Senior Health: When Injuries Are Serious Enough for an Orthopedic Visit

Senior Health: When Injuries Are Serious Enough for an Orthopedic Visit

Injuries can be difficult to evaluate if you’re not a trained professional. Especially if symptoms don’t start to act up until well after the injury occurred. So how can you tell if your injury needs to be examined by an orthopedic specialist?

Here are some signs for seniors to watch for after an injury.

Foot or Ankle Injuries

Did you twist your ankle stepping off a curb or drop a heavy box on your foot? If you notice swelling that doesn’t go away or pain when you place weight on the injured limb, you might require a visit to our clinic or to a foot specialist on the Orthopedic Institute (OI) team, such as Dr. Watson.

You definitely need to get checked out upon difficulty walking or if you can’t manage to move more than a few feet.

OI actually offers walk-in hours for immediate check-ups, weekdays from 3-7 p.m., and Saturday from 11 a.m.-4 p.m. You can also make an appointment online here.

Ligament Injuries

Consistent pain isn’t the only indicator for a visit to the orthopedist. A torn ACL doesn’t always result in pain but certainly warrants a clinic trip. If your knees feel strange turning corners or they feel unstable, these are signs you need to see a health professional. Torn cartilage and ligaments can also cause problems by causing joints to stick or outright lock up.

Just like for foot or ankle injuries, OI can check out the effects of a ligament injury during walk-in hours, weekdays from 3-7 p.m., and Saturday from 11 a.m.-4 p.m., or by setting up an appointment online here.

Muscle Injuries

Muscle pulls, also known as strains, are common. It’s also common, when lifting weights, to experience some minor soreness that dissipates within a day or two.  However, severe tears can require surgery to piece the muscle tissue back together. A strain of this nature can sometimes be associated with a weakness sensation or inability to use the associated muscle or tendons.

Our specialists at OI can complete a series of orthopedic tests on areas of pain in order to pinpoint any possible tears. If more information is needed, an MRI can diagnose the tear’s severity.

Wear and Tear

Over time, areas such as the knees, ankles, shoulders and other parts that see a lot of use, can start to act up. Inflammation in joints can get worse, causing pain and stiffness. When arthritis sets in, it can cause many daily activities to become painful chores. Consistent joint swelling, tenderness and restricted range of movement can be signs of arthritis. Check out our blog on alternative therapies for more on possible treatments.

Time for a Visit

If you’re experiencing any of the above symptoms and have a concern, it’s never a bad idea to get checked out by an orthopedic specialist. Your health is important to the team here at OI. We can set you up with the right treatment plan to help you recover and once again get your body back in motion.

10 Questions with Dr. K.C. Chang

10 Questions with Dr. K.C. Chang

We’re diving into getting to know the team at Orthopedic Institute (OI), introducing you to some of our illustrious team members.

Today’s featured team member is Dr. K.C. Chang, one of our physicians. Dr. Chang graduated from Florida State University before attending medical school at University of Florida. With 25-plus years of experience treating neck and back pain in orthopedic patients, he’s an incredibly valuable part of the staff.

Let’s take a deeper dive into what Dr. Chang loves most about his work and how he approaches his work at OI.

1. How did you decide to become a physician?

I think I decided to be a physician when I was really young – around six years old. I remember being at the clinic with my dad in Malaysia. I had been riding my bike, and it started to rain. I was close to the clinic, so I went there. Suddenly this guy came in carrying someone who is bleeding everywhere from his head down – he’d been in a car accident. My dad was able to perform suturing and control the bleeding. I realized, “Wow, that was amazing. I want to be a doctor.” From then on, I never questioned what I was going to do. It is a rewarding and noble profession.

2. What led you to join OI?

I was in Orlando, Fla., practicing with 12 other orthopedic surgeons for about 10 years. I was pretty happy with what I was doing, but the group had ran into some difficulties and the group was slowly dissolving. I decided I needed someplace different to work. My brother-in-law let me know that Orthopedic Institute was looking for a muscular skeletal specialist. So I interviewed and loved it here. That was in 2001. I just love it.

3. What is your favorite part of your job?

The best part of my job is to be able to help people control their pain without surgery. I try to control pain by providing them with different ways to treat it – acupuncture, injections, epidural injections, physical therapy. I am so happy when the patient feels better, and I can end some of their pain and suffering.

