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H E L P F U L I N F O R M AT I O N O N B O N E S , J O I N T S A N D
MUSCLES TO IMPROVE YOUR QUALITY OF LIFE.
2001 • ISSUE 7
Gardening doesn’t
have to hurt
What to do about those aches
and pains that come every spring
Page 2
In this issue:
The high peril
of high heels
Those fashion statements are
killers on your feet Page 4
Ankle and foot
They may be little but they
cause big problems Page 5
Phony arthritis cures cost
consumers millions each year
Page 6
Arthritis knowledge Page 7
Ask us about
Sprains Page 8
IT’S SPRING !
(so those
All that pain doesn’t
have to be.
S
pring is here and
chances are you
already have
experienced sore
muscles from working in
the garden. Those winter
months of inactivity make
most people ripe for some
type of injury or soreness
in the spring.
The most common gardening
problem is lower back pain, says
Jodi Mann, lead physical therapist at OSMC, the area’s leading
orthopedic medical center.
“Most back injuries are caused
from excessive forward bending;
75 to 80 percent is forward
bending,” said Mann.
Traditional lore says to treat
that sore back, or any sore muscle, with heat. Mann said that
this is not a good idea. She
recommends using cold for
inflamed muscles. “Generally, if
it feels warm to the touch, it’s
probably inflamed. You want to
achy muscles must be from gardening)
put ice on it for 10 minutes. You
can do this four or five times per
day,” she said.
She said she does not recommend heat because as the body’s
temperature elevates, the muscles tend to shut down and the
blood flow to that area decreases. She said healing occurs
when fresh oxygenated blood
flows to the affected muscle and
removes the chemicals causing
the inflammation.
Besides cold, Mann recommends light movements that
pump the muscle. Again, the
idea is to increase the flow of
blood to and from the muscle.
For lower back pain, Mann
recommends laying on your
back with your knees bent and
your feet braced on a short table
or stool. “Move the knees from
left to right in a small arc of
motion. This pumps the back
muscle, giving oxygen and getting the inflammation out. Do
about 30 motions. There should
be no pain. It should be a comfortable rocking back and forth,
back and forth,” she said.
The healing process for
inflamed muscles takes seven to
14 days. This type of pain will
be a dull, throbbing, achy, stiff
pain. If it is not gone after two
weeks, seek a physician’s care.
“If it’s a sharp, sudden, intense
pain that causes numbness or
tingling, then you probably
should see a doctor right away,”
she said.
While these are tips on taking care of sore muscles, Mann
suggests the best way to care for
the muscles is to prevent the
injury in the first place. For
instance, when people bend
That gardening can make your muscles sore points out an
important fact: Gardening can be good exercise.
over, they should bend at the
knees and not just bend straight
over. Bending over without
using the knees can strain the
ligaments in the lumbar spine.
Another common type of
problem is shoulder pain. Mann
said this most often occurs when
people over reach while doing
something like pruning trees.
The National Institute for
Occupational Safety and Health
said there are substantial studies
that show that repetitive motion
while the arm is extended overhead can cause musculoskeletal
injury.
NIOSH recommends avoiding awkward postures and overextension of the arms. Mann
“If a muscle starts to hurt, its sending you a message,”
said Mann.
said the typical situation occurs
when someone is painting and
over-reaches. She recommends
using a proper step ladder so
you don’t have to overreach.
A third problem, carpal tunnel symptoms caused by overgripping tools or working with
them for a prolonged period.
“When your hands and arms
begin feeling tired, that’s when
you need to stop and rest. It also
helps to alternate activities. That
way you are not overworking
the same muscles,” said Mann.
“If a muscle starts to hurt, its
sending you a message,” said
Mann. “If it hurts, you’re pushing it beyond the limit.” She recommends that is the time to take
a rest. Let the muscle relax. It
also helps to warm up before
doing anything strenuous. Mann
recommends walking and
stretching for five to 10 minutes.
That gardening can make
your muscles sore points out an
important fact: Gardening can
be good exercise.
“It’s good for you mentally,
as well as physically,” said
Mann. “And, its an activity that
can be fitted to any physical
condition.”
If the person is out of shape,
start in slowly and work to more
strenuous exercise. If the person
is handicapped, adapt the gardening to the condition. For
instance, raising the garden bed
can allow a person confined in
a wheelchair the chance to
enjoy gardening. For people
who cannot kneel for long
periods, a small stool can allow
them to sit while gardening.
