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 www.orthopedicinstitutesf.com/services/aquatic-therapy/ 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.


Understanding Arthritis (And What Your Options Are)

Understanding Arthritis (And What Your Options Are)

There are nearly 40 million people in the United States affected by some form of arthritis.

Which means one very likely thing—odds are, you know someone with arthritis. You might even have it yourself. The unfortunate fact of the matter is, though, that a majority of Americans are ignorant to the true details of the disease until after they’re diagnosed. And this keeps them from taking the appropriate steps within their power to avoid the onset.

Read on to learn a bit more about the disease itself, in what forms it comes and what you can do to prevent it.

What are the symptoms?

Arthritis can be misdiagnosed and mistaken for other common aches and pains. While a majority of people will experience pain and stiffness regularly as they age, it’s when hands and knees become increasingly swollen and immobile when you should be concerned about arthritis.

How is it caused?

When inflammation develops in the tissue that lines your joints, these areas can become painful and stiff. Essentially, think of any place where two bones meet, like your elbows and knees – these are common areas to encounter arthritic symptoms.

What are the types of arthritis?

While there is a vast variety of types of arthritis – some even estimate it’s in the hundreds – most cases fall into three common types.


More often than not, a person who contracts the disease will be suffering from this type of arthritis. It’s caused by general wear and tear that may include overuse of your joints or simply getting older. It can be injury-based (making it especially common in athletic or active people) or weight-based.

Where you see it: Most commonly found in weight-bearing joints, such as knees, hips and feet

How to detect it: This type of arthritis is accompanied by deep pain; difficulty with simply, everyday activities like getting dressed and crouching; and regular stiffness during the morning hours

Rheumatoid Arthritis

Not all forms of arthritis are caused by usage over time and aging. This type, in fact, is a disease related to your immune system in which, many believe, the body is attacked systematically and particularly in the joints. Some researchers have attributed this to the body merely confusing elements of its own systems for virus or disease and attacking itself.

Where you see it: Can be found in any joints throughout the body – it varies greatly from person to person

How to detect it: This type of arthritis is accompanied by symptoms similar to the ones found in osteoarthritis – just more intense, and, for joints that come in pairs, you’ll likely experience these symptoms in both (i.e., knees, elbows, etc.)

Psoriatic Arthritis

Sometimes inflammation of the skin and joints can cause arthritic conditions – and it’s the third-most-common form of the disease. Though borne out of psoriasis, only about 10-30 percent of people with psoriasis end up with related arthritis. Also, unlike the above types, it might just affect one or two joints, rather than most or all.

Where you see it: Most commonly found through swelling of the fingers and toes

How to detect it: This type of arthritis is accompanied by symptoms such as discoloration of the fingernails and patchy, red skin

What can I do?

Despite the fact that there is no surefire way to keep from getting arthritis, there are things under your control that can help keep your joints healthy and mobile. By maintaining a healthy weight, you can stave off osteoarthritis, which is most often caused by obesity when found in young people. By avoiding injury, you can prevent chronic conditions – be careful during athletic activities and get properly trained. Finally, quitting smoking actually has a great effect on contraction of rheumatoid arthritis – keeping off cigarettes keeps your immune system strong.

While there’s no one way to prevent or diagnose arthritis, there are things in your power to affect change—take care of yourself and make smart decisions, and it’ll pay off in your older years.

How to Combat Shoulder Pain

5 Ways to Combat Shoulder Pain

Shoulder pain can really do a number on your day. Especially when it’s most days. 

When it comes to intermittent shoulder pain, it can sometimes be aggravating enough to impede you from doing everyday tasks you enjoy or even need to do to accomplish tasks at work or home. It can keep you from engaging in enjoyable physical activities, such as swimming or water sports, in conversation or even in sleep.

There are a lot of causes of shoulder pain—and if you’re ready to see a doctor, stop by our walk-in clinic or schedule an appointment. But between now and then, try out these tips to lessen the pain.

1. Warm Up

If you’re exercising regularly, it’ll solve a whole lot of problems with your physical state. But if you’re not exercising properly, it can really do a number on your shoulders. Make sure that before you jump to the bench press you take time to stretch and warm up – it’s key to your exercise regimen.

2. Emphasize Posture

What you were taught in grade school still stands. Sitting up in your chair really does matter. Especially if you work an office, be aware of how you’re sitting at your desk. Plant your feet flat on the floor, support your elbows, sit up and don’t slouch and – potentially most importantly – take a breather every 30 minutes or so by rolling your shoulders and stepping away from the screen.

