What do you do when you are diagnosed with an old (chronic) Achilles tendon rupture?

Sean C. Peden, MD

Sean C. Peden, MD

Sean Peden, MD is an orthopedic surgeon who specializes in foot and ankle surgery. Dr. Peden has expertise in treating a variety of foot pain and deformity related conditions including Achilles tendonitis, ankle instability, cartilage injuries, bunions and hammer toes.  His practice will also focus on youth athlete sports injuries and the types of injuries seen in field athletes, gymnasts and ballet dancers.

Achilles tendon ruptures will often not be discovered for months after the injury. In the months between injury and showing up at the doctor’s office, the torn tendon develops scar tissue which decreased the quality and elasticity of the tissue. Because of this, directly repairing the torn tendon, as is done in an acute injury, becomes is less than ideal. In this situation, we will supplement the tendon repair with a tendon transfer. Essentially, we borrow a tendon that bends the big toe (there is another tendon that compensates when it is borrowed), reroute it, and reattach it to the heel bone. This does two very important things:

 

1. It supplements the strength of the torn Achilles, allowing a quicker and better recovery.

2.It provides improved blood supply to the Achilles repair, providing healing factors to the area of diseased tendon.

In summary, ruptures of the Achilles Foot_AnklePictendon are increasingly common in our aging yet increasingly active population. In cases where an Achilles rupture is missed or the rupture cannot be repaired directly under normal tension, adding the flexor hallicus longus tendon transfer allows for significantly improved results with a shorter recovery.

If you suffer from foot and ankle pain and would like to attend a free seminar, Dr. Peden of ONS and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage is an orthopedic surgeon specializing in foot and ankle surgery. He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

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Suffer from Bunion Pain? Dr. Clain Offers Solutions

Michael Clain, MD

Michael Clain, MD

“Bunions are a common deformity encountered in the foot where the big toe is out of alignment. This creates pain in that toe and often in the lesser toes as well. The deformity makes it difficult to find shoes that fit comfortably.  Ill-fitting shoes can contribute to the situation but the underlying deformity is genetic. This is why most patients can recall a parent or grandparent that had the problem.

In consultation, I often tell patients that the options are to accommodate the foot with wider shoes, gentle arch supports and sometimes padding or I encourage them to consider surgery.  The decision to proceed with surgery should be based on the overall level of discomfort and deformity.  This will differ from patient to patient.  It is the rare patient that must have bunion surgery.  Most people chose surgery due to the accumulation of annoyances, discomfort, pain and deformity in other toes.

Actual X-ray of patient of Dr. Clain before bunion surgery

X-ray of patient of Dr. Clain before bunion surgery

Same Patient. Post-Bunionechotmy

Same Patient. Post-Bunionechotmy

It is very important, from my point of view, to communicate realistic expectations for the procedure and the ultimate result. I try hard to be very specific about the time involved in recovery and give every patient a written “expected surgical recovery.” It is obviously difficult to remember everything when you as the patient are given a great deal of information so it’s helpful to have a summary to refer to.

Not all bunions are the same. Routinely, I perform about six different surgical procedures.  The goal is to do the most appropriate operation for your particular foot and circumstance.  With careful communication and a well thought-out plan it is highly likely that we should be able to get a great result for almost any foot.”

For more information about Dr. Clain, click here: http://onsmd.com/physician/michael-r-clain/

If you suffer from bunions and would like to attend a free seminar on foot pain Dr. Peden of ONS and Greenwich Hospital will present Solutions for Foot & Ankle Pain: Beyond Foot Massage is an orthopedic surgeon specializing in foot and ankle surgery. He will present treatments and surgical techniques for bunions and other foot deformities. Learn more and register online here.

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ONS Physiatrist, Christopher Sahler, MD presents “Exercise as Treatment for Chronic Pain”.

Christopher Sahler, MD

Christopher Sahler, MD

Christopher Sahler, MD of ONS and Greenwich Hospital, is an interventional physiatrist specializing in sports medicine. His focus is non-operative treatment of musculoskeletal injuries, restoring proper function, reducing pain and promoting active lifestyles.

