Wednesday, December 31, 2014

Congratulations to our Home Town ASU Team, Dr. Chhabra and Dr. Economopoulos!

Hyundai Sun Bowl

Congratulations to our Home Town ASU Team, Dr. Chhabra and Dr. Economopoulos (Team Physicians for ASU) for the Sun Bowl Win!

The 2014 Sun Bowl featured a devilish faceoff between Arizona State and Duke. Both teams fared well during the regular season, earning 9-3 records; however, a few tough games took them out of contention in their respective conferences. The Hyundai Sun Bowl marked the first meeting between the 2 teams. This was Arizona State's 278th bowl appearance and thrid under third-year head coach Graham. 
Arizona State Edges Duke, 36-31, at the 81st Hyundai Sun Bowl
Duke had the ball with under a minute remaining at the ASU 14-yard line and threw the ball to the corner of the end zone but the pass was intercepted by Brown.
The Sun Devils picked up their 10th win of the year in front of 47,809 for their second-straight Sun Bowl appearance, defeating Purdeu, 27-23, in 2004. Senior quarterback Taylor Kelly highlighted the ASU offense with 240 yards passing and 24 yards rushing for 264 of total offense. After the 81st Hyundai Sun Bowl, Kelly becomes the third player in ASU program history to tally 10,000 yards of total offense with 10,223 yards.


Wednesday, December 17, 2014

Congratulations to Dr. Bailie!

Congratulations to Dr. Bailie who was invited to act as an Editorial Board Member for the World Journal of Orthopedics!

"Given your outstanding achievements and reputation in the field of orthopedics, we now invite you to act as an Editorial Board Member of the WJO." - World Journal of Orthopedics



Monday, December 15, 2014

TOCA's Monday Motion: How to Stretch Out Properly

Stretching out before exercising is an important, and often neglected, step in your workout. A good routine should be established, and following the suggestions below will help you on your way.

1. Know your sport: Whether you're in the gym, on the track, or anywhere else, it's important to know what your workout will involve. Understanding which muscles will be worked is the only way to know how to best stretch out.

2. Focus on those muscles: While a good overall routine is helpful, your emphasis should be on the muscles that will be most heavily involved in your workout.

3. Warm up before stretching: Just some easy walking or a light jog will be sufficient to warm up your muscles, but it will make the stretching session much more valuable.

4. Begin Slowly: You don't need to touch your toes right away: Begin slowly and push yourself as your muscles loosen up. Stretching too much, too soon can be painful and potentially harmful.

5 .Hold the stretch: Once you feel your muscles reaching their limit, hold the position for a count of 10. Then push yourself a little further and hold again for a count of 10.

6. Don't rush your stretching routine: If you're going to have to cut your workout short, don't skip or shorten the stretching. This is more important than an extra set of reps or another half mile.

7. Do it again:
Once you're finished working out, stretch again. Not only is it an excellent way to cool down from your workout, but this is the time that you will improve your flexibility the most.

Don't bounce! You will get the best stretch, and prevent injuries if you avoid bouncing. Instead, hold the stretch, and feel a constant pull in the muscles.

Stretch both sides: Many people have a tendency to under-stretch the 'healthy' side after an injury. Use the same stretches, for the same amount of time, for both sides of your body.

Utilize a professional:
Gym trainers, physical therapists, exercise instructors will all know great ways to stretch. When you're getting started, have someone knowledgeable watch your routine and offer their suggestions.

#results.#recovery.#relief. #mondaymotion 


Friday, December 12, 2014

Dr. Carter: Lateral meniscus transplantation

Recently Dr. Carter spoke on the topic of Lateral meniscus transplantation: tips and tricks, in Las Vegas at the Orthopaedic Summit 2014- Evolving Techniques in Sports Medicine and Arthroscopy Surgery. 

What is a Meniscal Transplant?
The meniscus is a C-shaped cushion of cartilage in the knee joint. When people talk about torn cartilage in the knee, they are usually referring to torn meniscus.

If a meniscus is so badly damaged it cannot be repaired, it may need to be removed or trimmed out. Without the meniscus cushion, persistent knee pain and arthritis can develop.

For many older patients with this condition, a knee joint replacement might be the right option. But active people younger than 55 may be eligible for an alternative treatment: meniscal transplant surgery.

A meniscal transplant replaces the damaged meniscus with donor cartilage.

Meniscal transplants are not right for everyone. If you already have arthritis in your knee, a meniscal transplant may not help you. But for a select group of people, meniscal transplants can offer significant pain relief.

If you are suffering from knee pain, we can help! Call or visit us on-line for RECOVERY.RESULTS.RELIEF.


