Tuesday, January 17, 2017

Understanding Achilles Tendonitis and How to Treat It



Achilles tendonitis is the inflammation of the achilles tendon due to overuse or injury and is common in athletes especially runners or those who play sports during the weekends or infrequently.    It normally develops after abrupt changes in training, training on uneven surfaces and using worn or poorly fitted shoes. If left untreated, this could lead to degeneration of the tendon.

The most common cause is overuse of the foot or excessive stress transmitted to the tendon. Too much stress will lead to micro-injury of the tendon fibers and, if not given proper time to heal, the body is not able to repair the tendon before it is injured again.

Managing Achilles Tendonitis with Conservative Managements

Mild cases of achilles tendonitis usually respond to over the counter pain medications and resting the tendon so that it may heal.

On the other hand, if the pain is chronic, Physical Therapy is often used.  A Physical Therapist will teach patient how to stretch the calf muscle and Achilles tendon to avoid injury. Strengthening of the calf muscle as well as the ankle and foot is also necessary to stabilize the ankle. Additional strengthening exercise include heel lifts and eccentric strengthening.

Physical Therapy program can also be combined with different forms of ultrasound therapy or steroid injections by a physician.

In addition, correct footwear must be worn like shoes that are softer over and under the heel.

Surgery is a rare treatment for achilles tendinitis and is only performed when the tendon is already ruptured. Surgical options include gastrocnemius recession, debridement and repair and debridement with tendon transfer. The type of surgery to be performed depends on the location of injury and the amount of tendon damage.


The most important factor to expedite healing the tendon is to seek the advise of an orthopedic or foot specialist so that treatment can begin before the damage worsens.

At Advanced Bone & Joint, our team specializes in muscle, bone and joint injuries - including sports injuries and overuse injuries. Contact us today to schedule a consult with one of our Orthopedic Specialists! We have offices in St. Peters and O'Fallon, MO.

Understanding and Treating Weightlifter's Shoulder



Weightlifter's Shoulder is a term used to classify painful wear and tear of the distal end of the collar bone and is an overuse injury that can cause small fractures along the end of the collar bone. In some instances, osteolysis or bone breakdown occurs.

The condition is know as Weightlifters Shoulders because weightlifters are commonly affected due to the repetitive motions and heavy weight bearing loads on the shoulder joint associated with weightlifting.  However, they are not the only ones affected and jackhammer operators, baseball and football players and soldiers can also develop this problem.

What Causes this Condition?
Repetitive trauma or stress from training and lifting can cause small fractures on the distal end of the collarbone. When the elbows drop below or behind the body during bench press, excessive traction on the AC (acromioclavicular) joint occurs. As a result, the shoulders are in a position of excessive extension and since the bone does not have the chance to heal prior to the next training session, the shoulder can become painful and suffer from reduced strength and range of motion.

Treatment Options for Weightlifter’s Shoulder
Treatment for weightlifter’s shoulder usually starts with conservative or non-operative management. This may include rest and changes in weight-training activities and techniques and over-training must be avoided so that the joint can heal.   A physical therapist or a weight trainer can help with activity modification and design strength training for your condition.


For those who do not improve with conservative therapy, or have significant damage to the shoulder joint, an arthroscopic surgery may be recommended. During surgery, the surgeon removes portions of the damaged end of the collarbone in a procedure known as “distal clavicle excision”.   This procedure is generally performed as an outpatient procedure and most patients are able to return home the same day as their procedure.  Physical Therapy is often recommended after surgery to improve strength and restore range of motion.  Fortunately, most patients suffer no loss of function in the shoulder after surgery and are able to resume normal activities following rehabilitation.

At Advanced Bone & Joint, our team specializes in muscle, bone and joint injuries - including sports injuries and overuse injuries. Contact us today to schedule a consult with one of our Orthopedic Specialists! We have offices in St. Peters and O'Fallon, MO.

Tuesday, November 15, 2016

Research Links Ideal Protein Protocol with Reduced Healthcare Costs

For years, ABJ's OWN Weight Loss Coach, Delia Rice, has been singing the praises of Ideal Protein to help with weight loss and nutrition. Now, a recently published study continues to show the benefits of Ideal Protein. Read below to find out more. If you have been considering your weight loss and nutrition options, or want to learn more about Ideal Protein, contact us today!


Findings show weight loss with Ideal Protein Protocol could save payers millions in healthcare costs, help lower risk of heart disease and diabetes


