Category Archives: Uncategorized

The Poor Misunderstood Baker’s Cyst – Not From Baking!

September 9, 2019

Baker’s cysts, or more correctly popliteal cysts, are fluid filled structures, located in the back part of the knee.  While relatively common and frequently detected on routine knee examination or by feeling a lump behind the knee, they are not associated with being a baker!  In fact, most of the general public and even some clinicians commonly misunderstand the cause and treatment of these cystic structures.

Bakers cysts, named after the physician who originally described them in the 1800’s, essentially are bursal sacs that become distended with fluid exiting from the back part of the knee joint.  This pressurized fluid enters into the bursa via a one-way valve mechanism causing swelling and possibly a painful lump behind the knee. They are detected on imaging studies like ultrasound and MRI’s but cannot be visualized on a standard x-ray. While these cysts can cause local symptoms from the pressure they create and may even rupture if extremely large, their presence is often indicative of an underlying problem within the knee joint itself.  Conditions, which frequently cause Baker’s cyst, include knee effusions (water on the knee), cartilage injury, meniscal tears, and osteoarthritis.

While it seems tempting to simply have the cyst drained in the hopes of resolving the swelling, the success rate of this treatment can be poor as the bursa will often refill with fluid. More importantly, the underlying problem itself within the knee joint needs to be addressed in order for the cyst to be appropriately reduced in size.  While surgery may be indicated in rare circumstances, most non-surgical treatments can be extremely helpful in resolving symptoms from a Baker’s cyst.

So remember the next time someone tells you they have a Baker’s cyst, tell them it’s not from baking and more significantly, their knee should be examined to determine precisely why they have this common but often misunderstood problem.

About the author Paul Lento, MD is a PM&R, Physical Medicine & Rehabilitation physician at 360 ORTHOPEDICS.  He is triple Board Certified and specializes in the non-surgical treatment of various musculoskeletal problems by identifying the cause of pain or loss of function.  360 ORTHOPEDICS treats patients in three locations and offers same day/next day appointments when needed.

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This entry was posted in on September 9, 2019 by SalesRep-Admin.

CAN YOU ‘GIT UP’? TAKE THE CHALLENGE!

September 3, 2019

“Move it or lose it” – “Motion is lotion” – “Keep moving” – “Git up and go”

If you’re a patient with us at 360-ORTHOPEDICS, you’ll hear these words of advice to keep your joints and muscles at their peak performance. Why?  Problems arise when you stop moving. We spend about a third of our life sleeping. What would happen if you stayed there?  What would happen if you stopped moving?

Your muscles and organs need oxygen to stay healthy. Movement encourages that flow of oxygen to keep you moving. Without it, muscles decrease and you lose 10% strength each week without movement. Bones lose mass.  Your heart rate goes up. Your blood volume goes down. Your endurance declines making it harder to move. If you’ve ever had to stay in a hospital bed for a period of time, you already know how quickly your body stiffens.

Of course, we’re not going to plan on remaining in bed for prolonged periods of time, but let’s consider one of the things that keep us from moving on a daily basis … sitting. It’s almost as harmful as smoking! Prolonged sitting can be detrimental to your health even if you are otherwise fit with an optimum BMI (body mass index).  Studies have shown sitting to be a contributing factor to increased blood sugar, blood pressure, and cholesterol.

Experts tell us we should sit no more than three hours in a day and for many, particularly those with a desk job, that’s impossible. A good guideline to follow is to take a break and stand once every hour. You may even want to set a timer to get up and stretch for a few minutes.

Some other things you can do to maintain your muscle and joint health:

  • Walk 30 minutes every day.
  • Develop a fitness routine that you are able to sustain. It doesn’t need to be high intensity; swimming, yoga, walking, cycling, and weight training are all great additions to your plan.
  • Maintain a healthy weight.
  • Eat superfoods (salmon, leafy greens, berries, nuts, eggs, ginger, turmeric, avocado).
  • Say NO to sugar!

Bottom line, moving is key to a healthy body, so “GIT UP”.  Check out this link to see how our staff at 360-ORTHOPEDICS took on the latest dance craze, the “Git Up Challenge” (by Blanco Brown) to encourage our patients to keep moving!  We hope it inspires YOU to “Git Up” too.