4. What are the strengths of the OI physician team?

We are all well-trained. We are all experts in each of our subspecialties. We have a comprehensive offering of all types of care from very conservative to the intricate work of specialized surgeries. Our doctors care about the patient – we have compassion for our patients, and they realize that.

5. What is the best part about working with patients?

The best part of working with patients is when they come in with pain and then are so grateful after the treatment you provide and how much relief you give them. To me, that is the best. When you know you did something to help them – it is so gratifying.

6. What would you consider your career highlight?

Joining Orthopedic Institute back in 2001 was the highlight of my career. I really like it here. My son Michael was one year old at the time. He was the youngest, and, even though he was born in Orlando, all he knows is South Dakota. A few months ago he asked me, “Dad, are you going to sell the house when you retire?” I told him “Maybe, I don’t know.” So he said, “Well if you don’t sell the house, can you give it to me? Because I love Sioux Falls!” My other kids say, “I want to go somewhere warm.” But Michael – I take him to New York, and he hates it. He always wants to come back to Sioux Falls!

7. How do you spend your time when you’re not at OI?

I like tennis, so I play singles on Mondays and doubles on Tuesdays. I was actually the No. 1 player on my high school tennis team in Florida. Right now, I am not that good, but I love to exercise! I like to read books and watch movies and travel.

8. What was the last book you read?

The Book of Joy by Archbishop Desmond Tutu and the Dalai Lama. It’s an interesting book about how to find happiness and identify the meaning of joy. I enjoy reading non-fiction.

9. What is your go-to movie snack?

I like action movies. And I like the popcorn at the movies, but my wife does not. She thinks it is too salty, so when we go, she say’s “No butter, no salt.” Then we have to get a small box and not a medium one. (You have to make your wife happy.)

10. If you could have dinner with one person living or dead, who would it be?

Gandhi I think is one person I would like to meet and talk about how he got into this non-violent thing and how he helped people. And Martin Luther King and JFK – those three people who influenced the world and changed the world for the better.

Free Book: Home Remedies for Back & Neck Pain

Free Guide: Home Remedies for Back & Neck Pain

We’ve all had that moment first thing in morning where neck or back pain (or a combination of the two) are making us feel like we’ll be down for the count that day. The truth is, it’s hard to remedy consistent back and neck pain without guidance from a professional who can tell you what to do and, more importantly, what not to do.

Luckily Orthopedic Institute (OI) has a book jam-packed with home remedies for just that.

“The Home Remedy Book for Back and Neck Pain” includes tips to:

  • Relieve simple back and neck pain
  • Strengthen your back
  • Make your back more flexible
  • Learn what various symptoms mean
  • Prevent future back pain problems

And best of all, all the techniques in the book are physician-approved, safe and effective.

How to Tell When Your Child Needs an Orthopedic Visit

How to Tell When Your Child Needs an Orthopedic Visit

Bumps and scrapes—every kid experiences them thanks to their penchant for physical activity in the outdoors. But when does a bump or a scrape turn into something worth visiting the orthopedist for? Not all symptoms are equally serious, so when should you take your child in to be examined?

Here are a few common symptoms that, if persistent or frequent, can be a sign it’s time to visit the orthopedic physician.

Injury-related pain

This one is the most clear-cut symptom – if your child experiences pain in an area in which he or she encountered a collision in a sporting event or a tumble in the backyard or any other directly associated injury event, it’s likely worth a clinic visit. Most impacts such as these will have immediate symptoms such as redness, soreness or swelling, but if they linger or continue beyond a couple hours, it might be a sign of a more serious injury.

Morning stiffness

As parents, we all have experienced that stiff and sore feeling when we get out of bed. But when our children start to experience it, it could be a sign of illness beyond just “sleeping too hard.” If this stiffness is regular or affects your kid’s day-to-day activities that used to come more easily (even tasks as basic as reaching for a cereal box or brushing his or her teeth), it could be a sign of the onset of juvenile arthritis. If symptoms are frequent or regular, check with your doctor.


When a child has a broken bone it might not always be obvious. Depending on the severity of the fracture, he or she might not exhibit obvious symptoms like searing pain or restricted movement. A fracture is still a serious ailment that needs to be treated quickly, though. One of the easiest ways to tell if a bone is possibly broken is bruising in an area that may have been impacted. If a bruise appears that is accompanied by tenderness or difficulty in moving limbs or joints in the surrounding area, it might be worth a visit to the orthopedist to get an X-ray.