GATINEAU, Quebec--(EON: Enhanced Online News)--Weight loss with the Ideal Protein Protocol, a medically designed and developed protocol for weight loss and weight maintenance, has been shown to potentially reduce healthcare claims and improve key markers of cardiac and metabolic health, according to findings detailed in two poster presentations unveiled at ObesityWeek 2016 in New Orleans today.
“As a self-insured organization, we are very encouraged by these outcomes”
The two studies with the Ideal Protein Protocol were led by cardiologist Timothy N. Logemann, MD, FACC, ABOM of Aspirus, a self-insured community-directed health system based in Wausau, Wisconsin. At ObesityWeek 2016, Dr. Logemann presented top HSR abstract winner Effect of the Ideal Protein Weight Loss Protocol on Employee Health Care Costs and Effect of a Ketogenic Diet on Advanced Lipid Profiles. Authors of both studies are Dr. Timothy Logemann; David K. Murdock, MD, MS, FACC, FACP, FSCAI and Kelly O’Heron, RD. John Grady also contributed to Effect of a Ketogenic Diet on Advanced Lipid Profiles.
The Ideal Protein Protocol is a four-phase, low carbohydrate, moderate protein, ketogenic weight management solution. Many healthcare practitioners offer the protocol to their patients to help them lose weight and as a result, reverse metabolic syndrome – the cluster of conditions including increased blood pressure, high blood sugar and abnormal cholesterol or triglyceride levels that are often pre-cursors to heart disease, stroke and type 2 diabetes.
As the obesity epidemic escalates, associated healthcare costs are rising in proportion. The price tag for overweight and obesity in America is estimated to range from $147 billion to nearly $210 billion per year in direct and non-direct medical costs, including surgery, medications, counseling, and cost for treating obesity-related complications.1
Effect of the Ideal Protein Weight Loss Protocol on Employee Healthcare Costs
In the study, Aspirus followed 306 employees who had successfully completed the Ideal Protein Protocol and analyzed claims costs for these employees from 2013 to 2015. Results from the study indicated an average of $916.97 (18% reduction) decrease in overall average costs. Females had the greatest decrease from 2013 to 2015 averaging -$974.71 (17%) from 2013. Comparing 2013 to 2015, males reduced their claims by -$472.88 (19% reduction).
“As a self-insured organization, we are very encouraged by these outcomes,” said Dr. Logemann, “This indicates that by offering workplace weight interventions, employers can potentially save between $500 and $1000 annually per employee on medical claims. With 70 percent of the U.S. population of overweight or obese,2 multiply those numbers accordingly – these types of workplace wellness initiatives could potentially save the insurance industry billions of dollars a year in claims related to the health complications of excess weight.”
Effect of a Ketogenic Diet on Advanced Lipid Profiles
Twenty patients (BMI >35) were enrolled in the 12 week study with the Ideal Protein Protocol, Effect of a Ketogenic Diet on Advanced Lipid Profiles. Sixteen patients completed the study, constituting an 80% compliance rate. Besides noticeable results in weight reduction, findings indicate that the Ideal Protein Protocol also has a positive effect on lipid abnormalities, with significant reductions observed in glucose and triglyceride levels. The Ideal Protein Protocol also has a positive effect on insulin, insulin resistance, and parameters of metabolic syndrome.
“It is gratifying to see that these scientific findings mirror the patient outcomes we see regularly at our clinic with the Ideal Protein Protocol,” continued Dr. Logemann, “The results demonstrate that when we address obesity as the root problem instead of just treating the symptoms, there is significant improvement in markers of cardiovascular and metabolic health as a result.”
The studies were funded by Aspirus with a grant from Ideal Protein, and performed by Aspirus research.
1 Cawley J and Meyerhoefer C. The Medical Care Costs of Obesity: An Instrumental Variables Approach. Journal of Health Economics, 31(1): 219-230, 2012; And Finkelstein, Trogdon, Cohen, et al. Annual Medical Spending Attributable to Obesity. Health Affairs, 2009.
2 Centers for Disease Control and Prevention. National Center for Health Statistics. Obese and Overweight. http://www.cdc.gov/nchs/fastats/obesity-overweight.htm

Tuesday, September 27, 2016

3 Signs Your Workout is Hurting More Than Helping

“No pain means no gains” may be a phrase commonly heard around the gym to motivate and inspire you through you workout. However, following this mantra may be doing more harm than good when it comes to your muscles, bones and joints. Below are 3 signs that your workout may be harmful in both the short term and long term.

1. You’re Still Sore Days After Your Workout
In most instances, Delayed Onset Muscle Soreness (DOMS) is the result of tiny tears in the tissue and typically subsides in 24-48 hours. While mild soreness is sometimes just part of the process, the duration and severity of this soreness is what can tell you whether or not you’re damaging your muscles and ligaments. If symptoms do not resolve after a day or two, it may be a sign of a more serious injury such as a tear or inflammation of the muscles or ligaments.

2. Sudden Sharp Pain During Your Workout
A sharp pain is your body’s way of signaling trouble in the ligaments or joints. In many cases, this sudden pain occurs during heavy lifting such as bench-pressing or squats due to the joints being overloaded with weight. If you do feel a sudden pain, it is important not to try to “push through it” as you may make the injury worse by continuing to stretch or damage the ligament or joint.

3. Your Ankles or Knees Are Swollen After Running
Most fitness fanatics would agree that cardio is an essential part of the workout routine as it helps you burn calories and fat. But, if your knees or ankles are baring the brunt of the pain, it may be a sign you need to slow down. Persistent pain or swelling can be a sign of an injury such as shin splints or Runner’s Knee. If addressed early, these injuries can be managed with rest and activity modification. But, trying to continue a rigorous cardio regimen can exacerbate these injuries and lead to more complex injuries.
At Advanced Bone & Joint, our team specializes in muscle, bone and joint injuries - including sports injuries and overuse injuries. Contact us today to schedule a consult with one of our Orthopedic Specialists! We have offices in St. Peters and O'Fallon, MO.