PAGE 3
These shoes make a definite fashion statement, but is the cost worth it?
The high peril of high heels
Granted, high heels are a must
for the well dressed lady. They
are chic. They are the perfect
compliment to the perfect dress.
More than half the women in
America wear high heeled shoes
at sometime in the day. But,
these shoes also exact a heavy
price.
According to the American
Orthopaedic Foot and Ankle
Society, high heels — heels that
are two inches or more — shift
the weight of each step from the
entire foot to the ball of the foot
and the bones at the base of the
toes. Since the average person
takes about 10,000 strides each
day, that is a lot of stress on a
small part of the foot.
The Society also reports that
women have about 90 percent of
the 795,000 annual surgeries for
conditions such as bunions,
hammertoes and trapped nerves,
conditions brought on by poorly
fitting and poorly designed
shoes. The annual health care
cost is about $2 billion, with
another $1.5 billion expense for
Of women who wear high heels:
88% wear shoes too small
80% report foot pain
72% have a foot deformity
75% report heel pain
90% have foot surgeries
0
20
40
60
80
100
time lost from work. Another
problem brought on by the frequent wear of high heels can be
a shortening of the Achilles
tendon, leading to a loss of
range of motion in the foot and
heel pain. High heels also cause
distortions in the muscles, in
the knee, hip and lower back
and can lead to more problems
in these areas.
Many women are opting for
“more sensible shoes” for work.
Nearly 70 percent of working
women wear flats or low-heeled
pumps. OSMC physicians recommend for those women who
won’t forego their high-heels to
wear them only on alternate
days. Also, plan activities that
involve a minimum of walking
when wearing heels. And, wear
them only for part of the day.
Foot & Ankle:
For being so little they create an awful lot of problems
The toe bone is
connected to the foot
bone and therein lies
the problem
It’s little wonder that Americans
make more than 4.8 million
visits to physicians’ offices each
year because of foot and ankle
problems. “There are 26 bones
in each foot,” says Dr. Scott J.
Trumble of the Foot & Ankle
Center at OSMC. “The average
person walks about 1,000 miles
a year and each step can put
1-1/2 times your body weight on
your foot. That’s just an awful
lot of stress and an awful lot of
moving parts. It’s real easy for
something to go wrong.”
The fact that we wear shoes
compounds the situation, said
Trumble. “While shoes are a
definite plus — they protect our
feet from all sorts of nasty
things — shoes also can be the
source of a lot of problems. If
you force your feet into unnatural positions in tight, ill-fitting
shoes and you do it for a long
time, there are going to be
problems,” he said.
Most sports activities also
put stress on the ankles and feet.
Sporting accidents account for
the majority of ankle sprains and
breaks. Another problem, shin
splints, or pain in the front of
the lower leg are often caused
by overtraining, running on hard
surfaces or poorly fitting shoes.
Bunions are the result of
heredity or wearing ill fitting
shoes, said Trumble. “A bunion
is an enlargement at the joint of
the big toe. The skin over the
joint becomes swollen and tender,” he said.
In the cases of sports injuries
and bunions, often the treatment
is simply removing cause of the
stress and letting the foot and
ankle rest. Ice, compression and
elevation can be used for
sprains. Surgery is necessary for
severe injuries and fractures.
Trumble said there are a few
things people can do to lessen
the risk of these problems:
• First and foremost is pay
attention to footwear. Make
sure shoes fit correctly.
• Physical conditioning can
help. Warm up properly
before any sporting activity
and do stretching exercises on
a daily basis.
• Participate in a conditioning
program to enhance muscle
strength. Also, individuals
that are overweight have to
realize they are putting extra
stress on their feet and ankles.
OSMC opening Middlebury facility
OSMC has opened an office in Middlebury, its fourth location in
Elkhart County. The new office will allow OSMC to expand the
physician and therapy services it offers to businesses in the Crystal
Valley area.
“Local employers have found OSMC to be an ideal facility for
referring their worker compensation cases. Their employees can get
the medical care they need, as well as the follow up rehabilitation
therapy,” said Don Hammond, chief executive officer of OSMC.
“By opening an office in the Middlebury area we are making it easier
for workers and employers there to take advantage of our services.”
“Besides workmen’s comp cases, this
new facility will provide all of the
other orthopedic services offered
by OSMC, including diagnosis,
treatment, rehabilitation and
wellness maintenance,” said
Hammond.