Tuesday, December 2, 2014

TOCA Tip Tuesday: Winter Sports Injury Prevention

According to the US Consumer Product Safety Commission, in 2010 more than 440,000 Americans were treated for winter sports-related injuries. That’s a whole lot of snow skiing, snowboarding, ice skating, sledding, and tobogganing injuries! Most of them involve dislocations, fractures, sprains, and strains.

144,000 injuries from snow skiing
148,000 injuries from snow boarding
58,500 injuries from ice skating
91,000 injuries from sledding and tobogganing

A majority of these injuries can easily be prevented if participants prepare for their sport by keeping in good physical condition, staying alert, and stopping when they are tired or in pain.

There are many things you can do to help prevent injury during favorite winter activities.

- Warm up thoroughly before playing or participating. Cold muscles, tendons, and ligaments are vulnerable to injury.

- Wear appropriate protective gear, including goggles, helmets, gloves and padding.

- Check that equipment is working properly prior to use.

- Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body's constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.

- Know and abide by all rules of the sport in which you are participating.

- Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snow boarding. Learning how to fall correctly and safely can reduce the risk of injury.

- Pay attention to warnings about upcoming storms and severe    drops in temperature to ensure safety.

- Drink plenty of water before, during, and after activities.

- Avoid participating in sports when you are in pain or exhausted.



Thursday, November 20, 2014

Congratulations to Dr. Evan Lederman!

Congratulations to Dr. Evan Lederman! Dr. Lederman’s work has earned him acceptance as an associate member of the American Shoulder and Elbow Surgeons (ASES) and is only the second surgeon in Arizona to receive this prestigious honor.  He has been awarded the distinction of Phoenix Magazine’s TopDoc and Phoenix SuperDoctors.

What is the ASES? Through educational programs and by encouraging research, the organization seeks to foster and advance the science and practice of shoulder and elbow care. The American Shoulder and Elbow Surgeons (ASES) is a society made up of leading national and international Orthopaedic surgeons who specialize in surgery of the shoulder and elbow. Through continuing medical education, the ASES Annual Meetings serve as a forum where persons involved in this field of medicine can meet, discuss new ideas and present scientific material. The membership, which is by invitation only, currently consists of 420 members. The ASES typically holds two meetings annually: The Open Meeting and Closed Meeting. The Open Meeting is held during the AAOS Annual Meeting, on Specialty Day. The Open Meeting is open to members and non-members while the Closed Meeting is for members only. The Society is an educational body responsible for development of scientific programs, for organization of current knowledge, for standardization of nomenclature and for publication of scientific materials.


Tuesday, November 18, 2014

Dr. Carter speaks at the Arthroscopy Association of North America

Dr. Carter spoke on the topic of using allografts for reconstruction of the anterior cruciate ligament at the annual fall meeting of the Arthroscopy Association of North America November 6th and 7th. 

What is the ACL? The anterior cruciate ligament is one of the most important of four strong ligaments connecting the bones of the knee joint. It is often injured.

Ligaments are strong, dense structures made of connective tissue that stabilize a joint. They connect bone to bone across the joint.

The function of the ACL is to provide stability to the knee and minimize stress across the knee joint:

* It restrains excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur).

* It limits rotational movements of the knee.

A tear of the anterior cruciate ligament (ACL) results from overstretching of this ligament when certain movements of the knee put too great a strain on the ACL. It is usually due to a sudden stop and twisting motion of the knee, or a force or "blow" to the front of the knee.

Basically any athletic or non-athletic related activity in which the knee is forced into hyperextension and/or internal rotation may result in an ACL tear.

Often those are non-contact activities with the mechanism of injury usually involving:

* Planting and cutting - the foot is positioned firmly on the ground followed by the leg (and body for that matter) turning one direction or the other. Example: Football or base
ball player making a fast cut and changing direction.

* Straight-knee landing - results when the foot strikes the ground with the knee straight.Example: Basketball player coming down after a jump shot or the gymnast landing on a dismount.

* One-step-stop landing with the knee hyperextended - results when the leg abruptly stops while in an over-straightened position.Example: Baseball player sliding into a base with the knee hyperextended with additional force upon hyperextension.

* Pivoting and sudden deceleration resulting from a combination of rapid slowing down and a plant and twist of the foot placing extreme rotation at the knee. Example: Football or soccer player quickly slowing down followed by a quick turn in direction.



Thursday, November 13, 2014

Do you have hip issues?