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This entry was posted in on September 3, 2019 by SalesRep-Admin.

THE AWESOME FACTS BEHIND OUR BREAKTHROUGH CHANGE

August 5, 2019

If you haven’t heard the news already, Sarasota Orthopedic Associates has undergone a big change … our name. We continue to offer the same up-to-date technology and treatment with the same skilled physicians at the same three locations. And yes, we continue to offer same day/next day appointments. Only our name changed.  Take a look at our metamorphosis:

360 ORTHOPEDICS was founded in 1978 in a building on Hawthorne Street under the name of Sarasota Orthopedic Associates. By 2003, we outgrew our original location, thus renovating and moving into the former Doctors Hospital building at 2750 Bahia Vista Street. This is currently our largest facility and is home to a full range of orthopedic services from foot and ankle to neck and spine as well as X-ray, MRI, Physical Therapy, and a full size pool for aquatic therapy.

As our physicians began to treat patients from outlying areas, a second office was built in 2012 in Lakewood Ranch to accommodate “out east” patients. Our third location, built in 2014, is located in Venice with easy access from the highway and serves our patients from Venice to Punta Gorda.

As 360 Orthopedics continues to grow, we are adding new services, physicians, and technology to better serve you, our patients. Our presence in Lakewood Ranch has outgrown the current location and in the fall of 2019 we will move into a brand new building. The innovative 10,000 square foot facility is in the heart of Lakewood Ranch at SR 70 and Lakewood Ranch Boulevard and will be home to our current range of services along with additional amenities.

While our former name served us well for forty years, it did not completely reflect our growing mission, and, it implied boundaries of the areas we serve. Our name 360 ORTHOPEDICS now reflects that patients are the center of our care and that we serve a larger footprint on the Florida Suncoast. The colors in our logo, green and blue, have significance as well.  Blue represents trust, strength, and calmness while green represents balance and health. These colors also are indicative of our Suncoast blue gulf waters and majestic green palm trees.

We continue to provide the same excellent care and service and, our new name embodies a larger vision of the future. The physicians and staff at 360 ORTHOPEDICS are committed to providing the highest level of comprehensive, compassionate, and professional care.  Our mission is to get our patients back on their feet, back to work, back in the game, and back to life.

Take a look at our new website www.360-orthopedics.com

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This entry was posted in on August 5, 2019 by SalesRep-Admin.

WHY IS BACK PAIN SO COMMON?

July 29, 2019

back pain2

Up to 80% of Americans will experience low back pain at some point in their life. Why is it so common and is there anything that can be done about it?

It has to do with the shape of the spine, specifically the part of the spine in the lower back called the lumbar spine. The spine is made of vertebrae bones stacked on top of each other separated by spongy cartilage-like discs acting like shock absorbers.  The spine supports all the upper body weight which puts a lot of load on the lumbar spine and results in mechanical stress and strain. The lumbar spine is curved at the bottom. This is normal anatomy, however, it predisposes the lowest segments of the lumbar spine to extra wear and tear. The cumulative wear and tear can cause longer lasting and constant low back pain that may become chronic (lasting at least 3 months). The most common reasons for low back pain include:

  • Degenerative disc disease is when the lumbar discs wear down over time from cumulative wear and tear and no longer do their job of providing a cushion between the vertebra bone.
  • Herniated disc is sometimes called a “slipped disc”. In this case part of the disc bulges out from its normal location. This may result in not only back pain but also pain that radiates down the leg if the bulge pushes on a nearby nerve, commonly referred to as “sciatica.”
  • Spinal stenosis is when the spinal canal has become narrowed over time resulting in less room for the nerves. Often this is due to a combination of arthritis of the spine as well bulging discs. Over time it leads to pain in the lower back as well as in the legs, especially with walking and standing for long periods of time.
  • Vertebral compression fracture – In this case the cause is fractured vertebrae bone due to osteoporosis (brittle bones due to low bone density).
  • Facet joint pain – Here the pain is due to arthritic pain stemming from the spinal joints called facet joints. These attach vertebra bones to one another. The pain here is typically in the lower back and mostly with prolonged standing and walking.