Warmth and swelling

One sign of a joint condition in a child (or anyone for that matter) is a joint feeling warm or appearing visibly swollen. As outlined above, this is normal in the immediate time after an injury, but persistent or unexplained hotness or redness might be a calling card of an inflammation that needs to be treated. If swelling sticks around for more than a few days or keeps returning time and again, ask your doctor about a possible inflammatory condition.

Persisting pain

One-off joint pain can sometimes be attributed to basic growing pains, particularly in pre-10-year-old children, but if the pain is persistent and continues beyond a night or two it might be a sign of lasting ailments, such as childhood arthritis or various types of infections. If pain lasts for a week or more, it’s time to set an appointment with an orthopedic physician to eliminate any serious complications.

10 Questions with Sean Magee

10 Questions with Sean Magee

We’re giving you a peek into what makes Orthopedic Institute (OI) tick by shedding some light on our best and brightest.

Today’s featured team member is Sean Magee, one of our physical therapists (PT). Sean graduated from the University of North Dakota. He has a rich 26 years of experience evaluating and treating the spine with mechanical diagnosis and therapy.

Let’s take a deeper dive into what motivates Sean and keeps him passionate about treating patients at OI. 

1. How did you decide to become a PT?

I read a job description about physical therapy in a career magazine, and I was hooked.

2. What led you to join the OI team?

I was recruited to come to Orthopedic Institute. They were looking for a physical therapist that was certified in mechanical diagnosis and therapy to start up its Spine Physical Therapy Program.

3. What is your favorite part of your job?

Utilizing mechanical diagnosis and therapy to evaluate and treat patients

4. What makes your spine therapy program different from other general physical therapy options?

Our Physical Therapists in the Spine Physical Therapy Program are certified in Mechanical Diagnosis & Therapy of the Spine through the McKenzie Institute USA. There are only three Physical Therapists in the state of South Dakota certified in Mechanical Diagnosis and Therapy of the Spine, two of which are at Orthopedic Institute ( the skilled Ryan Otto, and myself).

5. What is the best part about working with patients?

Educating and empowering them to participate in their treatment plans, to achieve their goals and to prevent future exacerbations

6. If you could tell every patient one thing before they came in, what would it be?

Our highly trained staff of doctors, nurses, physical therapists and occupational therapists are here to serve you and your individual orthopedic needs with the most up-to-date orthopedic care in the region. 

7. What do you feel is your number one strength as a PT?

I think my two biggest strengths are: 1. My 28 years experience in evaluating and treating spine patients, and 2. Being certified in Mechanical Diagnosis and Therapy of the Spine since 1994. That certification allows me to assess patients with a standardized mechanical evaluation. Based on the results of that evaluation, I am able to infuse the patient with knowledge about their mechanical diagnosis. After that, I am able to instruct them in things such as: improving their posture, correcting their dysfunctional movement patterns, preventing future exacerbation, and developing an individualized home exercise program to decrease their pain. All of these factors work to increase their limited range of motion, to improve their strength deficits and to decrease their functional disability.

8. Why should a patient come to your spine therapy program as opposed to another program?

At the Orthopedic institute, they will be evaluated by a one of our Physical Therapists certified in Mechanical Diagnosis and Therapy of the Spine. Certified clinicians take a detailed history of the patient’s symptoms and how these symptoms behave with different activities and positions throughout the day and night. Using repeated end range movements or positions and observing how their range of motion has changed, my team will be able to create an individualized treatment plan for the patient. The patient will be prescribed specific exercises and given guidance for appropriate postures and behaviors to adopt or to temporarily avoid outside of the clinic (at home & work). By learning how to self-treat their current problem, patients gain hands on knowledge to minimize the risk of recurrence and to rapidly deal with symptoms if they recur. This program is amazingly individualized and complete unlike anything else in the area.

9. How do you spend your time when you’re not at OI? 

Doing outdoor activities; spending time with family; playing with my 15-month-old grandson Lewi; reading physical therapy journals; listening to Christian music; reading the bible daily; praying for family, friends, colleagues and patients; and going to church as often as I can.

10. What is your ideal way to spend your birthday?

Spending time with family.

Experiencing spine pain? Meet with Sean and the rest of our experienced team. Make an appointment today!

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!

