Radial Pulse Therapy used to treat Plantar Fasciitis, Tennis Elbow, and other forms of Tendinitis at Orthopedic Institute.

The Best Treatment for Plantar Fasciitis and Tennis Elbow

Stem Cell Therapy vs. Joint Replacement for Knee Pain

Stem Cell Therapy vs. Joint Replacement for Knee Pain

Sitting, standing, walking, driving—those with knee pain know how much harder it can make doing the things we need to do every day. Traditional joint replacement can make a real difference, as can regenerative procedures, such as stem cell therapy, that use your own adult stem cells to naturally repair damage. Knee pain is debilitating and often tough to manage on your own, but navigating all of the potential treatment options can leave patients confused and wondering which option is right for them. In particular, patients struggle to decide between joint replacement and regenerative options, such as stem cell therapy, to manage their pain.

Read on to see if stem cell therapy or joint replacement is the right treatment for your knee pain. 


While stem cell therapy and knee replacement surgery are both straightforward procedures from an orthopedic standpoint, knee replacement surgery has a higher success rate at the cost of being significantly more invasive. Stem cell therapy is regenerative, meaning that it helps your body rebuild the damage in your knees naturally using your own adult stem cells. Because some people’s bodies react differently to stem cell therapy, the success of the procedure, in terms of pain alleviation, will vary by patient. To learn more about stem cell therapy, visit Dr. Carlson’s page, Using Adult Stem Cells For The Treatment Of Pain, then check out the video below the Mayo Clinic explaining the procedure:

Recovery Time

Perhaps one of the most significant differences between stem cell therapy and knee replacement surgery is the amount of recovery time required of each procedure. Because a knee replacement is such a significant surgery, the recovery time can take months. One of the major advantages of stem cell therapy is that patients generally see a much smaller reduction in their mobility as a result of the procedure. This translates to a shorter recovery period and significantly more freedom for patients following therapy sessions when compared to patients who undergo joint replacement surgeries.


Despite the fact that medical practitioners have used stem cells for decades in the treatment of various diseases, their use as a treatment for pain is relatively new. Due to the cutting-edge nature of regenerative medicine, many insurance companies do not yet cover stem cell therapy as a treatment for pain. However, Medicare and private insurance do  generally cover the majority of the costs associated with knee replacement surgery as a method of pain management. The cost of stem cell treatment varies based on which procedure is performed.

If you’re coping with knee pain and are interested in either of these options, make an appointment to see one of our specialists to find the treatment plan that works best for you.

Is the Bone Broken or Fractured?

Is the Bone Broken or Fractured?

Many people have the misconception that broken bones and fractures are different injuries. In reality, “fracture” is a clinical term and “break” is a lay term, but the two have the same meaning. Both words refer to a loss of integrity in the bone that can range from a simple hairline crack to a complex injury with multiple bone fragments. Additionally, people tend to believe that, if they can move their bone, it isn’t broken. This is not true. Any swollen, bruised, painful joint that has been injured should be evaluated and X-rayed to assess for a fracture. If you have an injury that fits this description, stop by our walk-in-clinic for a consultation. Even if you’ve injured the same bone as someone you know, your treatment options could vary greatly.

Your treatment options depend upon a number of things—most significantly, the location and severity of the break. At the Orthopedic Institute, we’ll clearly explain the options and provide you with the best possible recovery from your injury.

Check out these key signs that a broken or fractured bone needs surgery: 

Are the Bones Pulling Apart?

In order to fix a broken or fractured bone, it needs to be held in position long enough to heal itself. Normally this can be accomplished by carefully aligning the broken bone and wrapping affected limb in a plaster cast. However, in some cases, the bones attempt to pull apart, which prevents the break from healing properly and causes complications.

Does the Bone Break Skin?

When a broken bone breaks the surface of the skin, it is called an “open fracture.” In these situations, the bone needs to be moved back inside the body and realigned through surgery. These types of fractures are particularly serious because they open the wound and the bone itself up to the possibility of infection.

Does the Fracture Involve Joints?

Fractures that involve joints are called intra-articular fractures, and they generally require surgical intervention to correct. These fractures should not be taken lightly, as they often result in long-term complications. Joints are meant to fit together neatly, so they don’t rub or grind when you move. A fracture that damages a joint could potentially leave the surfaces uneven and cause them to grind on one another.

Are the Bones Displaced?

When a bone breaks and the two ends of the broken bone become significantly misaligned, it is called a displaced fracture. When the bone is broken into many pieces, it is referred to as a comminuted fracture. These fractures are complex and cannot be healed with a cast alone. Surgery is required to piece the bones back together so they can heal properly. Comminuted fractures can happen to any bone, but they are most common in the elbow, wrists and legs.

