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May 01, 2016

Story by Ross Henshaw, MD, Sports Medicine Specialist, Danbury Orthopedics

family runnersDANBURY, CT – As any runner will tell you, this simple sport is one of the most rewarding and convenient exercise activities. It’s a wonderfully efficient way to improve your health, except when it produces chronic, nagging injuries. So what’s the best way to safely enjoy a running program? Start smart, with a progressive training schedule that gradually builds the intensity and duration of your workouts.

What the Pros Say

Typically, a running coach or trainer will recommend increasing distances no more than 10% a week. If you have never been a runner, seek advice from friends, trainers or your local athletic store. There are also great resources online and in print. But if you have an underlying health condition or are new to exercise, make your first step a consultation with your physician to be sure it’s OK to start running. Orthopedically, running is a safe exercise for most people but there are exceptions, even among athletes. So if you have a history of orthopedic injury or joint pains, particularly those involving the legs or spine, seek the advice of an orthopedic surgeon.

While any form of exercise can cause or aggravate a preexisting injury, endurance sports generate typical injury patterns. Endurance sports by definition involve prolonged repetitive motion. While a soccer player may run 3-7 miles in a game, depending on position, he or she is rarely only running straight ahead at the same speed. But runners go straight ahead at a maintained speed, which means your hip, knee, ankle and arm motions are roughly the same for the duration of the exercise. Hills change the degree of motion and add more jarring forces.

The longer the duration and hillier the terrain, the more our joints are cycling and the more our tendons and ligaments are pulling and rubbing around our joints. When we start an endurance sport like running and build up too quickly, the abrupt increase in joint motion can lead to ‘overuse’ injuries.

The Top 5 Complaints

In my practice, the most common running injuries are hip bursitis, kneecap pain, shin splints, Achilles tendonitis and plantar fasciitis. Here’s a quick anatomy lesson:

Hip Bursitis – ‘Trochanteric Bursitis’ is an overuse injury caused by friction between the illiotibial tendon band and the hip bone. This large tendon travels over the bony prominence on the outside of the hip, goes all the way down to the leg and attaches just below the outer side of the knee. When we run, this band rubs back and forth over the outer hip bone; over time the friction creates inflammation. Our bodies have natural ‘cushions’ called ‘bursa’ that are designed to reduced this friction, but if they have not had time to adapt they can swell and hurt. (A related injury is ITB syndrome.)

Kneecap pain and Patella Tendonitis – Often grouped as ‘anterior knee pain’, this refers to pain in the front of the knee and is common among runners. The quadriceps muscle in the front of the thigh powers our ability to straighten the knee. It works by using the kneecap or ‘patella’ for leverage across the knee. This generates pressure and can cause the kneecap to become sore. It’s especially evident when people walk down stairs or inclines and is precipitated by excessive downhill running. The quadriceps muscle tapers to become a tendon that attaches to the kneecap and then to the shin bone (tibia) via the patella tendon. When strained, the quadriceps and patella tendons can also develop micro tears and become inflamed. Treatment includes rest, anti-inflammatories, strengthening exercises, cross training and progressing back to running while avoiding hills.

Shin Splints – Shin splints, or ‘posteromedial tibial stress syndrome’, can occur on one or both shins, but most commonly on the dominant leg depending on your stride. Pain originates at the lower third of the inner part of the shin just behind the bone. The pain is usually discrete and easily reproduced by pressing on the trigger point. This condition is caused by inflammation where the Soleus muscle in the calf attaches to the tibia. As the muscle helps runners with ‘pushing off’ it pulls on the attachment site, which may become inflamed and swollen. This pain usually hurts only when running, early or later in a run. Some people try to run through the pain, which worsens it so that even walking becomes painful. Treatment for this overuse is rest and cross training. Some people may be predisposed to shin splints because of running style or leg, ankle or foot alignment.

Achilles Tendonitis – The strong Achilles tendon is prone to inflammation when starting a running program, particularly on hilly terrain. Our calf muscle tapers off to become the Achilles tendon that inserts into the heel and powers the push-off of the running stride. Running uphill demands more stretch from the calf, forcing it to work harder. This can lead to micro tears of the small Achilles fibers. Micro tears do not become full tendon ruptures, but cause inflammation and swelling as the body tries to repair and regenerate the area. The usual treatment for this pain is rest, stretching, strengthening, cross-training and as the pain dissipates, a gradual return to running with limited hills.

