springs Orthopaedic Group, we have several excellent surgeons available to perform this surgery including:

CALL (719) 632-7669

What to do About a Fractured or Jammed Finger

If you have injured your finger, you may be wondering whether it’s a fracture or jammed finger. While both conditions can cause pain, each has unique but similar symptoms. This can make it difficult to distinguish between the two.

Jammed Fingers

With a jammed finger, you may experience:

Pain
Difficulty holding things
Redness and swelling in the injured area

You can get a jammed finger when you smash your finger against something and the force pushes the tip of your finger down towards your hand. In this case, the joint in the middle of your finger absorbs the force of the blow, and the ligament in your finger gets stretched. A jammed finger is a common injury while playing sports, like when you try to catch a ball. Alternately, you might jam it doing something as simple as closing a door or pushing the sheets under the mattress as you make the bed.

Fractured Fingers

Alternately, with a fractured finger you may experience:

Severe pain
Inability to bend or straighten your finger
Swelling in the finger that lasts for hours or days

You can get a fractured finger in the same ways you would get a jammed finger. The only difference is the severity of the injury.

Treating Injured Fingers

When it comes to how to treat your injured finger, it depends on how badly the finger is injured. If the injury is minor, you can try the following:

Apply ice for fifteen minutes each hour to bring down swelling.
Keep your finger elevated above your chest.
Take an over the counter pain reliever such as ibuprofen to ease any discomfort
If the finger looks like it is out of joint, do not pull on it. Instead, try splinting it or taping it to the neighboring finger
Keep the finger splinted until the pain stops. This can take about one to two weeks.

For more serious injuries, see a doctor. You may need surgery if you have a bone fracture or a torn ligament or tendon. An x-ray may be necessary to determine if the finger is jammed or if it is fractured instead. You should go to express care when your finger appears misshapen or deformed when the finger is numb, if you notice any signs of infection developing on or around the injury, or if the pain does not improve with rest, ice, elevation, and medication. The Express Care Clinic at Colorado Springs Orthopaedic Group is available to help in these situations.

CALL (719) 632-7669

Pulled Hamstring Prevention & Treatment

A hamstring injury is a tear or strain to the tendons or large muscles on the back of the thigh. Often referred to as a pulled hamstring, it is a common injury in athletes and can occur in different severities. There are three grades of hamstring tears: grade one is a mild strain or muscle pull, grade two is a partial muscle tear, and grade three is a complete muscle tear. A hamstring injury can occur when any of the muscles or tendons are stretched beyond their limit. They often occur during sudden, explosive movements, such as sprinting, jumping, or lunging. However, they can also occur more gradually if not treated appropriately upon initial injury.

Prevent a Pulled Hamstring

To avoid a hamstring strain there are multiple steps you can take:

Warm-up before physical activity
Stretch after physical activity
Boost the intensity of your physical activity slowly
Strengthen the hamstrings and glutes as a preventative measure

The best way to prevent injuries to the hamstring is through strength training for the surrounding muscles and stretching before any physical activity that could strain the hamstring muscle.

Treatment for Pulled Hamstring

When a hamstring injury occurs take the following actions to help speed healing:

Use an elastic bandage around your leg to keep down swelling
Apply ice for 20-30 minutes every three hours
Elevate your leg on a pillow while sitting or lying down
Take an anti-inflammatory painkiller such as ibuprofen, Advil, or Motrin.

You should consider seeing your doctor if you have any concerns about your hamstring pain. More specifically, consult your doctor if you think it is a severe injury, it is not healing, or your symptoms are getting worse. With a complete detachment, you will be in acute pain, may hear a popping sound, and might have significant bruising. Your doctor can also advise you as to when to return to normal activities and what exercises to do in order to help recovery. Physical therapy is sometimes required for full healing.