If you or your family member has a serious injury and you’re worried the bone may be broken or fractured, the experts at Orthopedic Institute are here to help, so make an appointment or stop by our walk-in-clinic for a physician consult.

Top 5 Knee Injuries for Kids and Teens

Top 5 Knee Injuries for Kids and Teens

Whether your child participates in after-school sports or just loves the monkey bars, some of the most common injuries they will have are knee related. Most children will recover from a knee injury within a few days, but it’s important to know what the most common knee injuries are and when to see a professional.

Check out our list of the top 5 knee injuries in kids and teens.

1. Sprains

The knee is a complex joint made up of ligaments, tendons, cartilage and bones. Sprains involve damage specifically to the ligaments that make up the knee. Most sprains are caused by damage to the anterior cruciate ligament or the medial collateral ligament, commonly referred to as the ACL and MCL. Tearing one of these ligaments completely can result in much more serious injuries.

Common signs of a knee sprain include:

  • Swelling around the knee
  • Pain in the knee when moving
  • Inability to stand or put weight on that leg

2. Strains

Strains, much like sprains, are a very common knee injury in children and young adults. However, knee strains are caused by damage to a muscle or tendon within the knee. These injuries are common in sports such as soccer, where sharp turns, cuts and pivots place a huge strain on the muscles and tendons that make up the knee. If your child has bruising around the knee and similar symptoms to a sprain, they may have experienced a knee strain.

3. Cartilage Tears

Cartilage tears in the knee often happen in conjunction with knee sprains. They can occur when making side-to-side movements or when rapidly changing speed, and they are regularly accompanied with tenderness, swelling, and a feeling of tightness around the knee. In some cases, a piece of cartilage can break off from the end of a bone and cause long-term knee pain. Though these injuries can require treatment in adults, cartilage tears may heal on their own in children and teens.

4. Fractures

Knee fractures are characterized as broken or cracked bones in the knee and are usually accompanied by a dislocated patella, or knee cap. Simpler fractures can be corrected with a cast or a splint, but fractures accompanied by a dislocated patella often require surgery to fix. Children with knee fractures often experience particularly intense knee pain. The Orthopedic Institute can help your child recover from a knee fracture, regardless of the severity.

5. Tendonitis

If your child is particularly active, they may be prone to tendonitis. Tendonitis occurs when the tendons in the knee become irritated, and it is often caused by overuse of the tendons, poor training or a combination of the two. Your child may have tendonitis if their knee hurts when walking, resting, bending or lifting. Treatment for tendonitis can involve physical therapy, medication or surgery.

Regardless of what knee injury your child has experienced, you should schedule a visit with a physician if they are experiencing significant pain, swelling, tenderness, and redness or if the injury is accompanied by a fever.

If you suspect your child could have a knee injury, schedule an appointment or stop in to one of our orthopedic walk-in clinics.

Uploaded ToTop 5 Reasons to Try Cooled Radiofrequency Treatment for Chronic Hip & Knee Pain

Top 5 Reasons to Try Cooled Radiofrequency Treatment for Chronic Hip & Knee Pain

Chronic hip and knee pain can really slow you down. Dr. James Brunz is fellowship-trained in pain management and dedicated to staying at the forefront of pain management technology. His arsenal now includes COOLIEF Cooled Radiofrequency (RF) Treatment—a non-surgical procedure that builds upon his years of expertise using Radiofrequency Ablation for patients with arthritis of the spine.

We sat down with Dr. Brunz to discuss the top 5 reasons Cooled Radiofrequency Treatment can help chronic hip and knee pain.

“Cooled radiofrequency treatment can be an excellent option for people who have had a knee or hip replacement but continue to have chronic pain, or for those unable to have replacement surgery because of a health condition,” said Dr. Brunz.

  1. Effective Pain Relief: COOLIEF Cooled RF is a minimally invasive, outpatient procedure that can safely treat chronic pain. This advanced procedure uses cooled radiofrequency energy to safely target the sensory nerves causing pain. You should begin to feel pain relief within one to two weeks. In some patients, the relief can be relatively long-lasting. In others, additional treatments may be required.
  2. Minimally Invasive: COOLIEF Cooled RF involves no incision, only a small puncture at the insertion site. You may experience some discomfort at the radiofrequency site for a short period, but this discomfort can be treated with common over-the-counter medication.
  3. No Narcotics: COOLIEF circulates water through the device while heating nervous tissue to create a treatment area that is larger than conventional RF treatments. This combination targets the pain-causing nerves without excessive heating, leading to pain relief.
  4. Quick Recovery Time: Every patient is different, but you can expect to return to work and normal everyday activities within several days. Dr. Brunz will recommend a specific amount of rest based on your unique needs and procedure requirements.
  5. No Overnight Hospital Stay: Procedure time varies, but it’s all done in an outpatient setting. COOLIEF requires no general anesthesia, and you should be able to return home shortly after the treatment. A responsible adult is required to be present in order to drive you home.