Plantar Fasciitis – Dreaded heal pain! Its most common early symptom comes not with running, but with the morning’s first step. The plantar fascia is a tight band of tissue that supports the foot arch. It attaches to the heel and traverses across the sole, attaching broadly across the end of the foot. When we run the plantar fascia can become overstressed at the smaller attachment on the heel, especially in individuals with tight calf muscles. Initially, inflammation starts after the run and hurts upon standing after a period of inactivity. When the foot and ankle bend to stand flat, the fascia stretches and hurts. Best treatment is to recognize it early and rest, cross train and take an anti-inflammatory. More severe cases may require calf stretching, night splints that keep the plantar fascia stretched, and heel pads.

Pain is a warning!

While it sounds like a lot can go wrong, most of us can enjoy running without ever suffering from these common maladies. As a sports medicine specialist, my best advice is to recognize symptoms early and not ignore the pain. Early recognition and treatment generally lead to a quicker recovery. I also recommend cross training. Even if you prefer running as your primary aerobic exercise, you’ll benefit by incorporating other forms of conditioning such as biking, elliptical or swimming into your routine. If you pay attention to symptoms and mix it up, you can help avoid painful injuries due to repetitive overuse of the joints … and stay active.

Accidents happen

Should an unexpected injury occur, runners in the region can access the orthopedic urgent care service offered at Danbury Orthopedics. OrthoCare Express, the walk-in, orthopedic emergency treatment center, is open 7 days a week in the heart of downtown Danbury, CT at 226 White Street. The Center is staffed by fellowship trained orthopedic surgeons and highly trained Physician Assistants, and is open weekdays from 8 am – 8 pm, and on weekends from 10 am – 3 pm. No appointment is necessary and no referral is required. Visit orthocareexpress.com or call 203.702.6675 for more information.


Dr Henshaw 770About Dr. Ross Henshaw:
Dr. Ross Henshaw is a fellowship-trained knee and shoulder orthopedic surgeon, who specializes in the treatment of sports-related injuries. He earned his medical degree from Columbia University and fellowship training at the Hospital for Special Surgery in New York City. Dr. Henshaw is highly sought by athletes for his skill in arthroscopic surgery – a minimally invasive approach offering less pain, small incisions, and quick recovery times. Dr. Henshaw's professional experience includes being part of the medical teams covering Yankee Stadium, The New York Mets, the U.S. Open Tennis Tournament, and the NCAA Division I Men's Lacrosse Tournament. He is a Top Doctor on the prestigious lists of U.S. News and World Report, Castle Connolly and Connecticut Magazine.


About Danbury Orthopedics:
Danbury Orthopedics is a multi-specialty practice staffed by leaders in orthopedic care since it first opened in 1954; the practice is a member of Western Connecticut Orthopedic Specialists, along with New Milford Orthopedics and Coastal Orthopedics, providing comprehensive care to the community. The practice’s Centers of Excellence provide integrated treatment, offering individualized and compassionate care by a team of specialists. The goal of the practice is to help patients regain mobility, lead active lives and attain optimal well-being. To make an appointment with any of the practice’s specialists, or to learn more about this procedure, or other outpatient procedures at Danbury Orthopedics, please call 203.797.1500.

Press contact:
Kate Fitzpatrick
Brandmark Studios
brandmarkstudios.com
917.301.2572
This email address is being protected from spambots. You need JavaScript enabled to view it.

March 29, 2016

press release photo 2 22 16From left, Dr. Ross Henshaw, Dr. John Dunleavy and Dr. Robert Deveney, are surgeons in Danbury Orthopedics recently completed outpatient surgery facility.

The News-Times — Doctors at the practice recently completed their first outpatient total knee, hip and shoulder replacements, which were performed at the practice’s new surgical facility that opened last year at its White Street facility. The introduction of the new service, doctors say, was driven by patients.

