OCIF Now Accepting Applications for $20,000 Grant

2015chipinforcharityblackThe Orthopedic Center of Illinois Foundation (OCIF) is now accepting applications from Springfield-area non-profit groups to receive a $20,000 grant from proceeds of the 12th Annual Chip in Fore Charity golf outing, scheduled for September 21, 2015. Interested groups should return a completed application and accompanying materials by Friday, June 12th.

Past grant winners:

  • 2004 – Central Illinois Foodbank
  • 2005 – Boys and Girls Club of Springfield
  • 2006 – Contact Ministries
  • 2007 – Southwind Park
  • 2008 – Big Brothers Big Sisters
  • 2009 – Sangamon County Child Advocacy Center
  • 2010 – Springfield YMCA
  • 2011 – Camp Care-A-Lot
  • 2012 – Springfield Sharefest
  • 2013 – genHkids
  • 2014 – Illinois Senior Olympics/Senior Services of Central Illinois

Date to remember:

  • Friday, June 12th: Completed grant applications due.
  • Friday, July 10th: Grant winner announced.
  • Monday, Sept. 21st: 12 Annual OCIF Open: Chip in fore Charity.

OCIF was formed in April of 2005  to support projects promoting patient education, continuing medical education, and regional charitable organizations. Funding is secured through charitable gifts, donations and grants. The Foundation partners with donors to strengthen and support health and fitness in meeting the medical needs of the community, and has awarded community impact grants totaling $205,000. Find out more on the Foundation website.

OCI Named “Good As Gold”

TAV Good As Gold 1 wb

Dr. Tim VanFleet accepted the Good as Gold award on behalf of the OCI Board of Directors April 15.

For the second year in a row, OCI was named “Good as Gold” by the University of Illinois Springfield, the Junior League of Springfield and the United Way of Central Illinois! The Good as Gold ceremony, held on April 15, 2015, recognized community volunteers and organizations who improve Springfield through volunteering their time and financially supporting programs that make an Good AS Gold Cert 1 wbimpact in the community. Thank you to the presenters and the hard work of the Good as Gold committee for a lovely event!



Solutions for Pain from Pedaling

By Theresa Delvo, Physical Therapist
Director of Therapy, Midwest Rehab at OCI

MWR PhotoThe snow has melted, the temperatures are rising and many of us are ready to get on our bikes and go for a long ride. Whether you’re an experienced cyclist, or just going out for a leisurely ride, below are a few hints in preventing injuries while riding.

Bike Fit

  • Keep a controlled but relaxed grip of the handlebars.
  • Change your hand position on the handlebars frequently for upper body comfort.
  • When pedaling, your knee should be slightly bent at the bottom of the pedal stroke.
  • Avoid rocking your hips while pedaling

Patellofemoral pain syndrome (PFPS)
One of the most common types of injuries particularly among athletes, active teenagers, and older adults is Patellofemoral pain syndrome (PFPS), which refers to pain at the front of the knee, in and around the kneecap or patella. It often occurs in people who are physically active or who have suddenly increased their level of activity, especially when that activity involves repeated knee motion– running, stair climbing, squatting, and cycling.

Patellofemoral pain affects more women than men and accounts for 20%-25% of all reported knee pain. Current research indicates the PFPS is an “overuse syndrome,” which means that it may result from repetitive or excessive use of the knee. Other contributing causes may include weakness, tightness, or stiffness in the muscles around the knee and/or an abnormality in the way the lower leg lines up with the hip, knee, and foot.

These conditions can interfere with the ability of the patella to glide smoothly on the femur (the bone that connects the knee to the hip) during movement. The friction between the under-surface of the patella and the femur causes the pain and irritation commonly seen in PFPS. Usually, patellofemoral pain is worse when you walk up or down hills or stairs and on uneven surfaces. This pain tends to increase with activity and improve with rest.

Common Problems
Anterior (Front) Knee Pain: Possible causes are having a seat or saddle that is too low, pedaling at a low cadence (speed), using your quadriceps muscles too much in pedaling, misaligned bicycle cleat for those who use clipless pedals, and muscle imbalance in your legs (strong quadriceps and weak hamstrings).

  • Neck Pain: Possible causes include poor handlebar or saddle position. A poorly placed handlebar might be too low, at too great a reach, or at too short a reach. A saddle with excessive downward tilt can be a source of neck pain.
  • Lower Back Pain: Possible causes include inflexible hamstrings, low cadence, using your quadriceps muscles too much in pedaling, poor back strength, and too-long or too-low handlebars.
  • Hamstring Tendinitis: Possible causes are inflexible hamstrings, high saddle, misaligned bicycle cleat, and poor hamstring strength.
  • Hand Numbness or Pain: Possible causes are short-reach handlebars, poorly placed brake levers, and a downward tilt of the saddle.
  • Foot Numbness or Pain: Possible causes are using quadriceps muscles too much in pedaling, low cadence, faulty foot mechanics, and misaligned bicycle cleat.
  • Iliotibial Band Syndrome (ITBS): Possible causes are too-high saddle, leg length difference, and misaligned bicycle cleat for those who use clipless pedals.

