Thursday, 17 of January of 2019

Tag » orthopedic injuries

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.

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

NSAIDs for Joint Pain

NSAIDs or non-steroidal inflammatory drugs are the number one choice for everything from headaches, colds, muscle aches and stiffness to minor orthopedic injuries like a sprained ankle or pulled muscle.

According to the American Academy of Orthopedic Surgeons, NSAIDs are also the most commonly prescribed medication for joint pain related to osteoarthritis in the hip, knee, elbow and shoulder.

Chances are that at some point in your life, you’ve benefited from taking an NSAID, which includes the familiar list found in most people’s medicine cabinets: aspirin, ibuprofen, Motrin, Advil and Aleve, all of which are available over the counter without a doctor’s prescription. Relafen, Celebrex and Naproxen are also NSAIDs, but require a doctor’s prescription.

How NSAIDs Work For Joint Pain

NSAIDs relieve pain and discomfort, lower fevers and reduce inflammation, which is why they are so effective for joint pain caused by osteoarthritis, a degenerative inflammatory disease that breaks down the cartilage cushioning the bones.

More specifically, NSAIDs block an enzyme called clocooxygenase or COX from being released by the body. There are two forms of COX: COX-1 helps maintain kidney function and protects the lining of the stomach from stomach acid, while COX-2 is produced when joints are injured or inflamed.

A Few Precautions

As with all medications, NSAIDs have potential side effects. For NSAID’s that means possible gastrointestinal stomach upsets, including ulcers and GI bleeding. To reduce this risk, it is generally recommended that you take NSAID medications with food and to not exceed the recommended dosage.

NSAIDs can also prevent blood clotting, which makes them helpful for people at risk for heart attack and heart disease. But the drugs’ anti-blood clotting properties can also make them a problem for people with heart disease who already take blood-thinning drugs. Because of these possible medical concerns, your doctor may prescribe an NSAID like Celebrex, which only blocks the action of COX-2 – it does not affect the lining of the stomach or interfere with blood clotting.

If you are unsure about whether it is safe to NSAID medications – or which ones, ask your doctor. While ultimately, patients with severe joint pain may need surgery to gain adequate pain control and restore mobility, most of the time non-surgical treatment that includes NSAID medication can be very effective, at least in the initial stages of osteoarthritis.

For more information about joint pain, go to

Steps to Better Bones

Although the fragility of bones increases as we get older, there are things you can do to help prevent injury.  Below are three steps that Dr. John Kagan recommends to help your body maintain optimal bone density and health.

  1. Get your recommended value of Calcium and Vitamin D – Calcium is essential to maintain strong bones and teeth, however, your body does not produce calcium naturally. Instead, calcium must be absorbed from your dietary intake. There are many sources of calcium; green leafy vegetables, milk and other dairy products, salmon, almonds, tofu and any food products fortified with calcium. Vitamin D is important for bone health because it aids the body in absorbing calcium. To get your daily requirement of vitamin D, just step outside in the sun and take a 10-15 minute walk each day.
  2. Know your body – If you have had fractures in the past, you’re more likely to have them in the future. Be aware of your body’s limitations and pain threshold.
  3. Exercise – It’s crucial to maintain an exercise regime at any age. To maximize bone health, try weight bearing exercises like running, walking or yoga.

Always consult an orthopaedic specialist before taking any medications, vitamin supplements or beginning an exercise regime for an orthopaedic ailment. For a thorough evaluation of your bone health, or for more information in ways to maintain healthy bones, call 239-936-6778 or visit or

New non-surgical treatment for healing – Platelet Rich Plasma (PRP) Therapy


One concern for many of my patients struggling with orthopedic injuries is avoiding surgical procedures, when possible. A fairly new option for treating patients with healing tendon and ligament injuries is platelet rich plasma (PRP) therapy, which is now offered at our office as an alternative to surgical procedures when appropriate.

How does this work?  Our trained medical team draws a small amount of blood, then places it in a centrifuge to produce the PRP. This process increases the concentration of platelets and growth factors, which are shown to accelerate tissue repair and regeneration. The PRP is then injected back into the patient to produce new collagen and begin the process of tightening or strengthening the damaged area of tendon or ligament.

Many patients are reporting a significant improvement in symptoms from this new treatment option. Please call our office to learn more about PRP and whether this is an option for you or someone you know. Call 239-936-6778 or visit our website at

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