The office is being located
in an 1,800-square-foot facility
at Heritage Square Complex on
801 W. Wayne Street. An existing building has been remodeled into a
medical facility provisioned with a full line of diagnostic equipment,
including an X-ray machine. The office will have two sections —
one a physical and occupational therapy suite and the other physician’s office suite.
Two orthopedic surgeons, Dr. Leonard J. Kibiloski and Dr. Scott
J. Trumble, will each spend a half day a week at the facility. The
therapy and support staff will be on duty five days a week.
Kibiloski, who has practiced at OSMC since 1992, is certified
by the American Board of Orthopaedic Surgeons. He specializes
in sports medicine, hand surgery, arthroscopic surgery, posttraumatic deformity and total joint replacement.
Trumble joined the staff in 2000
and is board eligible by the
American Academy of
Orthopaedic Surgeons.
Trumble specializes
in foot and ankle surgery,
sports medicine, hand surgery
and general orthopedic surgery.
PAGE 5
Hocus Pocus
Bogus arthritis cures promise the world but only steal your money
Everything from magic
mittens to magnets have been
claimed to cure arthritis or
relieve its discomfort. In fact,
peddling “miracle” cures
to the nearly 37 million
Americans who suffer the
unrelenting pain of arthritis
is big business. The distressing fact of life is, however,
there are no cures for the
more than 100 types of this
nagging and sometimes
crippling disease.
“Each type of arthritis has a
different cause, symptom and
type of treatment,” said Dr.
Leonard J. Kibiloski of OSMC.
“It is hard to give one treatment
for all arthritis. Arthritis varies
from person to person and people react differently to treatments.”
There are legitimate treatments for arthritis, said
Kibiloski, “Medication, rest,
heat or cold, special exercises
and surgery are all options that
can provide relief,” he said.
“There also is a new drug available, that helps relieve arthritis
pain without leaving the stomach as vulnerable to ulcers.”
However, for these treatments to work, the patient must
be disciplined and conform to a
PAGE 6
regimen developed with the
help of a skilled medical professional. It is easy for an arthritis
sufferer to become discouraged.
Perhaps this is why charlatans find arthritis victims easy
marks. The discomfort can be
unrelenting and victims become
willing to try anything for relief.
Also, the nature of arthritis contributes to the quackery.
“Arthritis has a way of coming
and going unpredictably, an
aspect of the disorder known as
spontaneous remission. The pain
and swelling can simply disappear for days, weeks, even years.
People experiencing this can
become convinced the home
remedy was the reason,” said
Kibiloski.
You can’t fool
all the people
all the time
There are ways to spot false
claims: If the product is advertised as a quick and effective
cure-all for a number of
ailments, don’t believe it. If the
advertisement includes undocumented case histories that claim
miraculous results, don’t believe
it. If the product is available
only through one source,
requires payment up front and
promises a money-back guarantee, don’t believe it.
Last year the Federal Trade
Commission reported that a
search of the Internet revealed
more than 400 Web sites that
made doubtful claims for products to treat medical conditions,
including arthritis.
According to the Arthritis
Foundation, there are some scientific reasons to think that diet
affects arthritis, but there is not
enough evidence to tell how diet
helps or hurts or to recommend
any specific diet as a treatment.
Con artists will play on this
by claiming “cures” for certain
herbal remedies or food concoction. “These con jobs can do
more than simply take someone’s money. They can be dangerous. Con artists have been
known to recommend patients
discontinue all other medications, putting the patient at risk,
or to prescribe herbs or drugs
that are actually detrimental to
the body,” said Kibiloski.
“Each type of
arthritis has a
different cause,
symptom and
type of treatment.”
Dr. Leonard J. Kibiloski, M.D.
These are some of the cons
used on arthritis sufferers:
• Copper Bracelets: These
bracelets are supposed to
work by allowing small
amounts of copper to be
absorbed by the skin. The
copper is said to alleviate the
symptoms of arthritis. While
many people, including some
famous athletes, swear by
these bracelets, there is no
scientific proof that the copper is absorbed by the skin or
that copper relieves the pain.
• Energy Point Stimulator:
This is a wand type device
that discharges a mild electric
energy charge. Stimulating
different parts of the body
was supposed to relieve
different types of pain. The
U.S. Food and Drug
Administration said that was
not the case. A large number
of the devices were seized
from Kansas stores in 1988
and ordered destroyed by a
court.