In the ER… insist on us. We'll be there.

When to Know If an ER Visit Is Necessary

Visiting the ER or emergency department of a hospital for immediate orthopedic needs can be a traumatic and stressful experience for anyone. But with the right team on the case and the right frame of mind, you can weather an ER visit without adding to the pressure.

Here are five details on ER care to keep in mind, courtesy of the experts at Orthopedic Institute (OI).

Is it a true emergency?

If you find yourself needing orthopedic care that is non-life-threatening and occurs between 7 a.m. and 5 p.m., you have the option of calling a clinic, such as OI (605-331-5890). Speaking with a knowledgeable and caring nurse will help you find out more about the seriousness of your injury and potentially get you scheduled with a doctor on the same day, encourage you to come to a walk-in clinic like the ones OI offers or head directly to an ER.

Emergency or urgency?

If you require urgent but not necessarily emergency orthopedic care, a walk-in clinic may be your best option. OI offers OI NOW from 3-7 p.m., Monday through Friday, and 11 a.m.–3 p.m. on Saturdays. Urgent care or walk-in clinics are typically staffed by a professional orthopedic physician assistant (PA). They’re an option when your situation is concerning enough that you don’t want to wait until the next day. The PA will be able to assess your injury and help determine what the best route is for you. You may need to see a physician, and the PA can get the ball rolling with X-rays and, when necessary, an MRI.

Is it after hours?

If you’re in need of orthopedic medical care after typical office hours and you’re not certain a trip to the emergency room is the right way to go, you can call a clinic’s after-hours service (OI’s is at 605-331-5890). The service provider will listen and take a message to quickly transmit it to an available doctor on call. He or she then calls you back to determine how urgent your situation is and whether a trip to the ER is necessary or you should set an office appointment in the next day or two.

Ready to wait?

Sometimes a trip to the ER is necessary—so it’s important to have a grasp on how best to approach it. More than 130 million times a year, people in the United States end up in an emergency room—often with non-life-threatening problems that can mean hours of waiting for treatment. Before seeing a doctor, expect to wait more than 55 minutes, the average ER wait time across the United States, according to the Centers for Disease Control and Prevention. On a busy night or weekend, the wait could end up being several hours, depending on where you live.

Seeing a specialist?

A word to the wise: If you do end up in the ER, most people don’t know that you can choose your own doctor. Your ER doctor may try to keep you within his or her network rather than offer you a choice of a specialist you may prefer, so you insist on seeing the doctor of your choice. Exercising this option can be useful if you regularly see a doctor familiar with your condition or if you have never been seen by a specialist such as an OI doctor, but wish to see one with skill in the area that’s landed you in the ER in the first place. Having the ER call an orthopedic doctor with whom you already have a relationship will get the process started much more quickly than with a doctor who has never treated you before. This will only help get you in and out of the ER as soon as possible and ahead of patients waiting to be assigned a doctor.

3 Ways Orthopedic Care Is a Gift During the Holidays

3 Ways Orthopedic Care is a Gift During the Holidays

The gift of healing. It’s a gift that keeps on giving and can keep you going. During the holiday season, this is one gift that may be critically important and highly useful. We are sometimes so worried about finding that perfect Black Friday deal or the perfect Christmas decorations that we might forget to take care of our own bodies.

Aches, breaks, and dislocations don’t take a break—here’s how orthopedic care can brighten your spirits over the holidays.

Always on call

The holidays don’t mean a vacation from potential orthopedic pitfalls, and, luckily for you, orthopedic caregivers are typically on-call throughout the break to ensure patients are well provided for in the event of an injury or incident. Pain can wear on you in both the physical and emotional sense and can consume your energy and focus. When that pain is alleviated, you can get back to the things you truly care about and were otherwise unable to do.

Because of a team of committed physicians, Orthopedic Institute (OI) is one such facility that has on-call physicians provide healing services from when the first snowflake falls to when the last one melts.

Physicians with passion

You won’t get better care than from physicians and clinic staff who have a drive and a passion for healing. That’s why selecting a healthcare provider with a stellar crew is so critical to your end results. OI’s own team members are drawn to the field of orthopedics for a variety of reasons, including genuine curiosity for medicine, family influences and a nurturing spirit. One thing they all have in common, though, is passion for healing.