Express Care for Sports Injury

While most hamstring strains can be cared for at home, sometimes the tear may be more severe. Some grade three hamstring tears may even require surgery. If your pain is intense and cannot be controlled with rest, ice, compression, and elevation (the RICE) protocol) along with anti-inflammatory medication, it is time to head to the Express Care Clinic at Colorado Springs Orthopaedic Group. Call 719-622-4550.

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Bone Health: Osteopenia, Osteoporosis & Osteonecrosis

Osteopenia, Osteoporosis, and Osteonecrosis are often called silent diseases because they have so few symptoms, but complications can cause disability, pain, and sometimes death. These diseases of the bone occur when people lose too much bone mass, make too little new bone tissue, or both. Up to 54 million Americans suffer from osteoporosis or osteopenia (low bone mass) which increases the risk of osteoporosis. Another disease, osteonecrosis, is caused by low blood flow to the bone.

Risks and Prevention of Osteoporosis and Osteopenia

Losing bone mass is a part of the normal aging process, however certain groups of people are more likely to develop osteoporosis. Women, people over the age of 50, people with low body weight, and those with a family history of osteoporosis all have an increased likelihood of contracting the disease. Since osteoporosis increases the risk of fractures, the focus should be on the prevention of breaking a bone. This can be accomplished by doing things in the home to prevent falls, using assistive devices or non-slip shoes when going out, and maintaining a good exercise routine. Another important part of prevention is including Vitamin D and Calcium in your diet.

Detecting Bone Diseases

Since osteoporosis can often go undetected, it is important for women aged 65 and older to have a bone density scan. People with one or more of the heightened risk factors should get bone scans done sooner than that. All men aged 75 years and up should also be tested for osteoporosis.

Make an Appointment

At Colorado Springs Orthopaedic Group we are fortunate to have Megan M. Perry, PA-C on staff. A move from Chicago brought Megan to Colorado Springs and a job assisting Dr. Watson and Dr. Cassidy with the hand and upper extremity specialty of orthopedics. She is passionate about bone health and actively educates patients on how to stay healthy. Megan is transitioning out of the hand department to pursue her passion in bone health. Call 719-632-7669 to schedule an appointment for a bone density scan with Megan today.

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Best Ways To Recover After A Skiing Injury

Skiing is an exciting, fun sport that the entire family can enjoy together. However, like any activity, injuries can and do occur which is why it’s important to know what to do when you find yourself knee-deep in snow and tending to an injury.

After a skiing injury

When an accident occurs, it is important to first determine whether you need immediate medical attention or simply have a sprain. If your body is disabled in any way, in severe pain, or you experience numbness you should seek immediate medical attention. In the case that the injury is mild, you want to apply an ice pack or snow from around you onto the area in pain immediately for 10-20 minutes as well as elevate the injured area if necessary. You do not want to apply heat during the first 72 hours following the injury; applying heat will increase pain, blood flow, and swelling, resulting in a slower recovery. It is also important to rest and let yourself heal. The rest period can take as little as a few days, or it could require weeks or months to recover.

When should I see a doctor?

After an accident, it is important to know which type of doctor to see and when. If you suspect a broken leg, broken arm, or broken ankle, visit an orthopedic specialist or a sports medicine doctor right away. If your injury doesn’t heal within three weeks you should consider making an appointment with your primary doctor, however, scar tissue can interfere with movement and cause pain in the future which is why you should also visit a physical therapist or massage therapist.

Express Care

The Express Care Clinic at Colorado Springs Orthopaedic Group can provide expert care whether you are dealing with a minor or major injury. It is a great alternative to the Urgent Care office as we have orthopedic surgeons on staff for when you need them. Express care is uniquely equipped to care for bone and joint injuries. Before you head off on your next Skiing excursion, be sure to save our number, 719-632-7669, in the unfortunate event of a skiing injury.

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The Anterior Approach To Hip Replacement Surgery

Hip replacement surgery requires the replacement of the top of the thigh bone as well as the socket of the pelvis. The damaged hip joint is then replaced with prosthetic components. This procedure is done to reduce pain and to improve hip function. With the traditional posterior (back of the joint) approach, the surgeon must cut through muscle and soft tissues in order to reach the joint. This creates a much larger incision, and the muscles must be repaired and reattached after the procedure. Since the muscles require significant healing time, the risk of future dislocation is greater.