Ready to learn more? Schedule an appointment with Dr. Brunz to see if this treatment could be right for you.

Outpatient Joint Replacement Surgery: The Benefits & How to Prepare

Outpatient Joint Replacement Surgery: The Benefits & How to Prepare

The idea of an outpatient procedure is always an attractive one—the ability to have your surgery and return home the same day can be valuable. In fact, at Orthopedic Institute (OI), joint replacement surgeries can often be performed outpatient—as much as 90 percent of such surgeries at OI are outpatient for select scenarios.

From total shoulder replacements to knee and hip procedures, why does outpatient matter—and how should you prepare?

The Benefits

Among the obvious benefit of being in the comfort of your own home post-surgery, outpatient procedures can have other marked benefits. Without the expense of a hospital stay, outpatient surgery will typically save money on your final bill. It has also been shown anecdotally to be less stressful—the familiarity of home often makes a great recovery space. It also means less of a time strain on your schedule—you can book your appointment on an ideal day and keep any unnecessary time off from work or other commitments to a minimum.

Preparing for Surgery

Informing Your Team

One of the first steps of prepping for an outpatient joint replacement surgery is informing your team of physicians about what medications you’re currently taking regularly. Some medications may need to be halted in advance of your surgery day, including over-the-counter medicine such as ibuprofen or aspirin. Make sure to provide honest answers to medical history questions—these will play an important role in clearing you for the procedure.

Getting Tested

Your doctor may order some tests prior to the procedure—these pre-op examinations may include X-rays, blood tests and EKGs to determine your readiness for surgery. Your physician should also provide you with materials you may need to help you better understand what the surgery entails—including what to bring on the day of, what will be the goal of the surgery and joint exercises to try leading up to the date.

Post-Surgical Recovery

Upon leaving the clinic, your surgeon or physician will offer you advice on how to care for yourself from home. For starters, you should plan on having someone to drive you—post-surgery, it’s recommended you don’t operate a vehicle due to drowsy or dizzy conditions. You should use medication as prescribed or recommended by your doctor—and make sure you have a phone number handy to call a qualified nurse or physician if you have any questions about medications or other elements of the recovery process.

5 Key Symptoms of Knee Injuries

5 Key Symptoms of Knee Injuries

Your knees help you get from place to place. They help you stay active, and they help you perform daily activities at home and at work. But when unusual symptoms set in, which are serious and which are worth ignoring?

Here are five key symptoms of knee conditions that are worth keeping tabs on.

Pain When Moving

Pain—it’s an obvious warning sign that something is going on with your knees. But the specific location of the pain and when it occurs (i.e., when moving or when sitting) can help determine the underlying problem. Tendinitis, for example, is a condition where pain is caused by kneecap-to-shin tendon irritation and the onset can sometimes be slow—especially when moving or exercising. Ice is a good first course of action in this case (when there’s not an explainable incident to link the pain to), after which an orthopedic doctor should be called if pain persists.


Experience an audible “pop” or even the feeling of popping when moving your knee joint? If you’re particularly active in health and fitness you may have experienced a knee injury—namely, an ACL injury, which is a particularly common ailment for athletes. If the popping is accompanied by pain, swelling or inability to fully utilize your knee, it’s a good idea to get yourself seen by an orthopedic physician.


Is your knee emanating an unexplained warmth? Heat at the joint site—especially when caused by a fall or tumble—can be a sign of an orthopedic condition, such as bursitis. This type of ailment can lead to infection, so if the heat is accompanied by fever, swelling or unusual sensitivity, you should plan on setting an appointment to be seen by a knee or joint specialist.


Have you had a recent impact to your knee that you may have simply ignored? If you begin to see bruising in the area, it might be more worth investigating than you might immediately suspect. Bruising from a collision or fall, particularly when it’s accompanied by difficulty walking or bending the knee joint, can be attributed to a fracture of your kneecap. Make sure to schedule a physical examination if the bruising and pain is persistent.


The feeling that your knee is locked in place—whether it’s in a bent or unbent position—can be a symptom of a variety of orthopedic conditions. One such ailment is a torn meniscus, something most commonly found in athletes who participate in physically aggressive sports and in seniors, whose knee joints have begun deteriorate with age. A locked knee is something that should be checked out by an orthopedic specialist who can determine if physical therapy or surgical treatment is necessary.