Do you have hip issues? Talk to Dr. Economopoulos…

TOCA (The Orthopedic Clinic Association) has been a leader in orthopedic care since 1949, led by nationally recognized, established orthopedic physicians like Dr. Economopoulos. He is a native of Arizona where he attended Brophy College Prep. He received his undergrad degree and medical degree at the University of Arizona in Tucson. He completed residencies in both general surgery and orthopedic surgery at Banner Good Samaritan Medical Center. He then spent a year as a sports medicine fellow at the University of Virginia specializing in shoulder and knee arthroscopy. He completed his training with a 6 month hip arthroscopy fellowship in Melbourne, Australia with John O’Donnell, a pioneer in hip arthroscopy and one of the highest volume hip arthroscopists in the world. Dr. Economopoulos is one of few orthopaedic surgeons in the United States to complete a concentrated fellowship in hip arthroscopy and the treatment of femoroacetabular impingement (FAI). His specialties are on hip and knees, which directly affects golfers.

What made you go into this nitch?
“I have always wanted to become a doctor and I followed the path of sports medicine because of my passion for sports. So, it fit well to go into orthopedics. I have been with TOCA for 15 months. Few people do this procedure so that’s when I decided this would be where I would dedicate my studies. I found my nitch in hips. I still operate on other parts but 1/3 of my work is in hips and 2/3 is in rotator cups, knees etc.”

Do you see a lot of young athletes?
“Yes, the shape of their hip changes and a bump forms on the hip. This is caused by wear and tear from sports. When these kids start playing sports at a young age the hip slowly starts to reshape. Hip pain usually comes about around ages 18-21. I will go in and reshape the hip and get them corrected.”

You said kids start developing this hip bump when they are younger from sports. Is there a way to prevent it?
“Developmental issues are almost inevitable (soft plate moving up and remaining). The best thing you can do is watch it and treat it as it goes. Also, just because you have the bump does not mean you are going to have symptoms. When patients see the bump the next step is physical therapy. You can strengthen the hip to hopefully avoid surgery but you cannot prevent the bump.”

Do you see a lot of wear and tear issues from older members?“I see younger patients in their 40s and 50s now needing hip replacements. The bump bangs up cartilage and we are seeing younger people needing hip replacements earlier. Golfers engage their hips on their swing.

Do you see young/old patients from golf with hip issues?
“Golfers develop hip issues on their twist, when they are rotating it pinches the nerve the hip. This can be treated with scoping.”

Do you have a message for golfers?
“If you are having hip pain, get it checked out earlier rather than later. Then hopefully that will allow for us to help prevent hip replacement.”

Check out Bunker to Bunkers segment with Dr. Economopoulos on Saturday 15th on radio station 98.7 at 7-9am.


Tuesday, November 11, 2014

Wishing you all a Happy Veterans Day!

Wishing you all a Happy Veterans Day! Thank you to all those in service, those who have served and to all of the families for your dedication and sacrifice.

In 1949, Dr. William Bishop and Dr. Alvin Swenson were orthopedic surgeons returning from service in World War II. Their mission was to provide the very best orthopedic care to the growing Phoenix community and the many Veterans returning from war with significant orthopedic injuries. That year they founded the Orthopedic Clinic (TOCA), the first medical practice specializing in orthopedic surgery in Arizona. Today, The Orthopedic Clinic (TOCA) has grown to 19 physicians with five locations across the Valley.


Thursday, November 6, 2014

Dr. Chhabra teaches 2nd graders all about bones!

These 2nd grade students had a fun morning with Dr. Chhabra learning about their bones and bone health! TOCA is proud of Dr. Anikar Chhabra's dedication and commitment to the community, and support/involvement with education from elementary school and on up!



Monday, November 3, 2014

Dr. Chhabra was proud to speak at the Arizona Men's Halth & Wellness Expo!

Dr. Chhabra was proud to speak at the Arizona Men's Health & Wellness Expo Saturday November 1st. The topic was Exercise and Aging: The Top 10 Orthopedic Injuries in Active Adults.

Results. Recovery. Relief.

Current Concepts in Sports Medicine Dinner Event

A job well done to Dr. Evan Lederman, Dr. Tom Carter, Dr. Anikar Chhabra, Dr. Kostas Economopoulos, Dr. Amy Jo Overlin, and Dr. David Barba (Fellow) in their presentations at the Current Concepts in Sports Medicine dinner event! This event was a Peer to Peer educational seminar for Family Practice and Primary Care Physicians managing sports injuries and osteoarthritis.


Friday, October 31, 2014

Halloween Safety!

Kids love Halloween. What’s not to love? Treats, tricks, goofy costumes, spooky costumes, even adults can get caught up in the fun of this holiday. With all the fun, kids can easily get carried away and forget some basic safety rules. That can lead to trips, falls, bumps and bruises, even sprains or fractures can put a stop to the Halloween fun.The American Academy of Orthopedic Surgeons has compiled a comprehensive list of Halloween tips to keep your children safe this year.