Why Anterior Hip Replacement May Be a Better Option

Anterior hip replacement is a minimally invasive option for hip replacement surgery when compared to the posterior procedure. Even though this is not a new procedure, it is estimated that only 15%-20% of all hip replacements use this unique approach. Anterior (front of the joint) hip replacement surgery is done with more specialized instruments and through smaller incisions. This provides several advantages over the posterior procedure. First, this is a muscle splitting approach rather than a muscle cutting approach. The surgery is performed between a natural separation of the muscles. This allows the integrity of the hip muscles to stay in place in order to better support the newly reconstructed hip joint. Second, with anterior hip replacement there is less post-surgical pain, faster healing time, and a shorter hospital stay. The final benefit of anterior hip replacement is the decreased risk of dislocations. Since the muscles were not cut, there is less healing involved. After the healing process is complete, the patient will enjoy a better range of motion as well.

Find Out More

Anterior hip replacement is a technically challenging procedure. Since the surgeon has a somewhat limited view of the hip joint in an anterior hip replacement surgery, it is important to consult a physician that is experienced in this procedure. Colorado Springs Orthopaedic group has two such surgeons. Call today for a consultation with Dr. Bron or Dr. Huang.

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How to Prevent Injury While Playing Basketball

Playing basketball is a great way to stay in shape while having fun and making friends it is not a sport that is played without some risks. While playing it is best to always strive to prevent injury, such as ankle injuries or knee injuries. The three most common basketball injuries are ankle and foot, followed by hip and thigh, and then knee injuries. Ankle Sprains are by far the most common type accounting for 43% of all basketball injuries. A sprained ankle occurs when the foot rolls inward or outward causing the ligaments in the ankle to stretch or tear from a sudden and unexpected movement. Hip and thigh injuries can occur when a player jumps, runs, or pivots while placing extra strain on the legs. Finally, knee injuries can either be severe, such as an ACL tear, or minor like a sprain or strain to the knee joint.

With basketball, as well as all sports, prevention of injury is key. To prevent foot and ankle injuries, the player needs the right kind of foot support. A good quality basketball shoe as well as taping up your ankle before a game can go a long way for staying on the court. To prevent hip and thigh injuries, do some good stretching and warming up before the start of every game and practice. For your knees, the best prevention is building stronger leg muscles. Working out when you are off the court will help strengthen the muscles that support the knee joint. Also, if your knees are prone to injury, always wear a knee brace when playing.

How We Can Help

If you are injured playing basketball, start with rest, ice, compression, and elevation (the RICE protocol). When your pain does not subside after using RICE, it’s time to head to the Express Care Clinic at Colorado Springs Orthopaedic Group. In some cases, the injury is still apparent after a few weeks, or the patient is a serious athlete who wants to avoid diminished performance or a risk of reinjury. For these instances it is important to consult a specialist who can effectively diagnose the injury and suggest treatment and rehabilitation options. Call us today if you think you are dealing with a foot, ankle or knee injury.

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The Sacroiliac Joint (SI Joint) and Back Pain

It’s estimated that approximately eight percent (8%) of all Americans will experience low back pain at some point in their lives. It is suggested to be the second most common cause of physical disability, Arthritis being the first. As medical technologies advance, Doctors are learning even more in depth potential causes, and in turn treatments, for low back pain. One potential cause is the sacroiliac joint, otherwise known as the SI joint. The sacroiliac joint is located in the pelvis and links the pelvic bone to the sacrum. This joint can be injured or deteriorate over time causing low back, leg, pelvic, or buttock pain.

Function and Causes

A properly functioning sacroiliac joint will provide stability for the pelvis and bear the load of the upper body. SI joint dysfunction can occur as a result of childbirth, trauma, degeneration, or other conditions.