5 Everyday Tips for Fighting Off Knee Pain

5 Everyday Tips for Fighting Off Knee Pain

We all experience aches and pains now and again. But it’s about how we treat these pains and respond to them that helps us to truly prevent future ongoing conditions. Knee pain is a particularly common one—but what can you do to fight off this common ache?

Here are just a few examples of how to change up your everyday habits to fight off knee pain.

Injury Awareness

Have you ever been dealt a blow to your knees from a fall, an accident or a tumble during physical activity? If so, you might occasionally experience lingering pain. Sometimes injuries even happen and you don’t realize it. That’s why it’s important to stay on top of common knee pain symptoms that can be a sign of injury. If you experience pain from a confirmed or suspected injury for more than a few days, it could be time to be seen by a physician.

Pre-Exercise Routines

If you regularly (or not so regularly) exercise, odds are you may encounter some aches and pains overnight that might hinder your routine the following go-around. Post-exercise knee pain might be a sign you’re not taking the proper precautions before you begin working out. It may be worth a visit to your doctor to diagnose the problem and heal or treat it through physical therapy. The causes could include a lack of stretching your hip flexors, hamstrings, IT bands, etc., before you begin exercising.

Change Your Jogging Habits

Speaking of exercise, jogging is a fitness routine that highly impacts your knees. For avid runners, knee injuries account for 42 percent of all related injuries. Why is that? A lot of these injuries have to do with how you jog. This primarily has to do with form, foot strike and, commonly, an inherent hip dysfunction. Want a personal take on how your running habits are affecting your knees and feet? Contact us to set up an appointment for a running analysis.

Workplace Stiffness

Sometimes knee pain is a direct result of the nature of your regular job. If you have an office job that entails being at a desk for most of your day, don’t sit for great lengths of time. Time out opportunities to take a stroll around the office on a regular basis to keep stiffness from setting in. Or consider looking for ways to stand and work throughout the day. Many offices have employed “sit-stand desks” to combat these types of conditions from setting in.

Know Your Feet

Your knee pain may be about more than just your knees. Your feet can have a dramatic effect on the wellbeing of your knees. What shoes you choose to wear, particularly during training or exercise, can have a big impact on your knee conditions. Luckily there are ways to pinpoint where you’re going wrong with shoe selection—stopping in to see our pedorthist Reid Herrboldt is a great first step. Want some guidance on the best types of shoes? Contact OI, and our pedorthist Reid Herrboldt will set up a running analysis/walking analysis to see what shoe might be right for you. 

Need to Be Seen?

If you’ve experienced knee pain from an injury, you can set up an appointment to see a physical therapist or specialized D1 trainer to establish an injury-prevention program to strengthen your core, hips, hamstrings and other lower extremities to positively impact your flexibility and strength.

5 Common Injections for Treating Orthopedic Conditions

5 Common Injections for Treating Orthopedic Conditions

Most of us have had an injection of some kind at some point in our lives, whether it’s a seasonal flu vaccine or a Novocaine shot at the dentist. But not all injections are built the same in their execution nor their purpose.

Let’s break down the six most prevalent injections you might receive when visiting Orthopedic Institute (OI).

Epidural Injection

Primary Function: Treatment of nerve pain

This injection takes place in the epidural space, directly over the compressed nerve root in the spine or neck. These types of injections are typically used in the treatment of back, neck or limb pain or inflammation that can be sourced back to nerve damage in the spine.

Facet Block Injection

Primary Function: Treatment of severe arthritis

Facet joints can be found at each segment of the spine. They help provide stability and your range of motion. These joints can become painful over time from arthritis in the spine, back injuries or other back conditions. A facet block injection is traditionally used to assist your physician in determining if facet treatment is necessary, as well as to offer continued pain reduction for the patient thanks to a steroid element.

Medial Branch Block

Primary Function: Diagnosis of facet-joint blockage

The medial branch block goes hand in hand with the facet block joints mentioned above. The blockage is treated by injecting an anesthetic near the small medial nerves connected to a specific facet joint. There are usually multiple injections that occur in a single procedure.

SI Joint Injection

Primary Function: Treatment of lower back pain

A sacroiliac, or “SI,” joint injection can work to counteract sacroiliac joint dysfunction. There are two of these joints in your body, and they’re located near the spine on either side, connecting the sacrum (between the hip bones). Inflammation of these joints causes pain that can be remedied by an SI joint injection.

Corticosteroid Injection

Primary Function: Relief of inflammation

Also known as cortisone injections, corticosteroid injections are concentrated injections of anti-inflammatories. These types of injections offer quick relief to potentially inflamed muscles, joints and tendons. The most common places for injections are the shoulder, knee, hip, elbow and ankle.


If you feel like one of these injections might help you with your own orthopedic care, talk to our team and make an appointment. We look forward to seeing you!