Costumes should fit properly. Costumes that are too long may cause kids to trip and fall, so trim or hem them as necessary.
Bright-colored costumes make it easier for children to be seen at dusk or in the dark. Add reflective tape to costumes and treat bags to provide additional visibility.

Wear sturdy, comfortable, slip-resistant shoes to avoid falls.
Masks can obstruct a child’s vision and should be avoided, along with hats that fall down over a child’s eyes. Child-friendly makeup is a good option.

Look for flame-resistant costumes and accessories.


Children younger than age 12 should be accompanied by an adult. Parents of older children should plan a safe trick-or-treating route together, and set specific times for children to check-in and return home.

Older children trick-or-treating without parents should be reminded to always stay together.

Walk on sidewalks and never cut across yards or driveways.

Cross streets at designated crosswalks and obey all traffic signals.
Both children and parents should carry flashlights to see and be seen.

Approach houses that are well lit. Remind children to never enter a home to obtain a treat.

Be aware of neighborhood dogs when trick-or-treating. Remember that these pets can pose a threat when you approach their home.
Carry a cell phone while trick-or-treating in case of an emergency.
Be sure to throw away any unwrapped or spoiled treats.

Many thanks to the American Academy for Orthopaedic Surgeons for compiling such a great list to promote safety this Halloween. 

Monday, October 27, 2014

Congratulations to Dr. Grant Padley

Congratulations to Dr. Grant Padley who was asked to be an oral examiner for the osteopathic orthopedic boards facilitated by The American Osteopathic Board of Orthopedic Surgery (AOBOS)

These are candidates that have completed their residency and are going through the steps toward board certification. The oral exam is the second step of the process. The first is a written exam and the third is a site visit with chart review and surgical observation. This allows patients the confidence to know if their surgeon has board certification they have been thoroughly tested prior to receiving their certification.

The American Osteopathic Board of Orthopedic Surgery

was established in 1979 and exists primarily for the purpose of assisting newly trained orthopedic surgeons in the certification process. The purpose of certification examination is to provide the public with a dependable mechanism to identify physicians who have met a standard to assure competent performance in the field of orthopedic surgery.

Certification for Osteopathic Orthopedic Surgeons was originally under the jurisdiction of the American Osteopathic Board of Surgery until the mid 1970's. The American Osteopathic Board of Surgery had one Orthopedist Member, Dr. Donald Siehl. The Orthopedic Examination for Certification (written, oral, and clinical) was given by Orthopedic Surgeons. Due to the increasing number of Residency Programs in the Osteopathic Profession in Orthopedic Surgery, and therefore the increase in number of graduates, the American Osteopathic Academy of Orthopedics began to lobby the American Osteopathic Association in the mid 1970's to form a Certifying Board for Orthopedic Surgeons.
A Committee was selected by the AOAO consisting of Peter Johnston from Columbus, OH; Dean Olson from Lansing, MI; Seymour Kaufman from Cherry Hill, NJ; William Monaghan from Kansas City, MO; and Bill Smith from Phoenix, AZ. This Committee began to develop the bylaws, regulations, and Manual of Procedures for the new Board, the American Osteopathic Board of Orthopedic Surgery. The AOA approved formation of the AOBOS in mid 1978. The members of the Committee then became the founding members of the American Osteopathic Board of Orthopedic Surgery. The first certification examination under their jurisdiction was given in 1979.
The first Chairman of the Board was Dr. Peter Johnston. The first Secretary-Treasurer was Dr. Dean Olson who served in this capacity until 1988. Membership on the Board attempted to represent the geographical areas reflecting larger concentrations of Orthopedic Surgeons. Some of the other Orthopedists who contributed by serving on the Board in its early days were Dr. William Luebbert, Dr. Bernard Zeliger, Dr. Gordon Thorn, Dr. Peter Ajluni, and Dr. Roger Grimes. Dr. Robert Kaneda began service on the Board in 1984 and developed the ties between the AOBOS and the National Board of Examiners. The NBME developed with Dr. Kaneda the AOBOS Test Committee to update the written and oral examinations.



Thursday, October 16, 2014

Sports Nutrition: Hydration

Sports Nutrition: 

Athletes who want a winning edge need the right nutrition. When you drink enough water and eat a balanced diet, your body can make energy efficiently and fuel top performance.

You can make the most of your athletic talents and gain more strength, power, and endurance when you train. Base your diet on a variety of factors, including your age, size, physical condition, and the type of exercise you are doing. See your doctor for individualized nutrition advice.


Water is the most important factor in sports nutrition. Water makes up approximately 60% of body weight and is involved in almost every body process. Your body cannot make or store water, so you must replace the water you eliminate in your urine and sweat.

Everyone should drink at least 2 quarts (8 cups) of water each day, and athletes need more. Drink plenty of fluids before, during, and after sports events to stay hydrated and to avoid overheating. When you work out or compete, especially in hot weather, try to closely match the amount of fluid you drink with the amount you lose in sweat.