Treatments

Did you know the pain however, may not be actually coming from in the sacroiliac joint itself but instead, within the soft tissues that surround the joint or other areas of the body? This is called radiating pain and can typically be treated with conservative approaches such as physical therapy, soft tissue message or mobilization, and acupuncture.

Some people see significant improvement with these conservative treatment methods when specialized to their individual low back pain needs. If previous conservative approaches do not show significant improvement, some may be advised to try therapeutic injections.

Surgically, typically used as a last option, an Sacroiliac Joint Fusion can be considered to alleviate chronic pain. During this fusion procedure, a small incision is made along the side of the buttock. Titanium implants are then be placed across the joint. The whole procedure takes about an hour, and the healing time with this minimally invasive procedure is significantly less than that of an open type of spine surgery. An Sacroiliac Joint fusion may be appropriate for patients who have been diagnosed with SI joint dysfunction and who have not responded to less invasive therapies.

Contact Us

Questioning your low back pain? Give us a call at Colorado Springs Orthopaedic Group to see what the best treatment option is for you. Our spine physicians are eager to help – Dr. James Bee, Dr. Roger Sung, and Dr. Paul Stanton. 719-632-7669

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The Truth About Stem Cell & PRP Therapy

If you are looking for a non-invasive treatment for degenerative arthritis, bursitis, tennis elbow, patella tendinitis, plantar fasciitis, rotator cuff tears, muscle injuries, shin splints, or a variety of other musculoskeletal conditions, Stem Cell therapy or PRP (platelet-rich plasma) therapy may be an option. Orthopedists are always looking for new and innovative ways to treat their patients. Stem Cell and PRP therapy both provide a promising method to promote healing without surgery or in addition to a surgical procedure.

Stem cells are the cells of the body that are undifferentiated, meaning they can turn into other cell types. Stem cells can be obtained from the umbilical cord, bone marrow, or adipose (fat) tissue. The stem cells obtained from the embryonic environment are preferred to other types of stem cells, first because the potential of stem cells is thought to decrease with age and second because it can be painful to extract bone marrow.

Platelet Rich Plasma (PRP) is plasma with many more platelets than is typically found in the blood. Platelets contain hundreds of proteins called growth factors which are very important in the healing process and can therefore stimulate that natural process in orthopedic injuries. With PRP therapy, the patient’s own blood is drawn, the platelets are concentrated using a centrifuge, and then the PRP is injected back into the injured area.

For both Stem Cell therapy and PRP therapy, the healing process begins immediately after the injection is given. The patient should start to experience a reduction of pain in 2-6 weeks. For some people, improvement may still be limited after three months. In these cases, a follow-up injection may be needed. Many patients will still experience relief up to two years after treatment.

Both Stem Cell therapy and PRP therapy are considered experimental and therefore are not covered by insurance. The cost will vary depending on the volume and type of injection to be given. Consult with one of our doctors at Colorado Springs Orthopaedic Group to see if Stem Cell or PRP therapy is right for you.

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Urgent Care Colorado: Orthopaedic Walk-In Clinic Pricing

When you are in pain or injured and need urgent care right away, choosing where to seek medical attention can be a stressful and complicated decision. There are three main options for treatment: Urgent Care Walk-in Clinic, Express Care, and Emergency Room. For each of these options, the care provided as well as the pricing will vary greatly.

Emergency Room

First, when should you seek treatment at an Emergency Room? As the name suggests, this is the place for genuine emergencies. The care provided at the ER is meant to stabilize and treat urgent medical situations. The providers assess patients as quickly and effectively as possible in order to save lives. However, the triage system at the ER allows for those needing immediate attention to be seen first. For this reason, if you arrive at the ER with a sprained ankle, for example, you will be a much lower priority to be seen. At the emergency room you are also exposed to a host of contagious germs. Some situations that necessitate a trip to the ER are chest pain, bleeding that won’t stop, loss of consciousness, and severe burns. The cost associated with a trip to the ER is also quite high.