• Herbs: The FDA says that no
herb or combination of herbs
can cure any form of arthritis.
The Arthritis Foundation said
there is some evidence to
think that diet can affect
arthritis but not enough to
recommend any specific diet
or food as a treatment.
• Seawater: This was a huge
craze a few years back; however, medical experts said
there was no evidence to
believe it did anything.
• Uranium: Exposure to low
levels of uranium by purchasing products that are supposed
to contain the substance, is
claimed to cure arthritis. The
FDA says there is no evidence
exposure to radioactivity
helps and uncontrolled doses
of uranium can cause radiation poisoning.
PAGE 7
In this column, experts at OSMC will answer your questions
about the medical or practical aspects of orthopedic medicine and the services we provide. Send your questions to:
Ask Us, c/o OSMC, 30651 Old U.S. 20 W., Elkhart, IN 46514,
or fax us at 219-674-9910.
OSMC, formerly Orthopedic & Sports Medicine
Ankle Center, Work Injury Care Center and The Pain
Center, has held a vision of comprehensive
Management Center.
orthopedic care which includes proper diagnosis,
Spacious facilities (more than 35,000 square feet)
treatment, rehabilitation, and wellness maintenance.
include an on-site Outpatient Surgery Center and
This vision is exemplified today by an expert med-
Therapy Center. OSMC also offers physician and
ical, surgical, therapy and support staff, working
therapy care in Nappanee and Middlebury, and
together for your good health and well-being.
physician care in Wakarusa. For more information
Located on California Road in Elkhart, OSMC staff
please call (219) 264-0791 or 1-800-398-2058.
Knee & Hip Center, Back & Spine Center, Foot &
2310 California Road, Elkhart, IN 46514
219-264-0791 • 1-800-398-2058 (toll free)
www.osmc-online.com
ELKHART
WAKARUSA
ELKHART
SR 19
The Hand Institute, Center for Sports Medicine,
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BRISTOL ST.
CR 40
CALIFORNIA RD
SR 20
MIDDLEBURY
SR 112
OSMC is Michiana’s leading center for
orthopedic care. Since its founding in 1973,
Information in this publication is general
in nature and should not be construed
as diagnosis by a physician. To get an
accurate diagnosis, you need to be
seen by a physician.
W. BEARDSLEY
20
US
NAPPANEE
ELKHART
US 6
SR 19
Q. I severely sprained
my ankle five years ago.
I continue to
experience
pain, weakness
and episodes
of “giving out”
when I attempt
to run or play
basketball. Is
there anything
I can do now
for this condition?
OSMC Divisions
The Hand Institute
Center for Sports Medicine
Knee & Hip Center
Back & Spine Center
Foot & Ankle Center
Work Injury Care Center
The Pain Management Center
BREMEN
A. Although Achilles tendon
rupture is relatively rare, it happens most often to the “weekend warrior.” The injury occurs
more commonly in men (ages
30 to 39) and is often preceded
by a sedentary lifestyle. Most of
these injuries occur while participating in sports, with soccer
and racquet ball having the
highest incidence rates. A primary principle for injury prevention is to train gradually and
use progressive increases in
intensity, frequency and duration
of load prior to competitive
SR 19
Q. What can I do to
prevent tearing my
Achilles tendon?
A. When injuries, even chronic
ones, continue to be painful and
prevent you from resuming
desired activities, they warrant
an evaluation from a specialist.
An orthopedic surgeon can perform a thorough examination to
determine whether your symptoms are a result of
muscle weakness or
instability as a result
of previous ligament
damage. Treatment
options involve
physical therapy in
most cases and
reconstructive
surgery in severe
cases. Both can
achieve favorable
results.
WAKARUSA
play. In addition, stretching the
Achilles tendon prior to activity
helps to warm the tendon tissue
and increase its flexibility. This
should help decrease the risk of
injury.
OSMC Physicians
Robert K. Ellis, M.D.
Louis C. Sfreddo, M.D.
Mark A. Klaassen, M.D.
Leonard J. Kibiloski, M.D.
Gregory A. Peyer, M.D.
Craig W. Erekson, M.D.
David A. Cutcliffe, M.D.
Scott J. Trumble, M.D.
Michael J. Hartman, M.D.
David A. Beatty, M.D.
Gene W. Grove, M.D.
and services are organized in several divisions:
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2310 California Road, Elkhart, IN 46514
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