Prevention is probably the most important type of treatment for low back pain and is not emphasized nearly enough in our society. Good posture, proper ergonomics and biomechanics, and daily exercise, especially core strengthening, is crucial in the prevention of back injury and unnecessary extra wear and tear. Once a back problem develops the treatments can vary, are usually diagnosis specific, and can be very effective. Most important, surgery is rarely needed and should be reserved for when conservative modalities are not effective or, when there is neurologic emergency such as weakness, numbness, incontinence, tumors, or infections.

If you are suffering from back pain it is important to see a skilled physician who offers you conservative treatment options.  Ashot Kotcharian, MD is a Physical Medicine & Rehabilitation physician with a specialty in Interventional Pain Management. He is accepting new patients at 360-ORTHOPEDICS where we offer same or next day appointments in any of our three locations.

Like us on FACEBOOK here. Follow us on TWITTER here.  Follow us on INSTAGRAM here.

This entry was posted in on July 29, 2019 by sarasotaAdmin.

WHY IS BACK PAIN SO COMMON

June 6, 2019

back pain2

Up to 80% of Americans will experience low back pain at some point in their life. Why is it so common and is there anything that can be done about it?

It has to do with the shape of the spine, specifically the part of the spine in the lower back called the lumbar spine. The spine is made of vertebrae bones stacked on top of each other separated by spongy cartilage-like discs acting like shock absorbers.   The spine supports all the upper body weight which puts a lot of load on the lumbar spine and results in mechanical stress and strain. The lumbar spine is curved at the bottom. This is normal anatomy, however, it predisposes the lowest segments of the lumbar spine to extra wear and tear. The cumulative wear and tear can cause longer lasting and constant low back pain that may become chronic (lasting at least 3 months). The most common reasons for low back pain include:

  • Degenerative disc disease is when the lumbar discs wear down over time from cumulative wear and tear and no longer do their job of providing a cushion between the vertebra bone.
  • Herniated disc is sometimes called a “slipped disc”. In this case part of the disc bulges out from its normal location. This may result in not only back pain but also pain that radiates down the leg if the bulge pushes on a nearby nerve, commonly referred to as “sciatica.”
  • Spinal stenosis is when the spinal canal has become narrowed over time resulting in less room for the nerves. Often this is due to a combination of arthritis of the spine as well bulging discs. Over time it leads to pain in the lower back as well as in the legs, especially with walking and standing for long periods of time.
  • Vertebral compression fracture – In this case the cause is fractured vertebrae bone due to osteoporosis (brittle bones due to low bone density).
  • Facet joint pain – Here the pain is due to arthritic pain stemming from the spinal joints called facet joints. These attach vertebra bones to one another. The pain here is typically in the lower back and mostly with prolonged standing and walking.

Prevention is probably the most important type of treatment for low back pain and is not emphasized nearly enough in our society. Good posture, proper ergonomics and biomechanics, and daily exercise, especially core strengthening, is crucial in the prevention of back injury and unnecessary extra wear and tear. Once a back problem develops the treatments can vary, are usually diagnosis specific, and can be very effective. Most important, surgery is rarely needed and should be reserved for when conservative modalities are not effective or, when there is neurologic emergency such as weakness, numbness, incontinence, tumors, or infections.

If you are suffering from back pain it is important to see a skilled physician who offers you conservative treatment options. Ashot Kotcharian, MD is a Physical Medicine & Rehabilitation physician with a specialty in Interventional Pain Management. He is accepting new patients at 360-ORTHOPEDICS where we offer same or next day appointments in any of our three locations.

Like us on FACEBOOK here.  Follow us on TWITTER here.  Follow us on INSTAGRAM here.

This entry was posted in on June 6, 2019 by sarasotaAdmin.

THE MONSTER OF ALL HEADACHES

May 6, 2019

migraine

Did you know there are 11 types of headaches, each with varying causes and symptoms, and all are painful in fluctuating degrees? Fortunately, most headaches are common and short lived, however one type of headache may prove to be life altering.

Migraine headaches typically occur on one side and may be accompanied by throbbing, nausea, and/or sensitivity to light and sound. Some may experience an aura of lights or flashing just prior to the migraine and while there are different triggers to set off a migraine, there is more and more evidence of genetics playing a role.