Urgent Care

An Urgent Care Walk-In Clinic handles less serious complaints, but those that should be treated within 24 hours. The Urgent Care is the right place to go for

allergies, sinus infection, headache, and cold or cough.

Express Care

Colorado Springs Orthopaedic Group’s Express Care walk-in clinic is a unique option for bone and joint injuries. At our clinic there is less waiting which means you can stop the pain sooner and start healing faster. Express is a specialty copay which is usually less than urgent care facilities, and the cash pay program is significantly lower than both an urgent care or the emergency room. With the CSOG Express Care clinic you have direct access to specialists in bone, muscle and joint injury care. There is also less risk of contact with possible contagious germs found in emergency care centers. At our Express Care clinic we treat all of the following:

Strains, sprains, and minor dislocations
Torn ligaments or tendons
Sports injuries
Sudden joint injuries
Bone Fractures

So when the unexpected happens, now you can go directly to our new Express Bone & Joint Injury Care Center with no appointment! Call (719) 622-4550 to learn more.

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3 Sports Medicine Tips For Preventing Skiing Injuries

Skiing is a great way to get outdoors, experience the beautiful Colorado scenery, and stay physically fit. Unfortunately, skiing brings a risk of injury. What do sports medicine specialists have to say about that? Some of the most common types of skiing injuries are knee sprains, fractured wrists, broken legs, head injuries, shoulder dislocations, and ankle and foot sprains.

By far the most common skiing injury is a sprained knee. This occurs when the ligament around the knee joint is injured by tearing or stretching too far. A knee sprain can happen during skiing when the knee bends in the opposite direction from how it normally bends or from too much strain on the knee joint. This can cause significant knee pain.

Braces

Thankfully, there are methods to help prevent injuries while skiing. One of the simplest and most effective ways to reduce injury is to wear a brace. Knee, wrist, and ankle braces are readily available and a great first line of defense against injury. Wearing a helmet is also essential in protecting the skull and brain. Our sports medicine specialists recommend another important step in preventing injury – wearing equipment that fits properly.

Conditioning

Conditioning is another way to prevent skiing injuries. Of course, you must do this this well before hitting the slopes. A good program will include endurance, strength, flexibility, and balance. Aerobic exercises such as swimming, cycling, biking, or jumping rope will all increase your level of endurance. Strength exercises such as squats, toe-raises, and sit-ups will condition your muscles for the strenuous sport of skiing. Stretches for the hamstrings, quads, and Achilles tendons are the third part of conditioning your body for your next skiing adventure. Finally, balance exercises such as standing on one leg and single leg hops will round out your conditioning regimen.

Stretching

One final way to prepare your body for skiing is to stretch before heading down that mountain. When most people set out to go skiing, this begins with a long car ride followed by waiting in line while standing in the cold. Your need to warm up your muscles to prevent injury. You can accomplish this by stretching after getting off the lift and then by taking an easy run the first time down.

By following these tips for preparation and prevention, you increase your chances of having a fun and injury-free day on the mountain. Of course, if you do happen to injure yourself, call 719-632-7669 to schedule an appointment with the best orthopedic specialists in Sports Medicine in Colorado Springs.

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Colorado Springs Orthopaedic Group Launches

A Free Surgery Day for Hands & Upper Arms

On October 6th, 2018, Colorado Springs, CO – Colorado Springs Orthopaedic Group (CSOG) is teaming up with the American Society for Surgery of the Hand (ASSH) to bring the first Free Hand & Upper Extremity Surgery Day to our region. Surgeries will take place at the Orthopaedic Spine Center of Southern Colorado on the second floor of CSOG’s current practice at 4110 Briargate Parkway, Suite 200.

“Many doctors do great things during medical mission trips. We at Colorado Springs Orthopaedic Group wanted to do something in our back yard.” said Jeff Watson MD.