Cool water is the best fluid to keep you hydrated during workouts or events that last an hour or less. Sports drinks containing 6% to 10% carbohydrates are useful for longer events. Most sports drinks should be diluted with approximately 50% water.

Drink water even if you are not thirsty. Thirst is not a reliable way to tell if you need water. You won't start feeling thirsty until you have already lost about 2% of body weight--enough to hurt performance. Also, if you stop drinking water once your thirst is satisfied, you will get only about half the amount you need.

Some tips for staying hydrated:

Drink small amounts of water frequently, rather than large amounts less often.

Drink cold beverages to cool your core body temperature and reduce sweating.

Weigh yourself after working out, and drink 2 to 3 cups of water for every pound lost. Your body weight should be back to normal before the next workout.


Wednesday, September 24, 2014

Gea Johnson, a patient of Dr. David Bailie, is bound for the Masters World Championships in Manchester!

Hello Dr. Bailie (The Rock Star Doctor),

Gea Johnson here! I realize you are very busy, but I am very excited to share with you what I
have been doing! A few years ago, I started track cycling even though Arizona doesn't have a
velodrome! I have had several successes…I even smashed a track record held by a woman, who
is bound for the 2016 Olympic Games and who is nearly half my age! Below, you will find my
“GoFundMe” link that also includes a very recent article detailing some of these successes.

For this next coming month, I will be competing “again” at the Masters World Championships in
Manchester, England. Unfortunately, this is very expensive. Dr Emerson and Dr. Martin have
both donated on and off of my “GoFundMe” site. I knew you would be interested too once you
heard of my successes; especially, since I am doing all of this at age 47 and with your shoulder
replacement! I would greatly appreciate any help you can provide.

I would also appreciate your help getting in touch with your contact at Biomet Orthopedics. I
have a partnership/sponsorship proposal to present to them. I would love to tell them the story
about my shoulder and how I am succeeding at such a “high” athletic level despite my so-called
shoulder “limitation.” I, regrettably, need serious funding to be able to train full-time near a
velodrome (located in Los Angeles) and to compete at UCI events to vie for a spot on the 2016
Olympic Team.


Gea Johnson

P.S. I can still do ALOT of pull-ups!

Wednesday, September 17, 2014

Dr. Zoltan: July 2014 Musculoskeletal Ultrasound Course

My recent attendance at the July 2014 Musculoskeletal Ultrasound meeting allows me to evaluate muscle, tendon or ligament injuries to the extremities. If indicated at a patient's initial visit, our office can complete an ultrasound evaluation of the soft tissues of the extremity to make accurate diagnoses of the severity of injury to these tissues. Musculoskeletal ultrasound is a noninvasive procedure without exposing the patients to radiation and is less expensive than an MRI.  This relatively new technique to assist a physician's diagnostic accuracy improves care by directing the physician to provide specific treatments sooner and afford the patient the opportunity for a quicker recovery.

- Dr. Jon Zoltan


Tuesday, September 9, 2014

Dr. Jon Zoltan Accepts the ALS Ice Bucket Challenge!

Dr. Zoltan (the first TOCA physician to accept the #alsicebucketchallenge#alsawareness) Marketing Director Susan Williams and Renee CA to Dr. Lederman all accepted the challenge and will be donating to the ALS Association! — at The Orthopedic Clinic Association TOCA.


Wednesday, September 3, 2014

Congratulations to the Phoenix Mercury!

Congratulations to the Phoenix Mercury who defeated the Minnesota Lynx to win the western conference championship and advance to the Finals!!! TOCA has been the team doctors for the Mercury since 1999. Team Physicians Evan Lederman, M.D., Amy Overlin, M.D, and Grant Padley, D.O., with Diana Taurasi and Britney Griner.


Friday, August 29, 2014

TOCA Scottsdale PT Ice Bucket Challenge!

The TOCA Scottsdale Physical Therapy Department accepted the Ice Bucket Challenge! The call out TOCA Arrowhead PT and TOCA Mesa PT! You have 24 hours to complete this challenge or donate $100 to the ASL Association.

#icebucketchallange #alsawareness


Thursday, August 28, 2014

TOCA Cast Tech Tony Delgado ASL Ice Bucket Challenge!

TOCA Cast Tech Tony Delgado accepted TOCA Phoenix PT's Ice Bucket Challenge! Not only did he complete the challenge but also gave a donation to the ASL Association! 