Common migraines may last one to several days and may be alleviated by OTC (over the counter) medication like Ibuprofen, rest, or ice. Chronic Migraines, however, are more serious and more difficult to treat.  These headaches last 15 or more days a month for a period of three or more months. In the past, prescription medications were commonly used as were alternative approaches like meditation and acupuncture.

Some fast facts about migraines:

  • They affect over 4 million people daily in the United States
  • 85% of all sufferers are women
  • 70% have a family history of migraines
  • 91% are unable to work or function normally during their episodes

While medications are helpful for the onset of a migraine attack, it is important to avoid overuse of these medications. Currently the only FDA approved intervention for Chronic Migraine is Botox or Onabotulinumtoxin A and has been in use for over ten years. It is also effective in relieving spasticity (muscle contraction) and cervical dystonia (painful spastic twisting of the head). The treatment is performed in office and takes about 30 minutes or less. A tiny dose of the Botox is injected into specific nerve endings to block pain signals to the brain. The most common side effect is a temporary sore neck which may be alleviated with icing.

Ashot Kotcharian, MD is a Board Certified Interventional Pain Management physician at Sarasota Orthopedic Associates. He joined the orthopedic group after serving as Assistant Professor of PM&R at Johns Hopkins University School of Medicine. 360-ORTHOPEDICS has three locations and offers appointments on a same day/next day basis when needed. For more information go to www.SOA.md or call 941.951.BONE.

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This entry was posted in on May 6, 2019 by sarasotaAdmin.

HELP FOR THE LADIES: HOW TO MANAGE YOUR ORTHOPEDIC PAIN

April 8, 2019

Does gender affect orthopedic injuries and conditions? The simple answer is:  you bet it does.  Consider the differences and where women are at higher risk and experience conditions exclusive or largely related to gender. More important, let’s look at how women can prevent risk.

Feet and Ankles

With 26 bones and 33 ligaments, so much can go wrong on both men and women. While genetics is a factor, women are two times more likely to experience foot injuries than men. So, what’s the variance? Those shoes! Stiletto heels … flip flops … pointy toes … any of these can cause a number of painful conditions like hammertoes, plantar fasciitis, bunions, poor posture, back pain and ankle strain. What to do? Be sure to stretch your calf muscles daily, opt for wedges when you want height, look for shoes with support, and alternate heel heights daily.  Check out Vionic.com for some stylish, yet practical choices.

spike shoes

Knees

Women have a higher risk for ACL tears than men. There are several theories as to why, however a common belief is that the space in a woman’s knee is narrower, leaving it at greater risk than men. Strengthening exercises like seated leg raises, side-lying leg raises, and calf raises may help. Always check with your physician prior to starting any exercise routine.

Headaches

Women are more prone to experience headaches, particularly tension headaches and chronic migraines. Of headache sufferers in the U.S., 70% have a family history of headaches and for chronic migraines, 85% are women. Among the reasons, aside from genetics, are diet, allergies, stress, sound, hormonal changes, and posture. There are multiple treatments for headaches including Botox injections of the head and neck to relax muscles. An Interventional Pain Management Physician can determine if you are a candidate.

Shoulders

This topic is common with women. Carrying a large shoulder bag can throw your body out Botof alignment causing multiple conditions. “Heavy Purse Syndrome” can create shoulder and neck pain from muscle overuse. It can also throw your entire body out of position and affect your gait. A change in posture may lead to falls.  There are a few things you can do to avoid discomfort: Use a wide strap for your bag and frequently alternate sides for carrying. Remove items you don’t need … do you really need to carry your partner’s keys or all those pens and candy? Make sure your bag weighs no more than 10 pounds.

shoulder bag

Back and Neck

Back and neck pain may be related to any number of reasons including a too-heavy purse, poorly fitting shoes, or weak muscles. Even frequent texting lowers your neck and can put extra pressure on your neck and spine … it’s good to follow mom’s wise words, “Sit up straight”! When lifting heavy objects be sure to lift properly by maintaining a wide base of support at your feet, squatting from the knees and hips (NOT at the waist), and maintaining a straight back. Pregnant women are more susceptible to low back pain due to swelling tissues along with changes in the musculoskeletal system. If a woman has back pain prior to pregnancy, she is two times more likely to experience it during the pregnancy.