Determined follow-through

A commitment to seeing the healing process through to a patient-pleasing ending is another crucial gift when it comes to orthopedic care, particularly during the holiday season. Injury can keep you from taking part in family traditions and things you truly care about, so having a caregiver with amazing follow-through can make all the difference.

OI’s physicians appreciate the opportunity to come alongside patients in their times of need, whether that’s a devastating injury or debilitating pain. They’re committed to walking patients through the process step by step – and the last step is resolution.  OI’s team strives to get patients back to the things that matter most to them through the healing process.

Just remember this season to always be conscious of your health. There is a lot of comfort in knowing that if unexpected injury or physical pain occurs for you or your loved ones, there are caring physicians in your community who are ready to deliver the gift of healing.

What Is Aquatic Therapy?

What Is Aquatic Therapy?

Whether you’ve suffered an acute injury or have ongoing pain or stress from a chronic illness such as arthritis, you have options when it comes to recovery techniques.

One such style of therapy can work wonders for your physical and mental wellbeing – aquatic therapy.

The Technique

Aquatic therapy is a form of physical therapy, offered in a warm water environment, that facilitates walking, joint and muscle mobility, balance, and reduction in swelling. Not all aquatic therapy sessions are alike! Your physical therapist will assess your strengths and weaknesses and build a program that is specific to your needs, and that will promote functional independence for you to return to your daily activities on land as soon as possible.

The Benefits

Exercising in the water is typically easier to tolerate than land-based exercise. The warmth of the water produces relaxation, decreased muscle tension, and often a reduction in anxiety or fear that may be associated with therapy. The buoyancy of the water allows for decreased stress on your joints, making walking and weight-bearing more comfortable. The hydrostatic pressure of the water on your limbs can help to reduce swelling, therefore allowing better circulation and mobility of the affected joint. For those who struggle with balance, aquatic therapy is a great way to work on stability without the fear of falling on a hard surface.

The Results

Studies have proven that aquatic therapy has great benefits for people with chronic illnesses, such as osteoarthritis. Research from the American Physical Therapy Association found that 72% of sufferers saw marked improvements in pain reduction and 75% in overall joint function as a result of just six weeks of aquatic therapy. A 2014 study of women who suffer from fibromyalgia found that four months of aquatic therapy significantly improved their quality of sleep, cognitive function and physical abilities.

The Opportunities

The best results will come from scheduling an aquatic therapy session with a licensed, trusted professional. If you are interested in aquatic therapy, and want to learn more, check out or call Orthopedic Institute to schedule an appointment at our physical therapy location inside the GreatLife Woodlake Athletic Club. 605.977.6845 or 1.866.777.7678.

Anterior Approach to Hip Surgery

Orthopedic Update: Anterior Approach Hip Replacement Surgery

The anterior approach to total hip replacement has emerged as a practical alternative to the posterior approach that most surgeons still use. Although it has been in use to some degree since the 1980s, new instrumentation allowing it to be performed using smaller incisions has made it increasingly sought after.

Called the anterior hip replacement, this procedure involves the surgeon making a four-inch incision through the front of the leg, rather than the back (the entry point for the more conventional posterior hip replacement surgery). Frontal entry makes it possible to reach the joint by separating the muscles rather than cutting through them and reattaching them (used in the posterior approach). By keeping the muscles intact, the Anterior Approach may allow for less pain, faster recovery, quicker stability and fewer post-operative restrictions.

Although each patient responds differently, studies have shown the potential benefits of the Anterior Approach.

  • Accelerated recovery time is possible because key muscles are not detached during the operation.
  • Potential for fewer restrictions during recovery. This procedure seeks to help patients more freely bend their hip and bear their full weight immediately or soon after surgery.
  • Possible reduced scarring because the technique allows for one relatively small incision. Since the incision is on the front side of the leg, you may be spared from the pain of sitting on scar tissue.
  • Potential for stability of the implant sooner after surgery, resulting in part from the fact that they key muscles and tissues are not being disturbed during the operation.
  • The Anterior Approach requires less tissue disruption, which may lead to faster rehabilitation.

We have four physicians at Orthopedic Institute who perform the Anterior Approach to hip replacement.

To schedule an appointment with Dr. Adler, McKenzie, Rothrock or Suga, please call 1-888-331-5890.

Michael J. Adler, MD

Matthew J. McKenzie, MD

Corey P. Rothrock, MD

Please check out this short video on the Anterior Approach to hip replacement.