Tag Archive: orthopedic surgery

What is Turf Toe and How is it Treated?

A turf toe is a sprain of the big toe’s main joint. This injury occurs when the big toe is forcibly bent upward, which is referred to as hyperextension. This can occur when pushing off into a sprint from the turf and having the toe get stuck flat on the ground.

Who gets turf toe?

Sprains of the big toe are prevalent among football players who play on artificial turf. Artificial turf is a harder surface than grass, and there is no “give” when force is placed upon it.canstockphoto12027384

Which toe structures are affected with turf toe?

The big toe has two joints. The largest joint of the toe is called the metatarsophalangeal joint (MTP). The MTP is where the first long bone of the foot (metatarsal) meets the bone of the toe (phalanx). With turf toe, the MTP joint is injured. The joint has many structures that form the plantar complex. These include:

  • Plantar plate – Thick fibrous tissue lying beneath the MTP joint. This prevents the big toe from bending too much.
  • Flexor hallucis brevis – Attaching to the toe bone, this is the tendon that runs under the first metatarsal bone. This structure provides stability and strength of the big toe.
  • Collateral ligaments – These are located on each side of the toe, and they connect to the metatarsal bone to the phalanx bone. These structures prevent the toe from going too far to either side.
  • Sesamoid bones – These two small bones are surrounded by the flexor hallucis tendon, and they help the toe move easily, provide stability to the MTP joint, and assist with weight-bearing on the forefoot.

How common is turf toe?

In a study of NCAA football players, the incidence of turf toe injuries was 0.062 per 1,000 athlete exposures. Football players were 14 times more likely to sustain a turf toe injury during games than during practice. Less than 2% of these injuries require surgical intervention.

How is turf toe diagnosed?

Turf toe is diagnosed based on symptoms, physical examination, and x-rays. To help the doctor devise a canstockphoto7107950treatment plan, the injury is graded from 1 to 3.

  • Grade 1 – The plantar complex is stretched causing slight swelling and tenderness.
  • Grade 2 – There is partial tearing of the plantar complex causing tenderness, swelling, and bruising.
  • Grade 3 – There is complete tearing of the plantar complex causing severe tenderness, swelling, and bruising.

During the exam, the doctor checks for range of motion, as well as swelling and bruising. The doctor will order x-rays to visualize the bones, and magnetic resonance imaging (MRI) scans for viewing soft tissues and cartilage.

What causes turf toe?

Turf toe occurs when the forefoot is fixed on the grown with the heel raised, and a force pushes the big toe into a hyperextended state. This injury can also occur during a forceful tackle.

How is grade 1 turf toe treated?

The RICE protocol is first-line treatment for grade 1 turf toe injuries. This includes:

  • Rest – Taking a break from sporting activities, avoiding walking, and not bearing weight on the affected toe.
  • Ice – Use of ice packs for 20-minute intervals several times each day.
  • Compression – Wearing an elastic compression bandage.
  • Elevation – Elevating the affected toe to decrease swelling.

In addition, taping the big toe to other toes (buddy taping) will restrict motion and improve healing. Nonsteroidal integrity-fracture-walkeranti-inflammatory drugs (NSAIDs) are used to reduce swelling and relieve pain. The athlete should use orthotics when returning to activity, such as a phraphite shoe insert with a stiff forefoot component.

How are grade 2 turf toe injuries treated?

For grade 2 injuries, the MTP joint is kept immobilized, and a walking boot is used for 7-14 days. For most athletes, a full 2 weeks of rest is recommended before returning to activity.

How is grade 3 turf toe treated?

For severe MTP joint injuries, the toe is immobilized for 3-4 weeks. The athlete uses a walking boot or cast that keeps the big toe in a downward position. Physical therapy is used to stretch and strengthen the big toe and to prevent joint stiffness.

Is surgery required for turf toe?

Surgery is required for:

  • Severe tearing of the plantar complex
  • Vertical instability of the MTP joint
  • Loose bone chips of the joint
  • Fracture of the sesamoid bone
  • Damage to the joint cartilage
  • New or worsening bunion

OSPI offers the top sports medicine orthopedic treatment in Arizona. The Gilbert orthopedic surgeons are experts in both the nonoperative and operative treatment of injuries such as turf toe. Most insurance is accepted, call today!


George E, Harris AH, Dragoo JL, & Hunt KJ (2014). Incidence and risk factors for turf toe injuries in intercollegiate football: data from the national collegiate athletic association injury surveillance system. Foot Ankle Int, 35(2):108-15. doi: 10.1177/1071100713514038.

