Dr. Haber, Orthopedic Hand and Wrist Surgeon at TOCA is spreading the word about TOCA and ASU across the world!

Dr. Haber, Orthopedic Hand and Wrist Surgeon at TOCA is spreading the word about TOCA and ASU across the world! 
Way to go Dr. Haber!

#Recovery. Results. Relief.

 602-277-6211 * www.tocamd.com

Monday Meet the TOCA Team: Samuel M. Harmsen, MD!

Dr. Samuel Harmsen is thrilled to be joining the outstanding physicians at The Orthopedic Clinic Association. He is fellowship trained in shoulder and elbow surgery with advanced training in complex shoulder and elbow reconstruction. Dr. Harmsen specializes in the treatment of all shoulder and elbow conditions including sports related, reconstructive, and traumatic injury. He performs arthroscopic and open surgical techniques and is uniquely skilled with reverse shoulder replacement and revision shoulder surgery. He also treats general orthopaedic trauma of the upper and lower extremities.

Dr. Harmsen was born and raised in Salt Lake City, Utah. He attended the University of Utah majoring in Japanese and Asian Studies, interrupting his studies to serve a two-year mission for his church in Japan. Prior to medical school he enjoyed several years of ski instructing at one of his favorite ski resorts, Deer Valley, UT.

Dr. Harmsen has had the opportunity to train under some of the world’s most renowned leaders in shoulder and elbow surgery. Following orthopaedic residency, he completed a complex shoulder and elbow fellowship at the San Francisco Shoulder, Elbow and Hand Clinic under Drs. Tom Norris and James Kelly. After fellowship, he extended his training by spending time with Dr. Laurent LaFosse in Annecy, France, and Dr. Pascal Boileau in Nice, France. This specialty training has helped him gain unique skills in advanced shoulder and elbow arthroscopy and reconstruction that are not widely available in Arizona.

Dr. Harmsen is very active in orthopedic research, having published and presented at a number of local, national, and international meetings. His primary area of interest is shoulder surgery, particularly in clinical results with shoulder arthroplasty. Dr. Harmsen plans to establish the Arizona Shoulder and Elbow Institute and, together with TOCA, develop a center of excellence within Arizona for shoulder and elbow research, education, and patient care.

Dr. Harmsen likes to create a professional but relaxed clinical atmosphere where everyone feels comfortable and able to ask questions freely. He wants you to leave each visit confident and encouraged. His clinical approach is centered around each patient’s individual concerns and goals. He believes that clear communication, patient education, and patient participation are vital to the success of any treatment, whether operative or non-operative.

To schedule an appointment with Dr. Harmsen please call 602-277-6211. To learn more visit: www.tocamd.com

‪#‎Recovery‬ ‪#‎Results‬ ‪#‎Relief‬

602-277-6211

www.tocamd.com

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

Hand Surgery and Breast Cancer Patients - Dr. Josh Vella

One of the more troublesome issues surrounding breast cancer surgery and lymph node dissection is the development of lymphedema in the arm. Traditionally these patients have been warned against having blood pressures taken, IV’s placed and surgery performed on the same side as lymph node dissection. However, recent research suggests that surgery is safe in patients who have previously had mastectomy and lymph node dissection.

A 2007 article studied 25 women who previously had mastectomy and lymph node dissection. Four of these women had a history of lymphedema. All of these patients underwent hand surgery on the same side as their lymph node dissection. There was no increased risk of infection in this group. Only 2 had a temporary worsening of their lymphedema. Of the women who never experienced lymphedema in the past, none of them developed it after hand surgery.

Another study in 1995 studied 15 women who had lymph node dissection and hand surgery. Seven of these women had a history of lymphedema. All of these women had hand surgery and none of them developed any symptoms of lymphedema after surgery.
While there is a perception, mainly among breast care nurses and breast surgeons, that hand surgery should not be performed after lymph node dissection, literature supports that it is safe. These articles suggest that hand surgery after lymph node dissection does not increase risk of developing lymphedema after surgery. Hand surgery is safe for women who have had mastectomy and lymph node dissection.

My hands helping your hands.

Josh C. Vella, M.D.