3. Don’t Slack Off

One of the first instincts we have when we’re sore is to take a load off. But try to resist that urge – plopping down on the couch for an extended period of time when you’re experiencing shoulder pain will likely slow down your recovery (unless recommended by a doctor). Let pain be your guide. If it increases your pain, don’t do it. Healing takes regular blood flow and movement – don’t forget to roll your shoulders and stretch an arm across your body at least hourly.

4. Get a Massage

Now for the fun one – it actually pays to get a massage. Treat yourself a bit and set up an appointment. Massage therapy can do a lot to treat mild and moderate muscle strains – it reduces spasms and inflammation. Let your masseuse know where your experiencing pain and avoid intense rubdowns that intensify your pain.

5. See a Doctor

If the pain is lingering and nothing seems to be nipping it in the bud, it might be time for a doctor to intervene. They can let you know if you should be concerned about a more serious condition, like a fracture or arthritis. It’s the easiest way to regain your regular mobility and eradicate or reduce the pain.

If your shoulder pain is getting out of hand, try out these tips – then call Orthopedic Institute at 605.331.5890. Shoulder pain (and many other types of joint pain) is something we’re well-versed in treating.

6 Things Every Orthopedic Surgeon Wants You to Know

6 Things Your Orthopedic Doctor Wants You to Know

At Orthopedic Institute, we have seen firsthand that the choices you make in your youth can affect the way your body ages. Our doctors have seen that many of our patients who age most gracefully have adopted common habits that help them maintain their physical, mental, and emotional health.

Check out these 6 tips that your doctor would likely want you to know about how best to approach your orthopedic care.

Take care of yourself

This one goes without saying, but your physician wants you to take the proper precautions with your day-to-day decisions to ensure your overall health stays in top form. Don’t smoke, cut back on unhealthy foods and get moving – cutting out bad habits and getting proper nutrition and exercise will have positive effects on your joint health. 

Maintain a healthy weight

Orthopedic surgeons have seen firsthand what being overweight can do to your joints and bones. Most notably, it can lead to osteoarthritis, or “wear-and-tear arthritis”. Staying at a healthy weight will also decrease your chances of breast cancer and diabetes during your later years. Lastly, it can increase your energy, enhance your mood, and help your body fight off illness. For more information on a weight loss plan our physicians recommend click here.

Build an active social life

Spend time with people you enjoy and who make you feel upbeat. Many of our happiest elderly patients are those who interact or converse with another person at least once every day. Find the strength to be the person who initiates outings such as lunch, days at the park and shopping. Volunteering is a great way to meet people with similar interests while giving back to the community.

Get a good night’s sleep

As adults, it is easy to place sleep at the bottom of the priority list. But this is a huge mistake. Your body needs sleep in order to heal from daily activities. If you’re not sleeping, this is not happening. If you have trouble falling asleep, increase your daytime activity. Develop bedtime rituals such as soaking in a bath, or listening to music to help you relax. Make sure your bedroom is quiet, dark and cool. Of course, we now know that lack of sleep can weaken the immune system, increase obesity, and put us at risk of developing diabetes and heart disease, so sleep does matter.

Exercise and stay active

As has been mentioned numerous times above, exercise is one of the most important ways to stay healthy. Exercise can have a profound effect on the brain by helping to prevent memory loss, cognitive decline and dementia. It can often improve your overall mood, as well as help lessen the effects of mental disorders such as anxiety and depression.


Now that you’re in the know, put these tips into action. However, if you have ongoing joint pain, it’s time to contact Orthopedic Institute and get the appointment ball rolling.

What Is Causing My Shoulder Pain?

What Is Causing My Shoulder Pain?

It happens to the best of us. We wake up, get out of bend and wince – “What is that pain in my [insert body part here]?”

When it comes to shoulder pain, there are a variety of causes, depending on your level of physical activity, age and even career.

Rotator cuff injury

You rely on your rotator cuff muscles to keep your shoulders in position and allow you maximum mobility in your upper body. So when the rotator cuff experiences a tear or strain, it can cause a lot of shoulder pain that might manifest itself most often when you’re lifting your arm up or pull on an object. If you’ve experienced a tear in your rotator cuff, surgery might be the answer to repair it, depending on the severity.


Joints as a general rule are prone to bursitis, and shoulders are no different. Bursitis refers to fluid accumulation in the form of sacs in or near your joints. Bursitis may be common, but it isn’t pleasant – it can cause pain, redness and inflammation. These issues typically occur as the result of some sort of bodily injury, so protect your joints when performing physical activity. Bursitis is typically treatable through a course of anti-inflammatories, but surgery and physical therapy may be necessary for long-term afflictions.