“These days, more and more of the expense and the burden of medical care is being transferred to the patient,” said Dr. Robert Deveney, who recently performed both a total knee and a total hip replacement on an outpatient basis. “As a result, it’s our goal to provide the highest-quality care in the most cost-effective environment.”

By providing total joint replacement on an outpatient basis, patients can often save thousands of dollars they might have had to pay as part of an overnight stay at an area hospital. The patients also receive extensive post-operative care in their home as part of their program to ensure a successful outcome.

Deveney said the practice is working with the Ridgefield Visiting Nurses Association to provide additional care for their outpatient clients including a visit to the home prior to the procedure. A nurse and a physical therapist are also at the home upon the patient’s arrival. Nurses also make daily visits to the patient’s home for up to a week after the procedure.

Dr. John Dunleavy, who also recently completed a total knee replacement, said joint replacement for outpatients isn’t the right choice for everyone, and that doctors carefully select who is a best fit. Someone who has a significant heart issue, for example, wouldn’t be considered for an outpatient surgery.

“Of course, the most important factor is the patient’s interest in having the procedure performed on an outpatient basis,” he said.

Dunleavy added, however, that advances in technology have allowed outpatient services that weren’t available in the past.

“Because the technology has advanced so much in the past 10 years, including anesthesia techniques and the smaller incisions that are now necessary, these outpatient procedures are now a reality,” he said.

Deveney noted that several practices in the Midwest have been performing total joint replacements on an outpatient basis for several years, and the service is now catching on along the East Coast.

He added that patients are also much more knowledgeable about their procedures than in the past.

press release photo 2 22 16Dr. Ross Henshaw, center, is a surgeon in Danbury Orthopedics recently completed outpatient surgery facility.

“In the past we would have taken a lot of time explaining the procedure itself,” Deveney said. “But these days people do much of their own research online and are already well informed. When they get to us, they usually have a number of questions including the length of the recovery time and when they can return to work. Much of these changes have really been driven by patient demand.”

While only a small percentage of the practice’s patients are eligible for the outpatient services, Dunleavy said that number will only increase as the program gains traction.

“Our experience so far is mirroring what other practices have seen in the Midwest,” he said. “They started with a select group of patients and began expanding the services out from there.”

Danbury Orthopedics completed the surgical center last year as part of a $5 million renovation of the facility.

February 20, 2016

Baseball Clinic Celebrates Max RosenfieldWe are pleased to support the Max Michael Rosenfield Foundation, dedicated to supporting a range of children’s activities and spread kindness and goodwill.

A baseball clinic to support the Max Michael Rosenfield Foundation will be held on Saturday Feb. 20 at the Danbury Sports Dome. Rosenfield, 7, died in 2012 and was an avid baseball fan, especially the Boston Red Sox.

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January 27, 2016

Patient Recovers Immediately at Home with Care from RVNA

Deveney Dunleavy 2 22 16DANBURY, CT. – Last month, Dr. Robert Deveney and Dr. John Dunleavy performed the first total knee replacement procedures ever done in this area on an outpatient basis.

Total knee replacements have been done on an outpatient basis on the West Coast for some time. Now, new technology allows for very specific preparation prior to surgery, reducing operating time and allowing for quicker post-operative recovery time.  

Dr. Robert Deveney and Dr. John Dunleavy, fellowship-trained orthopedic surgeons, and specialists in the treatment of hip and knee disorders at The Total Joint Center at Danbury Orthopedics, are pleased to offer outpatient joint replacements locally. In the past, patients needing joint replacements were required to stay overnight in the hospital. Dr. Deveney and Dr. Dunleavy are able to now perform this surgery, for patients meeting the criteria, right here at the new, state-of-the-art Western Connecticut Orthopedic Surgical Center (WCOSC) at 226 White Street in downtown Danbury.

press release photo 2 22 16Gary Furtak of New Fairfield has the distinction of being the first person in this area to have a total knee replacement operation and go home the same day. His ground-breaking surgery was performed by Dr. Deveney of The Total Joint Center at Danbury Orthopedics, at the Western Connecticut Orthopedic Surgical Center in downtown Danbury, CT (wcosc.org). Furtak is shown here (center) with Amy Tagg, RN, (left) and Tricia Brody, physical therapist (right), both of the Ridgefield Visiting Nurse Association. Tagg and Brody provided him with nursing care and physical therapy at his home, where his recuperation took place until he was ready to go to outpatient physical therapy at Danbury Orthopedics.