How can you empower your health resolutions this New Year?

Health is wealth and everything else in the world from money to career and family or even a car nothing is so precious than your health. If you do not have a good health then how can enjoy the world around you. For people who are suffering from chronic pains they also have the right to spend their life normally.

Health is the one thing we cannot live without. This is one of the core aspects where people have to constantly monitor to make sure that they enjoy a better life.

Here is some of the best health resolution for those, who want to grow fit by the end of this year :


Health is wealth

We are not just saying about those common free hand exercises. We are asking people to join yoga classes or take up gym sessions in the normal routine of their life. There is a necessity of the exercise to combat various types of pain condition and tougher part is to accept that exercise is not going to bring out results if you are going to do it in fits and starts.
Stop giving lame excuses for not going for exercise or gyms and yoga. The exercise is the store house of benefits such as feeling better, reduce stress, reduces the pain and slow the cause of various diseases if you miss a day or two from exercise, make sure you join it from the third day.

Stop smoking

stop smoking

Well the biggest health resolution for the smokers would be to quit their smoking habits. There is a known link between smoking and cancer and various other diseases targeting your lungs, heart and other body parts. If you are suffering from back pain and if you are a smoker, then you need to know two things –


  • Smoking is going to worsen your back and neck pain
  • Some back pain surgeons may even refuse to operate on your back if you are a smoker as smoking reduces the body’s ability to heal after the surgery

Talk to the physician about the various smoking cessation like gums, patches and oral medication to stop smoking for the beginning of this year.

Cut the clutter

mental health

It is time to get organized to a greater level. Stress is one of the contributing factors that have misled your life to clutters. If you want to stop the trigger like stress to reduce your back pain, then become organized in your home and outside world and do everything systematically.


All of the three resolution stated above is no doubt very common but for the back pain sufferer it is the Holy Grail. The good news is that despite all these physical support you will also get productive treatment from the best pain management clinics. You will draw out physical, mental and emotional health benefits following these three resolutions this year in 2016.

Therefore, it is better to start early. With the starting of the first month of 2016, get down to work soon and reduce your chronic pains.

Carpal Tunnel Release Surgery with a Gilbert Hand Surgeon

Carpal tunnel release surgery is only considered for patients who do not get relief of symptoms from nonsurgical measures. This procedure is done on an outpatient basis for most patients.

Why is carpal tunnel release surgery done?

Carpal tunnel syndrome (CTS) occurs when the tissues (synovium) around the flexor tendons and median nerve swell and cause pressure. These synovial tissues lubricate the tendons so the fingers can move easily. Over time, this swelling narrows the small space of the carpal tunnel and crowds the nerve.carpal tunnel horizontal wrist photo

Who is a candidate for carpal tunnel release surgery?

Candidates for carpal tunnel release surgery include those who:

  • Do not respond to conservative treatment (physical therapy and medications).
  • Have constant numbness and wasting of the thumb muscles.

How do I prepare for the surgery?

Before you undergo carpal tunnel release surgery, notify the doctor of all medicines you are taking. Certain blood-thinning agents must be held for 7 days before the scheduled procedure. Arrange for someone to drive you from the hospital, and do not eat or drink for 8 hours before the surgery.

Will I be given anesthesia?

The outpatient procedure only takes around 60 minutes. Before the surgery, you are given general anesthesia (put to sleep), which prevents pain and movement during the surgery.

How is carpal tunnel release performed?

There are two ways to perform the procedure:

  • Open carpal tunnel release – The surgeon will use a needle to administer a local anesthetic. A small cut icarpal tunnel anatomy pictures made in your palm, and the surgeon divides the transverse carpal ligament (roof of the carpal tunnel). A ligament is also cut from inside the carpal tunnel to speed up recovery, and tissue around the nerve is removed.
  • Endoscopic carpal tunnel release – With this procedure, the surgeon makes a small cut in the palm region of the hand, and inserts a small endoscope into the wrist. This tube has an attached camera and light so the surgeon can view images on a monitor. Small tools are inserted so the surgeon can cut the carpal ligament.

What is involved in the recovery process?

Immediately after surgery, you must frequently elevate your hand on pillows to reduce swelling and prevent stiffness. Some pain, stiffness, and swelling can be expected after the procedure. You are required to wear a wrist brace for 2-3 weeks, and you can use your hand normally.