"On behalf of Cammi Melendez and Gretchen Bauchman and Phx pt dept. I accept the ALS ice bucket challenge, I am challenging GERI PAEZ, ASC MANAGER, ERIK CHAVEZ PHX PATIENT LIASION OR WHAT EVER HE DOES AND THE PHX DME DEPT. Ok man up everybody and get it done! " - Tony Delgado

TOCA Phoenix DME, TOCA Patient Support/ Spanish Interpreter Specialist Erick Chavez and TOCA ASC Manager Geri Paez you have 24 hours to accept this challenge or donate $100.00 to the ASL Association!

#ALS #icebucketchallange #alsawareness


Wednesday, August 27, 2014

TOCA Phoenix Physical Therapy ALS Ice Bucket Challenge!

TOCA Phoenix Physical Therapy Department and Gretchen Bauchman accepted Allie Nosek's Ice Bucket Challenge! The Phoenix PT Department challenges TOCA Cast Tech Tony Delgado and TOCA Scottsdale Physical Therapy Department! You have 24 hours to complete this challenge!

#ALSawareness #icebucketchallenge



Monday, August 11, 2014

What Is an MRI and Why Do I Need It?

What Is an MRI and Why Do I Need It? 

Magnetic resonance imaging (MRI) is a safe and painless test that uses a magnetic field and radio waves to produce detailed pictures of the body's organs and structures. Unlike CAT scans or X-rays, MRI doesn't use radiation. An MRI scanner is a large doughnut-shaped magnet that often has a tunnel in the center. Patients are placed on a table that slides into the tunnel. Some hospitals and radiology centers use what are called "open" MRI machines. They have larger openings and are helpful for patients with claustrophobia (a fear of being in tight, enclosed spaces), but sometimes use a smaller magnet and might not have as high a quality image. During the MRI exam, radio waves manipulate the magnetic position of the body's atoms, which are picked up by a powerful antenna and sent to a computer. The computer does millions of calculations to create clear, cross-sectional black-and-white images of the body. These images can be converted into three-dimensional (3-D) pictures of the scanned area that can help pinpoint problems in the body. MRI is used to: Provide clear images of body parts that can't be seen as well with an X-ray, CAT scan, or ultrasound. MRI is particularly helpful for diagnosing problems with the joints, cartilage, ligaments, and tendons. They can detect a variety of conditions, including problems of the brain, spinal cord, extremities, pelvis, wrists, hands, ankles, and feet and can identify infections and inflammatory conditions or to rule out problems such as tumors .

Do I need an x-ray if I already have an MRI? 

An X-ray is a quick, painless test that produces images of the structures inside your body — particularly your bones. Typically x-rays are done in the office and generally provide a better look at you bone structure, alignment, and provide assessment of fractures and arthritis. These are usually a precursor to getting an MRI and give us valuable information that the MRI does not. The MRI and x-ray complement each other and are often both needed for a thorough evaluation.

Dr Grant Padley-TOCA

#Recovery. Results. Relief.

Wednesday, July 23, 2014

The new Biomet NANO stemless total shoulder, co-designed by Dr. Bailie

The new Biomet NANO stemless total shoulder, co-designed by Dr. Bailie, has been off to a fast start in Europe. Hundreds have been used for both primary and reverse should replacement with many European surgeon users raving about the simplicity and the ability to customize the device intra-operatively. In addition, the IRB/FDA approved clinical trial has started in the US at 12 centers, of which Dr. Bailie is one (the only center in the Western half of the US). He has enrolled and completed surgeries on qualified patients and will continue to enroll patients who qualify until he reaches the maximum allowed by the FDA. Great job Dr. Bailie!


Tuesday, June 24, 2014

Having a Heat Wave! Preventing Heat-Related Injuries.

Having a Heat Wave!

A heat wave is a long period of very high heat and humidity. The National Weather Service has come up with a heat index (HI) to warn the public about such conditions. The HI, given in degrees Fahrenheit, is a measure of how hot it really feels when the actual air temperature is combined with the relative humidity (which is a measure of the amount of moisture in the air compared to the greatest amount of moisture the air could hold at the same temperature). For example, if the air temperature is 95 degrees Fahrenheit and the relative humidity is 55 percent, the HI, or how hot it really feels, is 110 degrees F. The National Weather Service issues alerts when the HI is expected to be greater than 105 to 110 degrees Fahrenheit for at least two days in a row.

What Are Heat-Related Injuries?

There three types of heat-related injuries:

  • Heat cramps. These are painful muscle cramps, usually in the stomach, arms, or legs, that may occur during heavy activity. Heat cramps are the least serious type of heat-related injury. It can be dangerous to ignore them, however, since they are an early warning sign that the body is having trouble with heat.