Breast J. Hershko: Safety of Elective Hand Surgery following axillary Lymph node Dissection. 2007;13(3):287-90
Ann Surg Onc. Dawson:Elective Hand Surgery in Breast Cancer patient with prior ipsilateral axillary dissection. 1995; Mar;2(2): 132-7
Ann R Coll Surg Eng: Fulford: Hand Surgery after Axillary Lymph Node clearance. 2010; Oct:92(7):573-

RECOVERY. RESULTS. RELIEF.

602-277-6211

www.tocamd.com

Men vs. Women and Musculoskeletal health:

Men vs. Women and Musculoskeletal health: differences between males and femalse extend to their bone and joint conditions.

Women in general have a higher incidence of osteoporosis-related hip fractures yet, they have a lower rate of mortality than men with the same fracture, according to a study in the June 2015 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS). In addition, doctors don’t always recognize or treat osteoporosis in men as often as inwomen.

“Male and Female Differences Matter in Musculoskeletal Disease” details the differences between how common musculoskeletal disorders manifest themselves in males versus females. The paper also underscores how important it is, for healthcare professionals to understand those differences and recognize how multiple factors can contribute to musculoskeletal conditions and injuries.

There are differences between how males and females develop several common musculoskeletal disorders:

Anterior cruciate ligament (ACL) injuries are 2-8 times more common in females.
Females are 5-8 times more likely than males to suffer an ACL injury in high-intensity sports like soccer and basketball that require sudden changes of motion.
Ankle sprains are twice as common in females.
Osteoarthritis of the knee is more common in females.
Metacarpal and phalangeal (finger) fractures are more common in males.

Recognition of these differences can contribute to better care of individual patients, and to a higher index of suspicion for injury for certain diagnoses such as ACL tears.

#RECOVERY.RESULTS.RELIEF.

602-277-6211

www.tocamd.com

Thursday Midday with Dr. Jon Zoltan: Diagnostic Ultrasound for Musculoskeletal Problems

Diagnostic Ultrasound for Musculoskeletal Problems

Everyone knows ultrasound is an imaging procedure that evaluates a mother’s fetus prior to birth. It is safe and valuable in evaluating the growing baby while still in the mother’s womb. 

Did you know this imaging technique has many other uses in medicine? With regard to bone, tendon, muscle, nerve and ligament problems, these structures can be identified and evaluated in the office at your first visit. Your doctor can accurately diagnose your condition without the need of exposing you to radiation. The procedure is painless and you do not have to make an additional appointment at another facility.

What are some common uses of the procedure?

Ultrasound images are typically used to help diagnose:

• tendon tears, or tendinitis of the rotator cuff in the shoulder, Achilles tendon in the ankle and other tendons throughout the body.
• muscle tears, masses or fluid collections.
• ligament sprains or tears.
• inflammation or fluid (effusions) within the bursae and joints.
• early changes of rheumatoid arthritis.
• nerve entrapments such as carpal tunnel syndrome.
• benign and malignant soft tissue tumors.
• ganglion cysts.
• hernias.
• foreign bodies in the soft tissues (such as splinters or glass)
• dislocations of the hip in infants.
• fluid in a painful hip joint in children.
• neck muscle abnormalities in infants with torticollis (neck twisting).
• soft tissue masses (lumps/bumps) in children.

How does the procedure work?

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as the object's size, shape and consistency (whether the object is solid or filled with fluid).

In medicine, ultrasound is used to detect changes in appearance, size or contour of organs, tissues, and vessels or detect abnormal masses, such as tumors.

In an ultrasound examination, a transducer both sends the sound waves and receives the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound's pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Small loops of the moving real-time images may also be saved.

This diagnostic imaging is available at TOCA. Ask your TOCA physician if this procedure is right for you.

#REOCVERY.RESULTS.RELIEF.

602-277-6211

www.tocamd.com

Dr. Padley was asked to speak at the Smith&Nephew

Dr. Padley was asked to speak at the Smith&Nephew Summer national sales meeting in Chicago about his experience with their new rotator cuff repair product. Earlier in the summer he was 1 of 15 surgeons from across the country who were asked to participate in the products "Limited Commercial Release". He spent time with company representatives on product usage, tips and pearls for other surgeons and gave a talk as well as question and answer period to over 300 national representatives.

#RESULTS.RECOVERY.RELIEF. 

602-277-6211

www.tocamd.com

TOCA Tip: How to Use Your Crutches!

TOCA Tip: How to Use Your Crutches!