Osteopenia / Osteoporosis

Lastly, the aging process may sometimes be unkind. Osteoporosis is a common condition affecting over 10 million Americans. Of those, 80% are women. It is predicted that one in two women over the age of 50 with osteoporosis will eventually break a bone. What to do?  Exercise and diet play a significant role in keeping bones healthy.

What’s a girl to do? The good news is that YOU are in control. Keep these helpful hints in mind:

  • Strengthen your muscles with exercise
  • Watch your diet and maintain an optimum weight
  • Practice good posture
  • Empty out that purse
  • Wear smart shoes with support
  • Lift properly
  • Use a cross body purse instead of a shoulder bag
  • See your physician if discomfort persists

One small change can make a huge difference. Be well!

Sarasota Orthopedic Associates has three locations and offers same day / next day appointments when needed. Our commitment is to get our patients back on their feet, back to work, back in the game, and back to life.

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This entry was posted in on April 8, 2019 by sarasotaAdmin.

A PHYSIATRIST: Taking a Look at the Big Picture

February 18, 2019

physiatrist

Physical Medicine and Rehabilitation (PM&R) physicians known as physiatrists (fizz-EYE-ah-trist) are medical doctors who have graduated from medical school and have completed 4 years of residency training. The specialty is a very small one beginning with WWII when many military personnel returned home with various disabilities from the war.  Over time the specialty has grown and now board certified physiatrists care for those with amputations, stroke, spinal cord injury, and traumatic brain injury, including concussions.

In addition to these conditions, physiatrists may also have sub-specialty certification in the management of sports medicine injuries.   While they complement orthopedic surgeons in their care, they do not perform surgery, preferring to treat the injured athlete utilizing the most effective research-based non-surgical care.  In addition physiatrists do not limit their care to only one area of the musculoskeletal system but instead focus on the interaction of how one link in the kinetic chain may affect the rest of the problem (i.e., “the shin bone’s connected to the knee bone” philosophy).  For instance an overhead athlete such as a tennis player with recurrent shoulder pain may have inflexibility to their hamstrings or weakness of the hip muscles as the underlying issue.  Similarly, a runner with knee pain may have difficulty with absorbing shock due to ankle and calf mobility issues.

While an athlete’s history and examination will often determine the cause of an athletes’ condition, a physiatrist will often utilize musculoskeletal ultrasound (US) to examine the injured area.  Musculoskeletal US, much like that used to examine a pregnant woman, is able to use sound waves to determine if any ligaments, muscles, or tendons have been sprained or torn.  Unlike MRI, claustrophobia is not a problem using US and the patient can actively move the injured tissue to give a dynamic picture to the physiatrist.  This allows the physiatrist a glimpse as to what is happening at the tissue level. In this way they are better able to give an athlete a more accurate diagnosis as well as guide appropriate therapy.

360-ORTHOPEDICS believe in treating the whole person so you can get back on your feet, back to work, back in the game, and back to life.  We have three convenient locations and are able to accommodate same/next day appointments.

Paul Lento, MD is a Fellowship Trained / Triple Board Certified PM&R physician with a subspecialty in sports medicine. He specializes in the non-surgical treatment of various musculoskeletal conditions to determine if the problem is mechanical, inflammatory, or degenerative.

Top Doc       blue shirt cropped

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This entry was posted in on February 18, 2019 by sarasotaAdmin.

TUESDAY TRIVIA ORTHOPEDIC POP QUIZ – How Much Do You Know?

February 12, 2019

SKELETON THINKING

Let’s have some fun today and see if you can answer these questions.  Answers below…no peeking!