  • Heat exhaustion. This is the body's response to losing too much water and salt in sweat. It often occurs in people who exercise heavily or work in a hot, humid place, which makes them sweat a lot. Elderly people and those with high blood pressure are also prone to heat exhaustion. As the body overheats, blood flow to the skin increases, which decreases blood flow to other organs and causes weakness, confusion, and can cause collapse. If heat exhaustion is not treated, the person may suffer heat stroke.

  • Heat stroke. This is the most serious type of heat-related injury. Heat stroke, also known as sun stroke, occurs when the body becomes unable to cool itself down. The body's temperature may rise to 106 degrees Fahrenheit or higher within minutes. If heat stroke is not treated quickly, it can lead to brain damage or death.

How Can Heat Injury Be Prevented?

To prevent heat-related injuries, keep cool and use common sense. The following tips may help on hot, summer days:

  • It is important to consume plenty of fluids, regardless of thirst. During heavy exercise in hot weather, it is important to drink at least two to four glasses of cool fluid each hour. Water is always a good drink choice. Very cold drinks can cause stomach cramps. Avoiding drinks containing caffeine, such as iced teas and colas, is important because they just cause the body to lose more fluid. Salt tablets should be avoided.

  • Slowing down the pace is important also. It is important to cut back on heavy exercise, or to move it to the coolest time of day, usually very early in the morning.

  • Staying indoors if possible also can help. The best way to beat the heat is to stay in an air-conditioned room. An electric fan can make things more comfortable, too, but a fan alone may not be enough during a severe heat wave. If it is very hot at home, spending a few hours at an air-conditioned mall or public library can help.

  • Lightweight, loose-fitting clothing also helps. Light-colored fabrics are the best, because they reflect away some of the sun's energy.
  • It is helpful to eat smaller, more frequent meals, to avoid generating the extra body heat associated with digesting large meals.

Who Is At Risk?

Several things affect the body's ability to cool itself during very hot weather. One of the main ways the body cools itself is by sweating. The evaporation of sweat from the skin cools the body. When humidity (the amount of moisture in the air) is high, the sweat does not evaporate from the skin. Other things that can limit the body's ability to control its temperature include old or very young age, being overweight, fever, heart disease, sunburn, alcohol or drug use, and dehydration (dee-hy-DRAY-shun), which is excessive loss of water from the body due to illness or not drinking enough liquids.
Some people have a high risk of heat-related injuries:
  • Babies and children under age four. Babies and young children are very sensitive to the effects of high temperatures. They become dehydrated very quickly because of their small size. They are also unable to help themselves if they start to get overheated.
  • People over age 65. An older person's body may not control its own temperature as well as a younger person's. Older people are also less likely to notice and respond to changes in temperature.
  • People who are ill or taking certain medicines. Any illness or medicine that leads to dehydration raises the risk of heat-related injuries.


Monday, June 2, 2014

Hand Therapy Week 2014: June 2-8, 2014

Hand Therapy Week 2014 Starts Today! June 2-8, 2014

Hand Therapy Week (previously known as Healthy Hands Week) is an integrated national program sponsored by ASHT (American Society of Hand Therapists). For one week, ASHT members sponsor and organize events in their communities, promoting the benefits of the hand therapy specialty and the services they provide.

Hand Therapy Week brings the benefits of the hand therapy specialty to new audiences – demonstrating the advantages of prevention and treatment procedures for patients who have been affected by an accident or trauma, and educating the public.


Friday, May 30, 2014

Dr. Grant Padley

Meet Dr. Padley!

Dr. Grant Padley invites you to view his video sharing his expertise as a Board Certified and Fellowship trained Orthopedic Surgeon and Team Physician for the Cincinnati Reds and the Phoenix Mercury.

Dr. Grant Padley specializes in Sports Medicine with an emphasis on treating knee, shoulder, hip, and elbow injuries. He performs shoulder, elbow, hip and knee arthroscopy with ligament reconstruction, cartilage restoration and joint replacement.



Tuesday, May 27, 2014

Memorial Day 2014

Memorial Day – For most it was a three-day weekend, filled with bar-b-que’s and picnics . . . A time to get away from the normal humdrum of the week. For other’s it was the beginning of summer, a time to look towards the long lazy days and a time to plan your summer get-a-ways. Though for some, Memorial Day holds a special significance.

On May 5, 1868, an order issued by General John Logan established a day of remembrance for those soldiers who died during the Civil War. May 30, 1868, was the day designated for this observance and flowers were placed on the graves of the fallen soldiers of both the Union and Confederate Armies. New York was the first state to officially recognize this observance in 1873 and in 1971 with the passage of the National Holiday Act; Memorial Day was designated as the last Monday of May.

Now for many of us, the Civil War, the Spanish-American War, WWI, WWII, and the Korean War are ancient history. The Vietnam War a fading memory. But with the recent Operations Desert Storm, Enduring Freedom, and Iraqi Freedom we, the American people have once again been thrust into a position of remembering those who are fighting and dying today.