If you are suffering from chronic pain, you are not alone. It is estimated that 100 million Americans are currently living with chronic pain. The pain may make it difficult just to get out of bed or do household chores, let alone be active and exercise. Studies have shown this inactivity can actually cause you to experience a worsened level of pain and for a longer period of time. Exercise actually improves your pain threshold. Even simple exercises such as walking can provide some benefit.

Join Dr. Sahler as he presents his first health Seminar “Exercise as Treatment for Chronic Pain” at Greenwich Hospital. Come learn how staying active and performing exercise may help treat an array of chronic pain conditions.

When: December 2nd, 2014
Time: 6:00 p.m.
Place: Noble Auditorium at Greenwich Hospital

Register for Free

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ONS Physiatrist, Christopher Sahler, MD on post New York City Marathon Tips for Runners

Christopher Sahler, MD

Christopher Sahler, MD

Christopher S. Sahler, MD of ONS is an interventional physiatrists specializing in sports medicine. His focus is non-operative treatment of musculoskeletal injuries, restoring proper function, reducing pain and promoting active lifestyles.

“Each year 50,000 people participate in the NYC marathon. If you are in that group and completed the race this past weekend, congratulations! It is an exciting accomplishment that you will remember for the rest of your life.

Now that the race is over, there are a few key points to remember that will help to maximize your recovery and minimize pain. Many athletes experience worsening soreness over the following days after the race. This is known as delayed onset muscle soreness and typically is most painful 48-72 hours later. After the race, your body is in a depleted state so it is important to take in plenty of water and healthy food. A combination of complex carbohydrates and protein help the muscles to repair themselves and re-build their energy stores. It is also recommended that you perform light, short duration activities such as walking, gentle jogging, biking, swimming etc. This helps to increase blood flow to the muscles and tissues that need the nutrients the most and helps to wash away the built up metabolic byproducts such as lactic acid. Gentle stretching and soaking in a warm bath may also help loosen up the muscles. Depending on your previous activity level, it is important to give your body time off before re-starting any intense exercise routines. Most runners should take at least one month off.

Congratulations again on the race!”

Dr. Sahler will present “Exercise as Treatment for Chronic Pain.” Learn how exercise can be used as a safe and effective treatment for chronic pain conditions. This free health seminar will be in the Noble Conference room at Greenwich Hospital Tuesday, December 2 at 6:00 p.m.  To register call 203-863-4277 or register online at https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=5348

 

Posted in Community Outreach, Greenwich community, Greenwich Hospital, Greenwich Hosptial, Health Seminar, Injury prevention, Management, Medical, medical expertise, News and Announcements, physiatry, physical medicine, Prevention, Running, Seminars, Sports Medicine, Uncategorized | Tagged , , , , , , , , , , | Leave a comment

Do You Experience Foot or Ankle Pain?

Sean Peden, MD will be speaking at the Noble in Greenwich Hospital December 9th at

Sean Peden, MD

Sean Peden, MD

6:30pm to address Solutions for Foot & Ankle Pain: Beyond Foot Massage. Here is a summary of what he will present:

A painful foot or ankle condition can limit a patient’s function and quality of life with every step. Conditions from the toes to the Achilles tendon will be discussed with emphasis on surgical and nonsurgical options, including old standards and the most cutting edge new technologies. Topics covered will include foot and toe deformities such as bunion, hammertoes, flat feet, and high arches, with special attention to when and how these conditions should be treated or when they should be left alone. Plantar fasciitis and Achilles tendonitis will be discussed in detail with emphasis on the natural progression of the disease, what we know works and what is experimental. Arthritic conditions of the foot, ranging from the big toe to the ankle will be included.

A team approach is an important aspect of foot and ankle care. ONS physical therapist Alicia Hirscht, DPT, SCS, CSCS will discuss and answer questions about the role of physical therapy to improve foot and ankle pain and dysfunction.

ONS Senior Clinical Specialist Alicia Hirsch

ONS Senior Clinical Specialist Alicia Hirsch, DPT, SCS, CSCS

Dr. Peden will introduce an orthotic maker he typically works with and will discuss when and how orthotics are used, from inexpensive over-the-counter inserts to custom molded prostheses. Other options to be discussed will include stem cell technology and image-guided injections.