If your job or your favorite after-work activities involve a lot of shoulder movement that repeats itself on a frequent basis, your tendons might be reacting to an irritation. Think of a baseball pitcher or tennis player who repeatedly moves his or her shoulder in the same way over and over. Your doctor or physical therapist will likely prescribe an over-the-counter medication, joint rest and hot or cold compresses to treat your tendinitis.

‘Frozen shoulder’

Just like any other join in your body, the shoulder can be prone to inflammation and swelling. In some cases, you may notice you’ve lost much of the mobility in your shoulder, causing “frozen shoulder.” This can be the result of inflammation or other sorts of chemical imbalances. The right course of physical therapy and meds often clears up frozen shoulder. But surgery can sometimes be necessary in severe cases. After a shoulder surgery, including total replacement, frozen shoulder should not occur if you are attending regular physical therapy and performing recommended exercises and treatments at home. 


Whatever your symptoms, Orthopedic Institute can help – set up an appointment with our team today to get to the bottom of your ongoing shoulder pain.

Using Pins and Needles to Get Rid of That Feeling of Pins and Needles

By any measure, Dee Larson and her husband Dale lived a pretty good life. Dee was an executive assistant. Dale was a pharmacist.  With two grown children, doing very nicely in distant cities, Dee and Dale regularly played golf together. When they weren’t golfing or socializing, they traveled to warm and sunny places on land and enjoyed the occasional cruise.

But about 10 years ago, something happened. Dee noticed her legs were tired and thought something was happening to her nerve endings that made her feel like something was crawling in her leg. Sometimes it felt like pins and needles.

It was disrupting her sleep. “I was tossing and turning constantly,” said Dee. “It was affecting my husband’s sleep, too.”

For those who don’t recognize these symptoms, Dee suffered from what is known as “restless leg syndrome” or RLS.  It affects about 10% of the population, mostly women in their 50s, and is a neurological condition characterized by unpleasant and painful sensations, like those Dee experienced, and an irresistible urge to move the leg. Maddeningly, lying down activates the symptoms and, left untreated, RLS can cause fatigue and exhaustion, impair memory and concentration, and make travel difficult. Dee did seek treatment. “I tried every kind of medication,” said Dee. “But I didn’t like how they made me feel—and they didn’t help that much.” But there was something worse. “I had terrible dreams.” Her life was becoming a nightmare.

Dee stopped taking medicine and found a surprising treatment:  acupuncture.   And it worked.

Life, as it happens, takes unforeseen turns and sometimes what you need is unexpectedly at hand.  Dee set up an appointment for acupuncture with  K.C. Chang, MD, a physiastrist specializing in non-surgical treatment of the spine at Orthopedic Institute. Twenty five years ago he integrated acupuncture into his practice.  He is one of a few medical doctors practicing acupuncture in the state of South Dakota. Dr. Chang, who has treated about 20 patients for RLS began to treat her.  Dee said things got “progressively better with each session until I felt I didn’t need it anymore.”

Indeed, one day, no more pins and needles. Which is ironic since acupuncture uses needles to stimulate “meridians,” or energy pathways, in order to modulate the neurological states that apparently cause RLS. Ironically, later, after Dee had knee surgery, the RLS returned. Again: Dr. Chang and acupuncture to the rescue.

Once again, life is good.

Aquatic Therapy: Treatment Offers Gentle Alternative for Some Orthopedic Patients

Article by Darcie Bontje, Sioux Falls Woman

While physical therapy is the prescribed course of treatment for many orthopedic injury sufferers, a land-based regimen is not suitable for some patients.

Brad Pfeifle, vice president of Sports Medicine and Rehab Services at Orthopedic Institute, says that’s where OI’s new aquatic therapy program fits in. “This is a great adjunct to our current physical therapy services for patients who can’t tolerate ground-based rehabilitation services.”

Through its partnership with GreatLife Malaska Fitness Club, Orthopedic Institute now offers aquatic therapy at GreatLife Woodlake Athletic Club, 4600 Tennis Lane in Sioux Falls.

Aquatic therapy allows patients who are unable to fully weight bear to ambulate sooner because they are more buoyant, Brad says.

The treatment minimizes swelling, improves range of motion, gently builds strength and decreases the impact on joints.  It can be used independently, where a patient is gradually transitioned to land-based therapy, or in combination with a ground-based program.