If you break a bone in your leg or foot, have a procedure on your knee or lower leg, or suffer a stroke, your doctor may recommend that you use a walking aid while you are healing or recovering. Using crutches, a cane, or a walker can help keep your weight off your injured or weak leg, assist with balance, and enable you to perform your daily activities more safely.

When you are first learning to use your walking aid, you may wish to have a friend or family member nearby to help steady you and give you support. In the beginning, everything you do may seem more difficult. With just a few tips and a little practice, though, most people are able to quickly gain confidence and learn how to use a walking aid safely.

Make Your Home Safer
Making some simple safety modifications to your home can help prevent slips and falls when using your walking aid:

*Remove throw rugs, electrical cords, food spills, and anything else that may cause you to fall.

*Arrange furniture so that you have a clear pathway between rooms.

*Keep stairs clear of packages, boxes, or clutter.

*Walk only in well-lit rooms and install a nightlight along the route between your bedroom and the bathroom.

*In the bathroom, use nonslip bath mats, grab bars, a raised toilet seat, and a shower tub seat.

*Simplify your household to keep the items you need within easy reach and everything else out of the way.

*Carry things hands-free by using a backpack, fanny pack, or an apron with pockets.

Crutches:

If you are unable to bear any weight on your leg or foot, you may have to use crutches.

If your injury or surgery requires you to get around without putting any weight on your leg or foot, you may have to use crutches.

Proper Positioning:
*When standing up straight, the top of your crutches should be about 1-2 inches below your armpits.

*The hand-grips of the crutches should be even with the top of your hip line.

*Your elbows should be slightly bent when you hold the hand-grips.

*To avoid damage to the nerves and blood vessels in your armpit, your weight should rest on your hands, not on the underarm supports.

Walking:
*Lean forward slightly and put your crutches about one foot in front of you. Begin your step as if you were going to use the injured foot or leg but, instead, shift your weight to the crutches. Bring your body forward slowly between the crutches. Finish the step normally with your good leg. When your good leg is on the ground, move your crutches ahead in preparation for your next step. Always look forward, not down at your feet.

Sitting:
*To sit, back up to a sturdy chair. Put your injured foot in front of you and hold both crutches in one hand. Use the other hand to feel behind you for the seat of your chair. Slowly lower yourself into the chair. When you are seated, lean your crutches in a nearby spot. Be sure to lean them upside down—crutches tend to fall over when they are leaned on their tips.

*To stand up, inch yourself to the front of the chair. Hold both crutches in the hand on your uninjured side. Push yourself up and stand on your good leg.

Stairs:
*To walk up and down stairs with crutches, you need to be both strong and flexible. Facing the stairway, hold the handrail with one hand and tuck both crutches under your armpit on the other side. When you are going up, lead with your good foot, keeping your injured foot raised behind you. When you are going down, hold your injured foot up in front, and hop down each step on your good foot. Take it one step at a time. You may want someone to help you, at least at first. If you encounter a stairway with no handrails, use the crutches under both arms and hop up or down each step on your good leg, using more strength.

*If you feel unsteady, it may be easier to sit on each step and move up or down on your bottom. Start by sitting on the lowest step with your injured leg out in front. Hold both crutches flat against the stairs in your opposite hand. Scoot your bottom up to the next step, using your free hand and good leg for support. Face the same direction when you go down the steps in this manner.

Wednesday Workout Tips!

Wednesday Workout Tips:

1. Be Consistent.
2. Follow an Effective Exercise Routine: The American Council on Exercise (ACE) recently surveyed 1,000 ACE-certified personal trainers about the best techniques to get fit. Their top three suggestions:
1. Strength training - Even 20 minutes a day twice a week will help tone the entire body
2. Interval training.
3. Increased cardio/aerobic exercise.
3. Set Realistic Goals: Don't strive for perfection or an improbable goal that can't be met, focus instead on increasing healthy behaviors
4. Use the Buddy System: Find a friend or relative whom you like and trust who also wants to establish a healthier lifestyle
5. Make Your Plan Fit Your Life: Too busy to get to the gym? If you've got floor space, try simple floor exercises to target areas such as the hips and buttocks, legs and thighs, and chest and arms (like push-ups, squats, and lunges). Aim for 10-12 repetitions of each exercise, adding more reps and intensity as you build strength.
6. Be Happy: Be sure to pick an activity you actually enjoy doing, And choose something that is convenient. Rock climbing may be a great workout, but if you live in a city, it's not something you'll be doing every day.
7. Watch the Clock: Your body clock, that is. Try to work out at the time you have the most energy. If you're a morning person, schedule your fitness activities early in the day; if you perk up as the day goes along, plan your activities in the afternoon or evening.
8. Call In the Pros: Especially if you're first getting started. By getting a professional assessment, you can determine your weakest links and focus on them. This will improve your overall fitness balance.
9. Get Inspired: Fitness is a state of mind. One trick to get and stay motivated is to read blogs or web sites that show him how others have been successful, ask "Who inspires you?"
10. Be Patient: Finally, remember that even if you follow all these tips, there will be ups and downs, setbacks and victories. Hang in there, and you'll see solid results