3 Signs Your Workout is Hurting More Than Helping

“No pain means no gains” may be a phrase commonly heard around the gym to motivate and inspire you through you workout. However, following this mantra may be doing more harm than good when it comes to your muscles, bones and joints. Below are 3 signs that your workout may be harmful in both the short term and long term.

1. You’re Still Sore Days After Your Workout
In most instances, Delayed Onset Muscle Soreness (DOMS) is the result of tiny tears in the tissue and typically subsides in 24-48 hours. While mild soreness is sometimes just part of the process, the duration and severity of this soreness is what can tell you whether or not you’re damaging your muscles and ligaments. If symptoms do not resolve after a day or two, it may be a sign of a more serious injury such as a tear or inflammation of the muscles or ligaments.

2. Sudden Sharp Pain During Your Workout
A sharp pain is your body’s way of signaling trouble in the ligaments or joints. In many cases, this sudden pain occurs during heavy lifting such as bench-pressing or squats due to the joints being overloaded with weight. If you do feel a sudden pain, it is important not to try to “push through it” as you may make the injury worse by continuing to stretch or damage the ligament or joint.

3. Your Ankles or Knees Are Swollen After Running
Most fitness fanatics would agree that cardio is an essential part of the workout routine as it helps you burn calories and fat. But, if your knees or ankles are baring the brunt of the pain, it may be a sign you need to slow down. Persistent pain or swelling can be a sign of an injury such as shin splints or Runner’s Knee. If addressed early, these injuries can be managed with rest and activity modification. But, trying to continue a rigorous cardio regimen can exacerbate these injuries and lead to more complex injuries.

3 Common Signs of a Rotator Cuff Tear

The rotator cuff is a series of four tendons that function together to lift and rotate the arm.  The rotator cuff tendons become weaker as we age, especially as we get to our 40’s and 50’s.  The rotator cuff tendons can tear, either as the result of the process of aging, or a sports, work or accidental injury.

The usual way a tear occurs in the rotator cuff is a forceful movement of the arm, such as in a fall or when reaching above the head.  Tears can occur with heavy lifting, or by pushing forcefully with the arm above the head.  Rotator cuff tears can also occur as the tendon  ”wears out” over time, and a specific injury is not always identified.  Rotator cuff tears occur most commonly in the dominant arm in patients in their 40’s, 50’s, or 60’s.

Lots of problems can cause shoulder pain.  Here are the top signs of a tear in the rotator cuff:

1. Nighttime Pain: Pain at night is a very common sign of a problem with the rotator cuff.   

2. Pain radiating down the outside of the arm:  Pain that radiates from the outside of the shoulder, down the outside of the arm, toward the elbow is very common in patients with a torn rotator cuff.

3. Difficulty reaching behind the back or overhead:  Since the rotator cuff’s primary function is to move the shoulder overhead or to rotate the arm, patients with rotator cuff tears often find it difficult to raise the arm overhead or behind the back.  Even if they can perform these tasks, it is painful to do so.

What Should You Do If You Think You Have a Tear?
First, see an orthopedic shoulder specialist.  If your doctor thinks you might have a rotator cuff tear, he will recommend an MRI.  An MRI test will show the tendons of the rotator cuff, and will show a tear.


If you have a rotator cuff tear, sometimes the tear will respond to treatment like physical therapy.  In more significant tears, surgery may be necessary to repair the torn tendon.  Your orthopedic surgeon will help you decide what the best course of treatment is for you.

At Advanced Bone & Joint, our team specializes in muscle, bone and joint injuries - including Rotator Cuff Tears.   Contact us today to schedule a consult with one of our Orthopedic Specialists! We have offices in St. Peters and O'Fallon, MO.

Monday, August 15, 2016

Understanding The Signs and Symptoms of Dupuytren’s Disease


















Dr. Paul Spezia Treats Dupuytren’s Disease


WHO GETS IT?
This disease affects people of all races, but is more common in Caucasians whose ancestors are from northern Europe. It is more common in men older than 50 years, but is also seen in woman and younger patients.

WHAT CAUSES IT?
The cause is unknown, but genetic factors seem to be important. In addition, alcohol consumption, diabetes, and smoking remain among the leading factors involved.

WHAT DO I LOOK FOR?
Painless lumps appear in the palm, often just below the base of the finger. Local pitting of the
skin may occur in response to the changing tissue layer. Over time, nodules under your skin may appear as “rope-like” cords under your skin. They may tighten, causing the finger to progressively bend toward the palm of the hand, resulting in what is called Dupuytren’s contracture.


Contact Dr. Spezia today if he can help you move past this condition and LIVE YOUR LIFE.

Click the video below to see Dr. Spezia treat this condition with a innovative non-surgical treatment called "Xiaflex".