How a Physical Therapist Can Help
Your physical therapist will perform a series of tests to evaluate the knee, check flexibility of the muscles in your leg, observe the alignment of your feet, analyze your walking patterns and test the strength of your hip, thigh and core muscles to find out if there is a weakness or imbalance that might be contributing to your pain. After performing a series of tests to evaluate the knee, your PT will analyze, and prescribe an exercise program just for you.

Your individual program may include:

  • Strengthening exercises targeted at the hip (specifically, the abductor and rotator muscles of the buttock and thigh), the knee (specifically, the quadriceps femoris muscle, which is located on the front of your thigh and straightens your knee), the ankle and core.
  • Stretching exercises for the muscles of the hip, knee, and ankle.
  • Taping of the patella to reduce pain and retrain muscles to work efficiently.
  • Exercises for improving your performance of activities that have become difficult for you.
  • If the alignment and position of your foot and arch appear to be contributing to your knee pain, they may suggest a special shoe insert called an orthosis. The orthosis can decrease the stress to your knee caused by excessive rotation or impact during walking and running.
  • Recommend that you apply ice or heat for relief

Your physical therapist will work with you to help you stay active and maintain your fitness level. You may need to modify your activity level or change your training activities until you recover; your therapist will show you how to do activities and exercises that will not increase your pain. Most importantly, your therapist can make recommendations to help prevent PFPS from returning.

If you have any questions about the information in this article or would like to talk with a therapist about your exercise routine, we can help. Call Midwest Rehab today to set up a consultation: (217) 547-9108.

Osteoporosis: Diagnosis and Treatment

May is Osteoporosis Prevention Month and a great time to become proactive about your bone health.

By Kari Senica, M.D.osteoporosis-bone

Osteoporosis is a bone disease characterized by low bone mass, deterioration of bone tissue, and disruption of bone architecture, compromising bone strength and increasing the risk of fracture.

It is estimated by the National Osteoporosis Foundation that approximately 9.9 million Americans have osteoporosis and an additional 43 million have low bone density. About one out of every two Caucasian women will experience an osteoporosis -related fracture at some point in their lifetime.

Fractures and their complications are the relevant clinical consequences of osteoporosis. The most common fractures are those of the vertebrae (spine), hip, and wrist.

By definition, any adult over 50 who sustains a fracture of the spine, hip, shoulder or wrist from a low energy trauma (a fall from a standing height) is considered to have osteoporosis. The diagnosis of osteoporosis can also be established by measurement of bone mineral density (BMD).

If you have sustained one of these fractures, you will need further workup with a bone mineral density test and appropriate lab work. There are also several recommendations for all patients to preserve bone strength including adequate intake of calcium and vitamin D, lifelong participation in regular weight-bearing and muscle-strengthening exercise, smoking cessation, avoiding excessive alcohol intake and preventing falls.

Only 23% of women over the age of 67 who have sustained an osteoporosis-related fracture receive a BMD test or take medication to treat osteoporosis. We don’t want you to become a statistic. We can help. Schedule a consultation or your BMD test today by calling (217) 547-9100.

Community Education: “Advances in Arthroscopic Rotator Cuff Repair”

RonRomanelli copyJoin orthopedic surgeon Ron Romanelli, M.D., for a free seminar to learn about leading-edge approaches and technology for treating shoulder pain and weakness. Discussion will include shoulder mechanics, diagnosis, refined surgical techniques and expected outcomes.

Wednesday, April 22 • 6:00-7:00 p.m.
Location: Orthopedic Center of Illinois
1301 S. Koke Mill Road, Springfield

Light refreshments provided. Reserve your seat today! Call (217) 547-9224.

Minimally Invasive Treatment of Sciatica

By Joseph Williams, M.D.
Board Certified Orthopedic Surgeon
Orthopedic Center of Illinois

Sciatica is a term that is commonly used to describe the pain an individual has radiating down an extremity. Patients will come to the office with complaints of severe pain down one leg or, less commonly, down both legs. The term is often overused and not all cases of self-diagnosed “sciatica” are actually correct.

sciatic anatomy

Sciatic nerve anatomy.

The sciatic nerve is the largest nerve in the lower body. It is made up of multiple nerve roots that originate in the low back, the lumbar spine and sacral spine. These nerve roots join together within the pelvis and form the sciatic nerve.   This nerve then travels down the back of the leg innervating the muscles and providing sensation to the leg.