#RESULTS.RECOVERY.RELIEF.

(The Orthopedic Clinic Association)

602-277-6211

www.TOCAMD.com

Weekend Warrior: Injury Prevention

Are you a weekend warrior? You are if your work and family demands keep you from exercising on a regular basis, so you make up for it by going “all out” on the weekends. But that Saturday morning pickup basketball game, football game or boot camp can leave you with aches and pains – or worse yet, a serious injury.

Each day, more than 10,000 Americans visit emergency rooms for sports and exercise-related injuries, according to the Centers for Disease Control and Prevention. Experts say weekend-warrior injuries are most common among formerly active men over age 30 whose weekend activities can be described as “too much, too fast, too far.” Even men who consider themselves in fairly good shape and take part in a highly-charged soccer game can end up with weekend-warrior injuries.

If you don’t exercise on a regular basis and you’re not conditioned for a particular sport or activity, you put yourself at risk for injury.

Regular exercise offers these important benefits:
•    Keeps your weight under control, which reduces stress on your joints, especially your hips and knees.
•    Maintains your muscle strength to help prevent arthritis and keep your joints flexible and protect them from damage.
•    Releases endorphins, which act as your body’s natural pain medication.

According to the National Institutes of Health, weekend-warrior injuries can occur for a variety of reasons, including poor physical conditioning and flexibility, failure to warm up and stretch muscles, competition intensity, participation in collision and contact sports and overuse of joints.

The most common injuries include sprains, strains, fractures, dislocation and inflammation. That means the orthopedic surgeons at TOCA see many patients with sprained ankles, shin splints, rotator cuff injuries, Achilles tendonitis, lower back pain, plantar fasciitis (heel pain) and knee pain.

The knee is at high risk for injury because of its complexity and the enormous amount of force it absorbs and stress it takes. Knee injuries often result from a blow to the knee, twisting or turning or an improper landing

The risk of injury does not mean you shouldn’t be active, though, and avoiding these injuries requires some common-sense prevention.

•    Exercise regularly and include a variety of cardiovascular activity, stretching and weightlifting in your routine. Cross-training helps to prevent overuse injuries, which develop from constantly using the same muscles and tendons.
•    Warm up and stretch to help prevent sprains.
•    Gradually increase your activity level – and intensity level – on a week-to-week basis.
•    Use proper technique.
•    Use proper gear and safety equipment.
•    Listen to your body. The “no pain, no gain” theory is not a good mantra.

Stop when you are fatigued. Muscle fatigue takes away your protective mechanisms and increases your risk of injury. And if you feel sharp or stabbing pain, stop exercising immediately.

#Results. #Recovery. #Relief.

602-277-6211
www.tocamd.com 

Dr. Carter presented on ACL Allografts

Saturday March 21st, Dr. Carter presented on ACL Allografts during the Sports Medicine Specialty Day at the American Academy of Orthopedic Surgeons Annual meeting in Las Vegas.

Dr. Carter is an expert in the field of orthopedic surgery and sports medicine. Since 2000, he has been the head team physician for the Phoenix Suns (NBA) and has served as the head of orthopedic surgery at Arizona State University for 14 years. Dr. Carter has also served as a member of the American Academy of Orthopedic Surgeons Sports Medicine Subcommittee, and a member of several committees for the Arthroscopic Association of North America. He has served as the state representative for the American Orthopedic Society for Sports Medicine. Dr. Carter has published numerous articles pertaining to orthopedic and sports medicine topics and has given presentations world wide. He was also awarded a patent for arthroscopic surgical instruments. Dr. Carter is considered a national authority on the topics of meniscal allografts and articular cartilage. He is also a member of the Herodicus Society which is considered the premier organization for Sports Medicine Orthopedic Surgeons with just over 100 members world wide.