Continue to remember those that gave their lives, so that we may continue to live in freedom as spelled out in the Constitution of the United States and the Declaration of Independence . . . Lest we forget.

TOCA is proud to have been founded by Dr. William Bishop and Dr. Alvin Swenson, orthopedic surgeons returning from service in World War II in 1949. 


Wednesday, May 14, 2014

Meet Gretchen Bachman - Hand Therapy Manager at TOCA

Gretchen Bachman is the Hand Therapy Manager at TOCA.  Hand Therapists, through advanced study and experience, specialize in treating disorders of the entire upper extremity. All hand therapists at TOCA are Certified Hand Therapists, certified by the Hand Therapy Certification Commission.  Hand Therapists help bridge the gap between medical management with a physician and facilitate patients return to their daily work, leisure and life activities.

Gretchen graduated with her Bachelor’s Degree from Saginaw Valley State University in her home state of Michigan. She became a practicing occupational therapist in 1998, then in 2001 went on to earn her Master’s in Business Administration in Health Care Management. In 2007 she completed her Doctorate in Occupational Therapy in a Hand Therapy cohort. She has been working with TOCA since 2010.
Gretchen has peer reviewed publications in the Journal of Hand Therapy and wrote a chapter on fracture management and dislocations of the upper extremity in the book, Advanced Concepts of Hand Pathology and Surgery: Application to Hand Therapy Practice. She has presented nationally and internationally on the topics of fracture management, digital replantation, rheumatoid arthritis, custom splinting/orthosis fabrication, and various topics related to evidenced based practice.

Nationally, Gretchen has served on the Board of Directors for both the American Society of Hand Therapists (ASHT) and American Association for Hand Surgery (AAHS). She has been intimately involved on various committees, task forces, and special projects within these associations. Gretchen has also served on the Editorial Board for HAND, the official peer-reviewed journal for the AAHS.
Internationally, Gretchen has served on the Education Committee for the International Federation of Societies for Hand Therapy (IFSHT) since 2008. She has also served as the IFSHT Special Events Chair for the 2010 International Meeting when hosted in Orlando, FL.

Gretchen was granted an award through the IFSHT in 2009 and organized a multi-discipline educational conference related to disorders of the upper extremity in Lima, Peru. The Peruvian therapist who hosted this conference won a subsequent award and grant from the IFSHT to travel to the USA, contributing to further educational outreach brought back to her home therapy community in Lima.

Gretchen is passionate about a non-profit organization called the Guatemala Healing Hands Foundation. She has been supporting and traveling on medical mission trips with this organization since 2005.  The GHHF is a nonprofit organization dedicated to improving the quality and availability of health care in Guatemala through education, surgery, and therapy.

There is a Venn diagram of 3 primary areas of service:  Direct patient care, education, and community outreach. Direct service care primarily specializes in the treatment of congenital and pediatric hand injuries.
Direct patient Care:  Following a mandatory screening day, where upwards of 200 children are evaluated to determine their best treatment plan:  surgery, therapy, or other intervention.  Due to GHHF’s unique infrastructure GHHF is able to monitor children year after year to insure they receive the best possible consistent care. Depending on the severity and length of each case, surgical patients are provided with both in and outpatient care with costs covered 100% by GHHF.

Education: Each mission, a two day educational conference is organized annually, and integrates the Guatemalan provider community. GHHF has a unique relationship with the Guatemala Hand Associations, and they are a trusted teaching source and a vital American group providing cutting- edge hand education to both the surgical and therapy communities to over 2,200 doctors, therapists, and students to date.
Community Outreach: The heartbreaking reality and reasons why we meet so many children with serious hand conditions and injuries of the people in this nation cannot be ignored and disregarded. GHHF is committed to addressing the sources behind the problems seen. GHHF has teamed up with the village of Chichoy Alto, in the region of Patzun, Chimaltenango, to improve sanitation, health, education, and the overall quality of life for these 120 families. Community members of Chichoy Alto are required to collaborate and provide a portion of the labor necessary to implement these improvements. Within this community, GHHF has sponsored and constructed 55+ latrines, sponsored and constructed 21 efficient ONIL stoves, distributing crucial fertilizer needed to replenish Chichoy Alto’s barely existent crops, distributed emergency maize to families struggling with malnutrition, helped dig hillside trenches to lay piping to supply fresh water throughout the village, purchased school supplies to the 100+ elementary aged children, and have sponsored many children to attend high school and education beyond. 

In her free time, Gretchen enjoys traveling; camping, reading, and watching her son grow. She enjoys volunteering at his elementary school, and she and her family all recently started volunteering with the Special Olympics, another organization Gretchen has supported for a long time.