Benefits of aquatic therapy:

  • Reduce pain
  • Minimize swelling
  • Improve range of motion
  • Gently build strength and muscle tone
  • Reduce fall risk
  • Improve circulation
  • Decrease impact on joints

Orthopedic Institute’s licensed physical therapists provide one-on-one sessions for patients in Woodlake’s therapy pool, which ranges from 84-86 degrees Fahrenheit and features a wheelchair lift.  The pool depth ranges from 3.5-6 feet.

The Woodlake facility also caters to privacy.  “Patients can go from the locker room to the pool and back to the locker room without having to walk around the facility.  This unique setup really takes away the intimidation factor,” he says.

We have been building this program for more than a year,” says Brad, who adds that standardized therapy protocols will be closely followed.  “This is great for the community and something that people are really going to benefit from.”

Insurance does provide reimbursement for aquatic therapy and OI accepts outside referrals, he says.

“Whether someone is a surgical or nonsurgical patient, our ultimate goal at Orthopedic Institute is to get them back to an active, healthy lifestyle,” Brad says.  “Water therapy is a great median for that.”

For more information on aquatic therapy, call 605-977-6845.

Common Foot Problems: Plantar Fasciitis

Plantar fasciitis is a common cause of heel pain. This chronic problem is an inflammation of the plantar fascia, a ligament-like structure that passes from the heel to the forefoot. The inflammation is caused by the fascia partially tearing or pulling away from the heel. A bony spur may also develop where the fascia and heel bone meet.

Self-care includes over the counter arch supports or heel pads, exercises, massage and heat or ice.

Doctor’s care may involve anti-inflammatory medications, custom-made orthotic supports or heel cups, night splints, physical therapy, and, if necessary, a cortisone injection. Complete recovery may take months.

Surgery can be performed to release the fascia in severe cases. It can be done traditionally (open surgery) or endoscopically (using a telescope-like instrument and small incisions).

If your foot flattens too much, the plantar fascia may overstretch and become inflamed.

If your foot doesn’t flatten, the plantar fascia may be pulled too tight, eventually causing pain.

What Orthopedic Institute offers with pedorthic care:

  • Custom Orthotics
  • Running/Walking Analysis
  • Shoe Recommendations
  • Diabetic Foot Care
  • Amputee Foot/Toe Filler
  • Custom Bracing/ AFO
  • Shoe Modifications
  • External/Internal Heel Lifts

Dr. Watson specializes in foot and ankle medicine, and also general orthopedics.  He completed his fellowship in foot and ankle surgery at GIKK in Omaha and the University of Nebraska Medical Center.

Reid Herrboldt, MS, ATC, CPED

Our pedorthist, Reid Herrboldt, has many years of field experience and specializes in diabetic care, athletics, and pediatric care for orthotics and bracing.

To make an appointment to see one of our specialists please call 605.331.5890 or 888.331.5890 E-mail: contactus@ortho-i.com

Common Foot Problems: Heel Pain

Heel pain is a common problem that can affect people of all ages. Over time, problems with the way you walk or stand can cause painful changes in ligaments and other tissues. The heel and ankle bones can be affected too. Heel pain also can result from an injury or a health problem, such as arthritis, that affects the entire body.

Self-care includes warm soaks and rest. Wear shoes that support your arches and have cushioned insoles. Stretching exercises and massage may also help.

Doctor’s care may involve oral medication to reduce inflammation, and stretching exercises. To relieve pressure, you may be given a special pad to wear in the heel of your shoe, or a removable heel cup or other orthotic support. If these methods don’t work, you may be given a cortisone injection.

Surgery is not common.

What Orthopedic Institute offers with pedorthic care:

  • Custom Orthotics
  • Running/Walking Analysis
  • Shoe Recommendations
  • Diabetic Foot Care
  • Amputee Foot/Toe Filler
  • Custom Bracing/ AFO
  • Shoe Modifications
  • External/Internal Heel Lifts

Dr. Watson specializes in foot and ankle medicine, and also general orthopedics. He completed his fellowship in foot and ankle surgery at GIKK in Omaha and the University of Nebraska Medical Center.

Reid Herrboldt, MS, ATC, CPED

Our pedorthist, Reid Herrboldt, has many years of field experience and specializes in diabetic care, athletics, and pediatric care for orthotics and bracing.

To make an appointment to see one of our specialists please call 605.331.5890 or 888.331.5890 E-mail: contactus@ortho-i.com