#RESULTS.RECOVERY.RELIEF.

TOCA

602-277-6211

www.tocamd.com

Congratulations to TOCA's Top Docs!

Congratulations to Dr. Anikar Chhabra and Dr. Evan Lederman who where voted PHOENIX magazine Top Docs! TOCA's Nationally and Internationally recognized orthopedic physicians and surgeons have been ranked as Top Docs since 2003! 
‪#‎Results‬.‪#‎Recovery‬.‪#‎Relief‬. ‪#‎TOPDOCS‬

TOCA
602-277-6211
www.tocamd.com

Dr. Burgess and Lisa Babel, PA-C, returned to El Fuerte in Sinaloa Mexico for another LIGA trip in early March

Dr. Burgess and Lisa Babel, PA-C, returned to El Fuerte and the clinic of San Blas in Sinaloa Mexico for another LIGA trip in early March.  Each trip back to Mexico has allowed this team to reconnect with staff and gain continued familiarity with their surroundings.  As always, the complexity and great need for care humbles and overwhelms those medical personnel who travel from different parts of the country to treat these patients.

This trip brought along some new volunteers from the Phoenix area.  An anesthesiologist and surgical nurse from the valley added to the San Blas team and were a great help to Dr. Burgess and Lisa.

Dr. Burgess was able to follow up with some of his previous surgical patients and was kept busy with surgeries his first evening in clinic and throughout the day on Saturday.  “It’s always a thrill to see previous patients and how they are progressing.  I was especially excited to see the patient I treated last fall who was highlighted in the MundoFox video segment.  He has been able to recover good finger and thumb movement despite not having access to a therapist,” said Dr Burgess.

Their first patient, Carmen, is a 53 year old female who had an explosive detonate in her hand in 2012.  As a result of this injury she lost her ring and small fingers while deforming the other remaining digits on her dominant right hand.  She is a florist and has to work in order to provide food for her family.  One of the local translators who assists with the clinic watched as she arranged flowers with her hand and was able to hear her story.  Carmen struggled with scar tissue in her hand making it difficult for her to reach or grasp objects.  Dr. Burgess was able to help her by surgically releasing the contractures giving her more space between her thumb and index finger improving pinch, grasp and grip. Carmen is recovering well and the translator was able to pass on she is pleased with her recovery and early outcome.

Carlos is a 3 year old male who suffered a high voltage cable accident in 2013 that left him with a contracted long finger in his right hand.  The initial treatment he received simply sewed the finger down onto itself rendering it useless and also preventing normal use of the rest of his hand.  As it turned out, do to his initial tendon, nerve and vessel injury, the only option was to remove the contracted segment of the digit.  He is now able to fully open and close the rest of his hand significantly improving his function. 

Edwin is a 7 year old male patient with Down’s syndrome.  He sustained burns to his hand after picking up a red hot coal from a fire when he was 3 years old.  As a result he had scars throughout his hands that prevented him from being able to flex or extend his fingers.  The fingers were stuck together creating a webbed hand which continued to progress as his hand tried to grow with his advancing age.  His surgical challenge was to separate the digits from one another and then lengthen scar in the palm in an effort to allow him to extend his fingers.  He has a very complex condition and Dr. Burgess expects to see and treat him in the future as his condition required progressively staged operations.

Roberto is a 44 year old male who suffered a severely broken wrist and severed tendons when he came upon thieves trying to steal his electrical tools.  He was beaten with a machete.  As a result, he has lost the use of his hand due to the severed tendons, he has developed contractures and scar to the hand and he has poorly aligned bone healing restricting joint movement.  The injury changed his life and has prevented him from doing his job.  Dr. Burgess operated on Roberto to release the scar tissue and to try and improve the tendon function of his wrist and hand.  His next procedure in the fall will be to release more of the joints in his hand and possibly transfer more tendons to increase strength.  Eventually he will require work on the bone to correct the joint destruction.  Dr. Burgess was deeply moved by Roberto.  “Roberto is a man of faith.  He harbors no resentment to those who harmed him and he has accepted his disability.  He was grateful I was willing to try anything to help him and said he accepted the outcome, good or bad, as God’s will,” said Dr. Burgess.  “You hear those words and it makes you want more than anything to make a positive difference in this man’s life,” reflected Dr. Burgess.