Dr. Peden will open up a question and answer session following the seminar. This event is free registration requested, call (203) 863-4277 or (888) 305-9253, or register online at:  https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=7253

Foot Ankle Pain Brochure

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ONS Orthopedic Surgeon Seth Miller, MD, Elected to Join Elite Medical Society

Seth Miller, MD

ONS Orthopaedic Surgeon, Seth Miller, MD

At the October Closed Meeting of the American Shoulder and Elbow Surgeons (ASES), held in Pinehurst, NC, ONS (Orthopaedic and Neurosurgery Specialists) orthopedic surgeon Dr. Seth Miller was elected to join the ASES organization.  “Membership in ASES is a privilege and an honor” said Dr. Jim Cunningham, ONS Vice President. Membership in American Shoulder and Elbow Surgeons is by invitation only. Only experienced orthopedic surgeons who have completed a fellowship in shoulder surgery, elbow surgery, and/or sports medicine are considered for membership.

Dr. Miller, in his 25th year in practice at ONS in Greenwich, has ascended quickly in his career being recognized with such a national honor.  Candidates must meet strict academic and clinical requirements to become members of ASES.

“ASES is a remarkable collection of like-minded surgeons, and researchers who, through their collaboration and the sharing of techniques and outcomes, work together to solve the most complicated and pressing shoulder and elbow disorders. Founded on the premise that by such sharing of ideas we can determine the most efficient, cost effective, high quality shoulder and elbow care” said Dr. Robert Bell, ASES President.

The American Shoulder and Elbow Surgeons was created to enhance the study of Conditions_shouldershoulder and elbow surgery and to foster advances in the field, serving as an educational body responsible for scientific programs and advances.  The Mission of the ASES is to support the ethical practice of evidence-based, high quality, cost-effective, shoulder and elbow care.

The society global impact on quality shoulder and elbow care is achieved through leadership, medical education, scientific research, and patient advocacy. Congratulations to Dr. Miller on becoming an Associate Member of the society.

ONS is an advanced multi-specialty orthopedic and neurosurgery practice serving patients throughout Fairfield and Westchester Counties and the New York Metropolitan area. ONS physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, visit www.onsmd.com, or call (203) 869-1145.

Posted in Castle Connolly Top Doctors 2014, Community Outreach, Greenwich community, Greenwich Hospital, Medical, medical expertise, New York Top Doctors, Orthopaedic Conditions, Orthopaedic Research, Shoulder and elbow, Sports Medicine, Surgery | Tagged , , , , , , , , , | Leave a comment

Orthopaedic Surgeon and Sports Medicine Specialist Dr. Demetris Delos on NY Giants Victor Cruz’s Injury

Dr. Delos served as Assistant NFL Team Physician for the New York Football Giants and

Demetris Delos, MD

Demetris Delos, MD

team physician for local high school and college athletes. His practice is focused on sports medicine and arthroscopic treatment of knee and shoulder disorders including knee preservation surgery, shoulder instability and rotator cuff repair. Upon hearing about the NY Giants’ Wide Receiver Victor Cruz’s knee injury, we reached out to Dr. Delos to give us insight on Victor’s type of injury. Dr. Delos said:

“Victor Cruz sustained a devastating injury to his knee last night, an injury that will cost him the rest of the season. While attempting to catch a ball in the end zone, he tore the patellar tendon in his right knee. The patellar tendon is a structure that attaches the kneecap (patella) to the shinbone (tibia). When the patellar tendon is torn, the player cannot straighten (extend) his knee and obviously cannot perform at the high level expected in the NFL.

Patellar tendon ruptures are relatively uncommon injuries that occur in otherwise healthy players without any predisposing factors. The mechanism of injury is typically eccentric overload (forcibly bending the knee while the quadricep is firing).

Studies of NFL players with this injury report that the vast majority are able to return to NFL level play after surgery and extensive rehabilitation. Let’s wish Victor a speedy recovery so we can watch him salsa in the end zone again!”

For more information on knee injuries, visit Our Specialties page.

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ONS SPONSORS NEWS 12 SCHOLAR ATHLETE AWARD

Orthopaedic-NeurosurgerySpecialists

October 2014 – June 2015, NEWS 12 CONNECTICUT will introduce and recognize a local area high school student athlete by featuring the student and their school during the NEWS 12 CONNECTICUT SCHOLAR ATHLETE weekly segment sponsored by ONS. Students who excel in both academics and athletics are nominated by coaches and athletic directors with extracurricular activities and leadership qualities noted. At the end of each academic year, scholarships are awarded to three NEWS 12 CONNECTICUT Scholar Athletes.