  1. Does cracking your knuckles increase your risk of arthritis?
  2. Should you put ice or heat on an injury?
  3. What’s the #1 condition experienced by seniors?
  4. How many years of education does it take to become a fellowship trained orthopedic surgeon?
  5. What’s the reason for most visits to the emergency room?

answers

  1. While the sound of cracking knuckles can be particularly annoying to some people, truth is, contrary to popular myth, that it does not increase your chances of developing arthritis. It does, however, increase chances of minimizing your grip strength over time. The popping sound you hear is merely nitrogen releasing from the liquid in your joints. That liquid helps to lubricate your joints and keep them moving. If you experience pain with the popping, see an orthopedic hand specialist.
  2. Trick question! The answer is both. Using ice at the beginning of an injury will assist in reducing swelling. After swelling subsides, heat will help to increase blood flow to the injury and may reduce discomfort. When pain is not alleviated, consult your physician.
  3. The most common complaint among the elderly is arthritis and over 50% of seniors experience discomfort from this chronic condition. Unfortunately, arthritis is part of the aging process, however, there are many simple remedies such as NSAIDS and exercise to alleviate the associated discomfort. There are more options for more aggressive pain. As with any condition causing pain, a visit to your physician is warranted.
  4. It typically takes 14 years of education to become a fellowship trained orthopedic surgeon. The requirements are 4 years of an undergraduate degree, 4 in medicine, 5 in a residency program, and 1 in fellowship. That’s a lot of education and it ensures you’re in good hands!
  5. Most emergency room visits are from falls and injuries. Sports injuries are common among youth sports participants, weekend warriors, professional athletes, and even “DYI” homeowners. Falls are particularly common among the elderly population and may occur from balance disorders, slip & falls, medication, obesity, walkway hazards, or poor footwear.

How did you do with your answers? Any surprises?

If you have a chronic pain or injury, you’ll be pleased to know 360-ORTHOPEDICS offer same day/next day appointments at all three of our locations when needed. Check out our website at www.SOA.md or call us at 941-951-2663.

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This entry was posted in on February 12, 2019 by sarasotaAdmin.

THE SUPER SEVEN

January 29, 2019

superfoods

Our previous blog post talked about foods and drinks to NOT put into your body. Now let’s talk about the 7 foods that are nutritious AND taste good to help preserve your musculoskeletal system.

  1. Salmon is often referred to as a “super food”, packing a punch of protein, minerals, and vitamins like B12. Most important: salmon is rich in omega-3 fatty acids.
  2. Greek yogurt is thicker than regular yogurt because the liquid is drained giving it a creamy texture. It contains probiotic cultures and is lower in lactose than regular yogurt. Greek yogurt is an excellent source of calcium, zinc, and B12. Stir some blueberries or strawberries into a cup of plain Greek yogurt and you have a great kick start to your day.
  3. Sweet potatoes are another “super food” and extremely versatile. Plain or fancy with stuffing or toppings, they are high in fiber and potassium. They are also known to maintain a healthy blood pressure. A sweet potato contains more nutrients and less calories than a white potato.
  4. While dairy products are essential to a child’s growth, it can be a source of discomfort for some adults. Dairy products are rich in calcium and vitamin D, along with other nutrients, to help keep bones and teeth strong. For those on a diet, you may opt for a fat free version and there are lactose free brands for those with a low tolerance. Both still have the calcium that is provided in regular milk.
  5. When your mom told you to eat your veggies, she was on to something. Leafy greens should be your “go-to” vegetable whenever possible. Greens like broccoli, kale, cabbage, spinach, romaine lettuce, and arugula contain essential vitamins like A (for the immune system), C (for tissue repair), and K (for blood coagulation). Nuts may also lower your blood sugar. The best nuts for your health are almonds, pistachios, walnuts, and cashews, however, go easy since a large handful may contain as many as 200 calories.
  6. Another great source of fiber and vitamin B can be found in beans. They may also help lower cholesterol and blood sugar. The best beans with benefits are chickpeas, lentils, peas, kidney and black beans.
  7. Figs, dried or fresh, are rich in fiber and give you a feeling of fullness. They are also high in calcium to help promote bone health.

So there you have it. Add these “Super 7” to your regular diet and you’re on your way to a healthy eating habit. When you do have pain or injury to your musculoskeletal system, 360-ORTHOPEDICS can be your “go-to” place for help. We have 3 convenient locations and offer same or next day appointments when needed.

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This entry was posted in on January 29, 2019 by sarasotaAdmin.