The total number of patients treated at the San Blas clinic in March for the weekend was 234.  These included specialties in general medicine, podiatry, plastic and general surgery, and hand surgery.  Dr. Burgess and Lisa are looking forward to returning again in the future.

You can learn more about LIGA on their website, at www.ligainternational.org.

#RESULTS.RECOVERY.RELIEF.

TOCA

602-277-6211

www.tocamd.com

TOCA Tip Tuesday: How to Sit at a Computer!

TOCA Tip Tuesday: How to Sit at a Computer!

Regular computer users perform 50,000 to 200,000 keystrokes each day. Under certain circumstances and for vulnerable individuals, frequent computer use that involves awkward postures, repetition, and forceful exertions may be related to nerve, muscle, tendon, and ligament damage.

If you use a computer extensively (several hours each day), many experts recommend that you consider proper workstation layout and posture techniques to minimize your risk of developing injuries of the hand/arm, shoulder, neck, and back.

Overuse injuries develop over time, and may set in more quickly if you spend long hours sitting at a computer at home, as well as at work.

Symptoms of a problem can include numbness in the fingers, sore wrists, lower back pain, or eyestrain (redness, dryness, soreness, temporary blurring of vision, and headaches).

You may also develop general aches and pains in the neck, shoulders, arms, back, thighs, and lower legs (postural fatigue) or persistent pain or discomfort in muscles, tendons, and other soft tissue (repetitive strain injury).

Injury Prevention: "An ounce of prevention is worth a pound of cure." Avoid most computer-related overuse injuries. Some experts suggest that to reduce your risk:

* Use a properly set-up workstation.
* Use correct posture including keyboard and pointing device techniques.
* And most importantly, take frequent rest breaks.

Workstation Set Up:
If you're like most people, you are more productive and efficient at a workstation that fits your body size.

Chair: Many people find that a good chair is one that adapts to their bodies. You may want to choose one that is stable and adjusts easily for height and tilt. Consider a chair with a backrest that supports the curve of your lower (lumbar) back. Sit back in the chair when you work at a computer.

Work Surfaces: Many people may be most comfortable when the height of the desks is at about elbow level when sitting down. Check that there is enough room below the work surface to comfortably fit your knees and thighs.

Monitor and Source Documents: Correct placement of your monitor may help some individuals prevent eye strain, neck pain and shoulder fatigue by keeping your head and neck as straight as possible. Some experts suggest that your monitor should be separate from your keyboard and centered directly in front of you.

#RESULTS.RECOVERY.RELIEF.

TOCA
602-277-6211
www.tocamd.com

TOCA patient Cate Bossard will be one of the celebrity dancers in Dancing with the Stars!

TOCA patient Cate Bossard will be one of the celebrity dancers in Dancing with the Stars, this upcoming February 20th at the Biltmore Hotel. This event is one of the main fundraisers organized by the Kidney Foundation and they are celebrating its 9th year in the valley.

Cate Bossard was a patient of TOCA’s Dr. Steen Johnsen. Cate‘s feet had become crippled with huge bunions and toes which had curled so badly, that she was walking on the tips of her toes on the right foot and on the nail of the toes on the left foot.

Cate has been very active in sports her whole life playing tennis, horseback riding, hiking as well as other multiple outdoor activities. This was all coming to an end. It became difficult to wear shoes. At this point Cate made the decision to take the time and try and get her feet back to some normality.

Dr. Johnsen took this task on. See the before and after pictures!!!

In Cates words…

“I am thrilled to be Dancing with the Stars event for several reasons.

THANK YOU to Dr. Johnsen of TOCA who rebuilt my two crippled feet between 2012 and 2014. Now I have twinkle toes enough to be able to dance in this very prestigious Kidney Foundation Event 2014.”


For more information please visit: https://azkidney.org/events/DWSAZ2015


#RECOVERY.RESULTS.RELIEF

TOCA
602-277-6211
www.tocamd.com

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.

Tips:
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 

TOCA
602-277-6277
www.tocamd.com

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.

http://www.ases-assn.org/


TOCA
602-277-6211
www.tocamd.com

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.

TOCA
602-277-6211
www.tocamd.com 

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:

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.

Trick-or-Treating:

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.

TOCA602-277-6211www.tocamd.com 

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.

#Recovery.Results.Relief

602-277-6211
www.tocamd.com