 

Watch NEWS 12 CONNECTICUT on Mondays 5 p.m. to midnight to catch the stories of the nominees. Cross-channel airing will run on CNBC, ESPN, ESPN2, MSG-TV, NBCS-TV or visit <NEWS 12 Sports online>.

 

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ONS Physical Therapist, Betsy Kreuter on How Even Men Can Be Diagnosed with Osteoporosis!

Betsy Kreuter, PT, CLT

ONS Physical Therapist Betsy Kreuter, PT, CLT

According to The National Osteoporosis Foundation, as our population ages, even more men will be diagnosed with osteoporosis. As many as one in four men over the age of fifty are more likely to break a bone due to osteoporosis than they are to get prostate cancer. Approximately 2 million American men already have osteoporosis.  About 12 million more are at risk.  Many of the risk factors that put women at risk apply to men as well. For example family history, smoking, drinking too much alcohol, not exercising, taking steroid medicines, and having low testosterone levels are all risk factors for men. Visit the National Osteoporosis Foundation to learn more about men and osteoporosis. 
osteoporosis
There are things you can do to minimize your risk factors for osteoporosis.  Speak to your physical therapist for recommendations on exercises and instructions in proper posture and body mechanics.

To learn more about osteoporosis, bone anatomy, fracture prevention exercises to promote bone health, updates on treatments, measures to promote strong bones and personal risk factors, attend a free health seminar on October 14, 2014 at Greenwich Hospital in the Noble Conference Room.  Orthopedic surgeon Steven Hindman, MD, endocrinologist Renee Ileva, MD and physical therapist Betsy Kreuter, PT, CLT will present a free health seminar and answer questions. For more information and to register visit  https://www.greenhosp.org/CREG/ClassDetails.aspx?sid=1&ClassID=6881

Posted in Community Outreach, Greenwich Hospital, Health Seminar, Management, Medical, ONS physical therapy, Orthopaedic Conditions, Osteoporosis, Uncategorized | Tagged , , , | Leave a comment

ONS Physical Therapist Betsy Kreuter’s P is for Posture When Sitting or During Chores!

OSTEO_graphicMost Americans spend too much time sitting and should take advantage of these tips to help keep good posture.

First, when sitting in a chair make sure your buttocks is all the way to the back of the chair. Using a lumbar roll in the small of your back will help to keep optimal alignment.

Second, if you  sit at a computer, your monitor should be at eye level, feet firmly on floor, hands and wrists in a straight line, shoulders back and elbows at 90 degrees. A break from sitting every 30 minutes will relieve your back of stresses placed on it while sitting. For a more detailed guide to improve seated posture, download Work Station Ergonomics  as a reference.

Posture is equally important when doing chores. While working, make sure your lower back is in a neutral position to avoid a forward curve in your spine. Watching your posture over the years will help avoid vertebral compression fractures due to osteoporosis.

Osteoporosis, or thinning bones, can result in painful fractures. Risk factors for osteoporosisosteoporosis include aging, being female, low body weight, low sex hormones or menopause, smoking, and some medications.

To learn more about osteoporosis, bone anatomy, fracture prevention exercises to promote bone health, updates on treatments, measures to promote strong bones and personal risk factors, register to attend a free health seminar on October 14, 2014 at Greenwich Hospital in the Noble Conference Room.  The panel of speaker include ONS Orthopedic Surgeon Steven Hindman, MD, Greenwich Hospital Endocrinologist Renee Ileva, MD and ONS Physical Therapist Betsy Kreuter, PT, CLT . After the seminar you will be able to ask the doctors and therapist questions.

Posted in Community Outreach, Greenwich community, Greenwich Hospital, Greenwich Hosptial, Health Seminar, Management, Medical, medical expertise, News and Announcements, ONS physical therapy, ONS Surgical Team, Orthopaedic Conditions, Orthopaedic Research, Orthopedics, Osteoporosis, Uncategorized | Tagged , , , , , , , , , , , | Leave a comment