Expect some soreness of the palm for several weeks, as well as pinching and griping weakness (will last for around 6 months). In addition, light gripping and lifting, self-care activities, and driving are permitted soon after the procedure.

What are the long-term outcomes of the procedure?

The majority of people’s symptoms improve after carpal tunnel release surgery. However, recovery is gradual. On the average, pinch and grip strength returns by the second month following the procedure. For optional recovery, physical therapy is prescribed.

What are the home care instructions?

It will take around 4 weeks to fully recover. For a full recovery, the patient should:

  • Take medications as prescribed.
  • Apply ice packs to the wrist and hand every few hours.
  • Avoid lifting heavy objects.
  • Elevate the hand and wrist frequently.

What are the risks and complications of the carpal tunnel release procedure?

All surgeries carry some risks. With carpal tunnel release surgery, risks include infection, nerve damage, bleeding, and allergic reaction to solutions and medications. Be sure to notify the Gilbert orthopedic doctor if you experience intense pain, fever, chills, unusual redness or swelling, chest pain, and/or shortness of breath.

At OSPI, top hand surgeons offer carpal tunnel release procedures for the entire East Valley including Chandler, Gilbert, Mesa and surrounding areas. Most insurance is accepted, and appointments are readily available. Call today for the top hand surgeons Arizona trusts!

What Are The Treatment Options For Frozen Shoulder?

A disorder characterized by pain, loss of motion/or stiffness in the shoulder, is known as frozen shoulder. The disorder affects about 2% of the general population, which means that it’s not that common but you can still suffer from it. Research done on the disorder shows that, women who are between the ages of 40 to 70 years old are generally more affected than other age groups or gender, although men can also develop the disorder.Shoulder pain

What are the Risks of Frozen Shoulder?

People who have been diagnosed with diabetes are at much higher risk of developing the disorder. In fact nearly 10% to 20% of such individuals develop frozen shoulder at some point in their lives. Some other medical conditions that increase the chances of developing the disorder are:

  • Hypothyroidism
  • Hyperthyroidism
  • Parkinson’s Disease
  • Cardiac Disease or Surgery

What Are The Symptoms of Frozen Shoulder?

The pain that is experienced by sufferers of this disorder is usually aching and dull, as compared to other joint injuries, although attempted motion can make the pain worse. The outer shoulder areas as well as the upper arm are the main locations when it comes to pain points, but a restricted shoulder motion and stiffness should also raise alarm bells about the possibility of the disorder.

According to most physicians, the normal course of a frozen shoulder can be described in 3 stages:

Stage 1: This is known as the ‘freezing stage’ and is known to last as long as 6 weeks to 9 months, depending on the nature of the injury. In this stage, the patient experiences a slow but gradual onset of pain, which worsens and results in the shoulder losing all motion.

Stage 2: The ‘frozen stage’ is characterized by a slow improvement in pain, although the stiffness of the shoulder still remains. This stage lasts for over 4 to 9 months.

Stage 3: This is the final stage, i.e. ‘thawing’ when motion in the shoulder returns back slowly towards its normal state. The thawing stage generally takes about 5 to 26 months to complete.

What Are The Treatment Options For Frozen Shoulder?

While the disorder can be effectively treated with the help of physical therapy and anti-inflammatory medicines, in extreme cases of the disorder, surgical intervention is needed when the pain doesn’t subside and/or shoulder motion doesn’t return to its normal course.Shoulder Arthroscopy

The surgery that is done to treat frozen shoulder effectively, aims at releasing or stretching the contracted joint capsule in the shoulder. Commonly tried methods are;

Shoulder Arthroscopy: In this, the orthopedic surgeon makes small cuts or incisions around the shoulder. With the help of a small camera and instruments attached to an arthroscopic device, the insides of the shoulder and the joint capsule are examined and operated upon.

Manipulation under Anesthesia: In this method, the surgeon gives the patient anesthesia and then manipulates the defected shoulder, i.e. forces it to move.

Of course, your designated Gilbert orthopedic surgeon will take you through the entire process and inform of the risks involved, before conducting the surgery which will make it easier for you to make the right decision.

OSPI is the top orthopedic practice in the East Valley serving Gilbert, Chandler, Mesa, Queen Creek, Maricopa and Casa Grande. There is also a physical therapy department, chiropractic, massage therapy and CrossFit too! Call (480) 899-4333 to receive treatment.