Thursday, 17 of January of 2019

Category » Orthopedic Injury

Running Injuries – How To Treat & Prevent Them



shutterstock_110884610Running is a popular exercise these days that offers many benefits, from physical fitness to cardiovascular health. But it also puts runners at risk for orthopedic injuries that can range from bothersome to debilitating. What are some of the most common concerns?

  • Shin splints (pain that runs down the front or inside of the lower leg)
  • Stress fractures (tiny cracks in the leg bone)
  • Achilles tendinitis (inflammation in the tendon that attaches the calf to the heel)
  • Muscle strains or tears (hamstrings, quadriceps, calf and groin muscles)
  • Illotibial band syndrome (inflammation of the ligament that runs from the knee to the hip)
  • Plantar fasciitis (inflammation of the tissue on the bottom of the foot, from heel to toes)
  • Ankle sprains (stretching or tearing of the ligaments around the ankle)

Ankle sprains are one of the most common injuries for all sports, including running, says the National Athletic Trainers’ Association (NATA). A recent article in the New York Times reported on a NATA study that suggests “ankle injuries are often mistreated or not treated at all and should not be taken more seriously to prevent re-injury, prolonged discomfort, chronic ankle instability and greater risk of early arthritis in the ankle.”

How are ankle sprains best treated? The study recommends never walking on a sprained ankle or ignoring the pain. Instead, ice it right away.  Wrap the ankle in a compression bandage, prop it up and apply cold pack for 10 to 20 minutes at a time.  Go ahead and take an over-the-counter pain medicine, such as acetaminophen, but wait a day or two to begin taking anti-inflammatory medications such as ibuprofens.  Initial swelling is part of the body’s healing process, but after 48 hours, you’ll want to prevent the swelling from getting any worse.

Although X-rays are typically taken at the ER or a doctor’s office, the study suggests that a medical professional can usually diagnose an ankle sprain based on guidelines such as deformity, swelling, tenderness and inability to bear weight. Once the initial acute phase is over, “functional rehab” is recommended to help prevent re-injury. That means doing exercises that help strengthen the ankle and improve balance and flexibility.

Here are some suggestions for runners to help prevent injuries of all kinds, including ankle sprains. Warm-up and stretch before going for a run. Vary your fitness routine so you’re not running every day. Select a course that has a flat, smooth surface (be careful of running on the beach and sidewalk, which are uneven) and wear appropriate athletic shoes that fit well and are made for running.

For more information about ankle sprains or other orthopedic-related injuries, go to or call Dr. John Kagan at 239.936.6778.

Orthopedic Conditions Specific to Women




shutterstock_107013878 copyIn honor of Mother’s Day this Sunday, May 12, Dr. John Kagan and his staff join families everywhere in recognizing and appreciating the vital role mothers play in our lives. It’s also the perfect time to discuss the type of orthopedic injuries that women are more at risk for than men, primarily due to biomechanical and structural differences.

According to the American Academy of Orthopedic Surgeons, studies show women have a greater tendency to develop ACL injuries, patellofemoral pain syndrome,  also called runner’s knee, as well as stress fractures. In addition, women are at higher risk for hip fractures with advancing age. Here’s an overview of each of these conditions.

The ACL is a rubber-band like connecting tissue that attaches the bone in the upper leg (the femur) with the bone in the lower leg (the tibia). The ACL stabilizes the knee. Women athletes tend to have more ACL injuries primarily because they put greater stress on their knee due to several factors – their knees more frequently  “turn in” toward the body than men; women tend to jump and run with the feet in a more rigid position; and they bend their knees less when jumping and landing.

Patellofemoral pain in the knee usually occurs at the front of the knee, with women complaining of burning or aching especially when bending, squatting, running or climbing stairs. Like ACL pain, this condition is also related to structural differences in women’s bodies, such as greater pelvis width and muscle imbalances or misalignment.

Stress fractures are usually related to overuse but may also be a consequence of poor bone density. The AAOS reports that a stress fracture occurs when the muscles become over-fatigued and transfer the stress to the bone, which can cause tiny cracks in the bone. Most stress fractures occur in the lower leg or foot. Athletic activities in which the foot continually strikes the ground, such as running, tennis, basketball and gymnastics place women at higher risk for stress fractures.

Hip fractures are a serious concern for the elderly, in particular women age 80 and over. According to the Mayo Clinic, menopause can accelerate bone loss, increasing the risk of weak, brittle bones. Muscle mass also decreases with.

The best prevention for sports injuries is to avoid overdoing it. If pain develops, take a break from the activity and ice the injury.  If pain persists, call the doctor for an evaluation to prevent chronic, long-term problems. Proper training and strengthening exercises can be beneficial in correcting imbalances.

To keep bones healthy no matter what your age, the best prevention is to stay active, eat a healthy diet and continue to exercise appropriately.

For more information about orthopedic-related injuries and the treatment options, go to 

PRP Therapy: What is it and does it work?





Platelet-Rich Plasma, better known as PRP Therapy, is a new cutting-edge treatment designed to accelerate healing and relieve the pain of orthopedic injuries without the need for surgery.