Dr. Cassidy further explains, “Many physicians go overseas to help people in need, but sometimes overlook the need in our own communities. I thought it would be a lot of fun to help people who don’t have access or resources otherwise. People are so happy to have someone to listen and genuinely care about them.”

“The Touching Hands Project is dedicated to expanding our reach right here at home. Our U.S. missions, called “Hand Day”, take place at the facilities of hand surgeon members of the American Society for Surgery of the Hand. During these one-day missions, the medical staff provides free hand surgery for patients in their community who do not have access to hand care. These patients need our help for a variety of medical conditions that require surgery to be able to return to work and support their families.” – from the American Society for Surgery of the Hand website (ASSH).

For additional information Please call 719-622-4546.

About CSOG: Since 1994, Colorado Springs Orthopaedic Group (CSOG) has been a one-stop-shop for comprehensive orthopaedic care in Southern Colorado. As a large multispecialty group, CSOG has physicians who specialize in treating sports injuries, hand and arm injuries, foot and ankle problems, back and neck pain, hip and knee conditions, and arthritis. This allows CSOG physicians to refer to one another when they come across an injury that another doctor may have more experience treating. As a patient, this is much more convenient than having to go to another office and fill out more paperwork.

Mourning the loss of beloved orthopedic surgeon, C. Milton Waldron, MD

Dr. C. Milton Waldron, Beloved Surgeon and Friend of Colorado Springs, Passes Away on June 5, 2018

June 5, 2018, Colorado Springs, CO – Colorado Springs Orthopaedic Group (CSOG) mourns the loss of beloved orthopedic surgeon, C. Milton Waldron, MD. Dr. Waldron died in his home on June 5^th after a long battle with cancer and leukemia. He was surrounded by his loving family.

Dr. Waldron was born in Kentucky and graduated from medical school at the University of Louisville School of Medicine, Louisville, KY. He moved out of state to complete his residency at the University of Colorado School of Medicine, Denver, CO. It was in 1965 when Dr. Waldron finally moved to Colorado Springs and started an independent orthopedic practice. Since then, he has earned numerous awards and was affiliated with the Alpha Omega Alpha Honor Medical Society, Best Doctors in America since 1996, American Academy of Orthopaedic Surgeons, Western Orthopaedic Association, El Paso County Medical Society, Colorado State Medical Society, and American Medical Association.

In addition to his success in academia and entrepreneurship, Dr. Waldron excelled at creating genuine relationships with those around him. He became like a father, brother, and mentor to many of his coworkers. He cared for his patients and treated others the way he wanted to be treated. He also became a familiar figure in college athletics by serving as the team physician for Colorado College Hockey. His involvement with students also included supporting the Semester at Sea program for students traveling around the world.

Before his passing, Dr. Waldron requested a private funeral service for his close family and friends. He wanted to depart from this world the same way he lived life; with little fuss and with great humility. Dr. Waldron gave much of himself to our community and he will be dearly missed. Our thoughts and prayers go out to his family and friends.

Colorado Springs Orthopaedic Group Launches Express Bone and Joint Injury Care Center

May 4, 2018, Colorado Springs, CO – Colorado Springs Orthopaedic Group (CSOG) announces its Grand Opening of Southern Colorado’s first express care facility dedicated to treating bone, muscle and joint injuries. The clinic will start seeing patients on May 7 on the first floor of CSOG’s current practice at 4110 Briargate Parkway, Suite 145.

“Injuries are not planned, so we decided to invest in express care that requires orthopaedic specialists for a community that enjoys such an active lifestyle,” said Nicole Banning, chief operating officer of CSOG. “We’ve seen this model successfully serve other active communities and we believe our residents deserve fast, affordable care to get them back to what they enjoy doing faster.”

In an article published by Wolters Kluwer Health, Inc., the findings for these facilities documented a reduction in wait time compared to ERs by as much as 60 percent and a savings by as much as 95 percent. The article cited the advantage of continuity of care when patients are treated by the same physician at the time of an injury that will oversee their ongoing care.