Danbury Orthopedics and Ridgefield Visiting Nurse Association (RVNA) partner to provide a smooth transition from outpatient surgery at WCOSC to recovery at home.  Patients receive a home visit and safety evaluation from an RVNA physical or occupational therapist before the scheduled surgery date. An RVNA nurse meets each patient at home upon discharge, and visits each day for the first week after surgery. Meanwhile, RVNA physical therapists also make home visits every day during the first week after surgery to work with the patient and prepare him or her for outpatient physical therapy.  Additionally, RVNA can provide an occupational therapist and/or home health aide to help the patient return to functional daily activities and assist the patient at home, if the patient requests one.

RVNA Director of Clinical Operations, Summer Williams, RN, is excited to be supporting this state-of-the-art operative approach. “Our physical therapists and nurses provide care at home that is usually provided in a hospital setting, and the patient response so far has been extraordinary. Their outcomes are excellent, and they enjoy being able to recover at home.”

“Recovering at home from day 1 is a huge plus for our patients,” says Dr. Deveney. “We anticipate better recoveries and improved mobility because of the immediate and focused physical therapy they receive.”  Dr. Dunleavy concurs, “We are at a time when advanced surgical technique and the benefits of the outpatient delivery system combine to really give patients better options.  We expect reduced post-surgical pain, improved function and a better surgical experience for our patients.” The orthopedic team, including surgeon, anesthesiologist and Physician Assistant, are available by phone to each patient 24 hours a day during the first few days after surgery, as are the RVNA nurses and physical therapists.

Western Connecticut Orthopedic Surgical Center (WCOSC) opened last year to offer the highest quality, state-of-the-art orthopedic surgery on an ambulatory basis to the community. The outpatient facility offers the most advanced technology to assist surgeons with routine and complex procedures. For more information on the center and the surgical center team, please visit www.wcosc.org.

About Danbury Orthopedics:
Danbury Orthopedics, founded in 1954, is a multi-specialty practice  staffed by leaders in orthopedic care; the practice is a member of OrthoConnecticut, along with New Milford Orthopedics and Coastal Orthopedics, providing comprehensive care to the community. The practice’s Centers of Excellence provide integrated treatment, offering individualized and compassionate care by a team of specialists. The goal of the practice is to help patients regain mobility, lead active lives and attain optimal well-being. To make an appointment with any of the practice’s specialists, or to learn more about this procedure, or other outpatient procedures at Danbury Orthopedics, please visit http://www.dortho.com/ or call 203.797.1500.

About RVNA:
RVNA cares for patients in their homes in 28 towns in Western Connecticut, including seven day a week physical therapy by experienced orthopedic therapists.  Founded in 1914, RVNA is a non-profit, fully-accredited, Medicare-certified home health care agency that also supports public health and safety, and promotes the highest quality of life. Services include skilled nursing, rehabilitation therapies, social work services, disease management, and private pay home health care, along with many community programs.  To learn more about RVNA or to request RVNA services, call 203-438-5555 or visit www.ridgefieldvna.org.

# # #

Gary Furtak of New Fairfield has the distinction of being the first person in this area to have a total knee replacement operation and go home the same day.  His ground-breaking surgery was performed by Dr. Deveney of The Total Joint Center at Danbury Orthopedics, at the Western Connecticut Orthopedic Surgical Center in downtown Danbury, CT (wcosc.org).  Furtak is shown here (center) with Amy Tagg, RN, (left) and Tricia Brody, physical therapist (right), both of the Ridgefield Visiting Nurse Association.  Tagg and Brody provided him with nursing care and physical therapy at his home, where his recuperation took place until he was ready to go to outpatient physical therapy at Danbury Orthopedics.

Contact:
Kate Fitzpatrick
Brandmark Studios
brandmarkstudios.com
917.301.2572
This email address is being protected from spambots. You need JavaScript enabled to view it.

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