Although some medical experts still consider the procedure controversial, PRP therapy is a widely used procedure in major medical centers and orthopedic practices around the country. Here in the Fort Myers area, Dr. Kagan offers it as a safe alternative nonsurgical treatment for a range of conditions, from sports-related overuse injuries to chronic degenerative joint pain from early-stage osteoarthritis.

What exactly is PRP?

A small amount of the patient’s own blood is drawn and placed into a centrifuge, a laboratory device that rapidly spins the blood fast enough to separate out the various components, including the platelets. The platelets, which have growth factors that promote healing and tissue regeneration, are mixed with the plasma, and then injected back into the patient directly into the injury site.

How quickly does the therapy work? 

Most people find that within three months they have marked improvement, although some may require more than one treatment. The idea behind PRP is that by injecting platelet-rich plasma into the damaged tissue, it will encourage the body’s own natural healing process for a faster recovery.

PRP therapy does not “grow” new cartilage, but it does reduce inflammation and speed up healing. Because the patient’s own blood is used, there is no concern about the body reacting to a foreign substance or the potential for negative side-effects.

PRP therapy is considered an “orthobiologic,” a treatment that the American Academy of Orthopedic Surgeons defines as a “product made from substances that are naturally found in your body. “ When used in higher concentrations than normal, these substances may heal damaged tissue faster.

A number of well-known athletes, including golfer Tiger Woods, Pittsburgh Steeler Hines Ward and Baltimore Ravens Chris Canty, have used PRP therapy to help get them recover from sports injuries and get back in the game faster.

For more information about PRP therapy or other nonsurgical treatments offered by Dr. John Kagan, go to

7 Tips For Avoiding Overuse Injuries and Joint Pain



runner trainingWith our beautiful spring weather, everyone is outside enjoying the sunshine before it gets too hot here in Southwest Florida. But it’s important to remember not to do too much too soon or the nagging pain from an overuse injury will stop you from having fun.

An overuse injury simply means you’ve overworked your arm, shoulder, knee or hip, stretching the muscles, ligaments or tendons beyond their capability. The American Orthopaedic Society for Sports Medicine  says overuse injuries are often subtle, occur gradually over time and are the result of repetitive micro-trauma to the tissue. The symptoms are a nagging pain, tenderness and stiffness.

Here are seven tips from the experts for avoiding overuse injuries this spring:

  1. Cross-train: Participating in just one type of sports activity every day can increase your risk of overdoing it. It’s better to work different muscles groups on occasion. If you run, balance it with strength training or stretching classes.
  2. Know your limits: Don’t overdo it. Working through pain is never a good idea, it simply increases your potential for getting injured. Listen to your body and know when it’s time to stop.
  3. Use proper technique: Get tips from a pro or take a lesson to make sure your technique and body alignment are correct.
  4. Wear the right type of athletic shoe to support your feet.
  5. Be sure to warm up and cool down.
  6. Don’t take on too much, too quickly. Use common sense when training or taking on a new sports activity.
  7. If you’ve returning your fitness routine or sport after injury, begin slowly and pace yourself to avoid re-injury.

Many medical experts recommend an overall fitness program that incorporates range of motion exercises to increase the flexibility of your joints; strengthening exercises to build strong muscles to support and protect the joint; and aerobic exercise to build heart health, control weight and increase your stamina.

Minor aches and pains from overuse can be handled with rest, ice and over-the-counter anti-inflammatory medications. But anything more serious may need medical evaluation. Learn more about how orthopedic surgeon such as Dr. John Kagan can help at or contact us at 239-936-6778.

Meniscus Tears of the Knee




Meniscus Tear 1Meniscus tears of the knee are a common orthopedic injury for people of any age. In younger adults, it’s often related to sports. A sudden twisting, turning or forceful squatting can cause a tear. Even the repetitive pounding the knee takes during jogging can increase the risk for this type of injury.

In older adults, a meniscus tear is usually related to degenerative disease. As the cartilage thins out and weakens, it can rip. Something as simple as stepping off the curb the wrong way or twisting when getting up from a chair can tear the tissue. Without treatment, a piece of meniscus could come loose and drift into the joint, causing pain and swelling and making it difficult to bend and move the knee.

Years ago, treating a meniscus tear required a two-to-three inch incision to repair the tissue and a two or three day hospital stay. Today, the procedure of choice is minimally invasive arthroscopic surgery, in which a small endoscopic tube is inserted through a half-inch incision. Patients go home the same day. Recovery is quick and pain is minimal.

What does the treatment involve? Surgeons can remove fragments of torn tissue, trim and smooth rough edges and use sutures to stitch the torn pieces back together.  The type of treatment best for your situation will depend on the size, location and type of tear.

How do you know if you have a meniscus tear?  Symptoms include a dull ache, swelling, tenderness, sensations such as locking, popping or catching, as well as difficulty bearing weight on the knee and limited range of motion.

Seek advice from an experienced orthopedic surgeon if you have lingering knee pain and problems walking. For more information about meniscus tears or other common orthopedic conditions, go to

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