“Our physicians are highly skilled in all types of injuries, including sprains, minor dislocations, torn ligaments or tendons in addition to breaks and joints,” said Ronald Hollis, MD of CSOG. “We have all the equipment necessary for stopping the hurting and starting the healing faster, such as X-ray, MRI, casting, a brace shop, physical therapy and a surgery center.”

“One of the reasons the care is expedited is that we specialize in orthopaedics, making it unnecessary for patients to wait behind strokes and heart attacks,” Banning said. “Additionally, our patients reduce the risk of contagious germs that they would encounter in other commercial urgent care outlets.”

The express care facility will have extended hours, which are Monday- Friday 9am – 7pm and Saturday 10am-2pm. No appointments are necessary for this walk-in care facility. A Grand Opening is being held on Monday, May 4 from 2pm to 5pm.

For additional information, call 719.622.4550, visit the website at http://csogexpress.com or email to [email protected].

ACL Reconstruction: Insights into the Procedure and Recovery

Understanding ACL Reconstruction Surgery

Determining the Need for ACL Reconstruction

The ACL Reconstruction Surgery Process

Recovering from ACL Reconstruction Surgery

Risks and Complications of ACL Reconstruction

Bones of the Shoulder Anatomy

Muscles of the Shoulder

Rotator Cuff Muscles

Deltoid

Trapezius

Rhomboids

Pectoralis Major

Tendons and Ligaments in Shoulder Anatomy

Shoulder Planes of Motion and Movement Patterns

Types and causes of Adult Scoliosis

Symptoms of Adult Scoliosis

Treatment Options for Adult Scoliosis

Physical Therapy Exercises for Adult Scoliosis

Anatomy of a Single Spinal Segment

Cervical Spine

Thoracic Spine

Lumbar Spine

Sacrum and Coccyx

Sacroiliac Joint (SI Joint)

The Impact of BMI on Hip Joints

The Effect of BMI on Knee Joints

The Role of Weight Management in Joint Health

What are Anterior Hip Replacements?

A Brief History

How Anterior Hip Replacement Differs

Anterior Hip Replacement Recovery

Who Would Be a Candidate?

Fellowship Training: Specialization and Expertise

Benefits of Fellowship Training

Board Certification: Recognized Expertise and Quality Assurance

Importance of Board Certification

The Doctor’s Timeline

Who is at risk for Osteoporosis?

How is Osteoporosis Prevented and Managed?

What is Bone Density?

Bones of the Hip

The Hip Joint

Ligaments of the Hip

Muscles of the Hip

Movements of the Hip

Healing Connection with Eric Jepson, DO

As the world’s fastest growing crime, generating over $100 billion per year, Human trafficking is a tragedy taking place everyday, everywhere, including here in our home town of Colorado Springs.

What is Human Trafficking?

Identifying Human Trafficking

Reclaiming Hope

1. Follow Your Doctor’s Instructions

2. Consider Which Arm Your Surgery Will Be On

3. Prepare to Get Dressed and Do Your Hair

4. Build Your At-home Recovery Supply

5. Get Plenty of Rest and Reduce Stress

6. Focus on Nutrition and Hydration

7. Take It Slow and Be Patient

8. Handling Setbacks

Meet Our Sports Medicine Providers

Jamie Friedman, MD

Michael Huang, MD

Christopher Jones, MD

John Redfern, MD

Richard Stockelman, MD

Craig Yager, MD

Anatomy of the Knee

Bones of the Knee

Ligaments of the Knee

Bursae of the Knee

Menisci of the Knee

Tendons of the Knee

To recap Tendons vs Ligaments:

The Iliotibial Band (The IT Band)

Muscles of the Knee

The Quadriceps

The Hamstrings

The Calf Muscles

Why Can’t I find Relief from Plantar Fasciitis?

Is Plantar Fasciitis a Tendon or Ligament?

Fellowship Training:
Specialization and Expertise

Board Certification:
Recognized Expertise and Quality Assurance