Sciatica is typically the term used to describe pain that one experiences in a leg, however, there is usually numbness or tingling and possibly weakness occurring as well.  As stated previously, the sciatic nerve provides innervation to multiple muscles in the leg and also sensation to specific locations of the leg. Thus, if there is enough dysfunction within the sciatic nerve, the person could very well experience more than just pain.

graphic disc herniation

A bulging disc pressed on the sciatic nerve.

The most common cause of sciatica pain is compression of one of the nerve roots that makes up the sciatic nerve. This compression is usually in the form of a disc herniation in the lower lumbar spine, typically, at the L4 – L5 disc or the L5 – S1 disc. These herniations protrude into the spinal canal and compress the nerve roots before they exit the spine and travel into the pelvis.  This compression of the nerve root will then initiate an inflammatory reaction. The nerve will swell, and the patient will experience immediate pain. As the inflammation grows, the pain will become more intense. Thus, the source of the pain is usually in a nerve root before it actually combines to help form the actual sciatic nerve.

Another group of people will experience sciatica pain not as a result of an acute disc herniation, but rather a chronic condition called disc degeneration.  These people are often older, and the pain may develop more slowly. The degenerative condition will cause collapse and bulging of the disc and ultimately result in a gradual narrowing of the spinal canal. The specific location of this narrowing is within the lateral recess, or the periphery of the canal. As this narrowing becomes more severe, the nerve root or roots will become compressed within the canal.  Again, the inflammatory cascade is initiated, causing the nerve to swell and pain to occur.

There are a variety of ways to treat sciatica, and the treatment depends on the cause.  A thorough physical exam needs to be performed in order to help determine the diagnosis. Typically, the treatment is initiated with a regimen of oral medications.  These medications can include non-steroidal medication, muscle relaxers and pain medications. In some cases, an oral dose of steroids is provided. In addition to medication, activity modifications are commonly required. The patient will receive instructions to refrain from any strenuous activities, including work related-activities and some hobbies.

If symptoms are poorly controlled with limited activity and/or medication, symptoms are worsening, or a physical exam warrants next steps, an MRI of the lumbar spine will be required. The timing of this MRI is somewhat controversial, because a significant number of sciatica cases will actually resolve with these simple treatments and time.  Those patients who experience symptoms and who do not respond to medication and rest may require further diagnostic workup. An MRI is always needed in the face of progressive weakness.

Typically, every effort should be given to first pursue the least invasive options. However, once a successful MRI has been obtained, another set of treatment options becomes available, including epidural steroid injections and possible surgical interventions. The epidural steroid injection is often times the first line of treatment for patients who do not get resolution with medications and activity modifications.  Epidural steroid injections are common and place steroid solution at the nerve root responsible for the pain symptoms. They are performed in a operating room with the use of X-Ray. The actual technique can often be performed in a matter of minutes, and they are low risk compared to other treatment options. Up to three injections can be performed in a twelve month period. Injections are a great option for those patients that do not wish to pursue a surgical option or individuals with medical problems that preclude a surgical procedure.

The last option for a patient with sciatic pain would be surgical intervention, and can be accomplished with minimally invasive techniques. The mainstay of surgical treatment for both disc herniation and/or a degenerative bone spur will involve a laminotomy. A laminotomy is a surgical procedure that involves removal of a small portion of the bone. It is a safe procedure, and the most common procedure performed on the spine. There are minimally invasive techniques that can be utilized that can decrease the pain associated with the procedure and offer quicker recoveries.

A patient with a disc herniation will undergo a laminotomy and removal of the disc herniation. Again, this surgery is done as an outpatient procedure—meaning the patient will not need to stay in the hospital. Typically, patients do not receive any formal physical therapy after the procedure. However, they are commonly restricted in their activities for a total of six weeks postoperatively. These restrictions can include limitations as to the amount of weight they can pick up and avoidance of strenuous activities including repetitive bending, lifting and twisting. These restrictions are required to avoid another disc herniation from occurring. Surgical results are often very successful and predictable. Often times, patients will have some tingling in the extremity that improves with time, and usually experience almost complete relief of the pain in the extremity. Symptoms can fully resolve with time as the nerve heals.

Sciatic nerve pain is a very common and debilitating condition. However, with proper diagnostic workup, successful treatment is possible. Typically, treatment starts with nonsurgical options. However, if this approach is unsuccessful, epidural steroid injections and possibly surgery are often utilized to resolve symptoms and return the patient to a pain free lifestyle. If you are experiencing the symptoms explained in this article, please do not hesitate to call our office and schedule a consultation. Our physicians want you to live pain free and can help you get the relief you need.

This article was published in the April-June 2015 edition of ”FYI from OCI”, a quarterly publication created by the Orthopedic Center of Illinois. To see the full publication, click HERE.