Common Foot Problems: Hallux Rigidus

Hallux rigidus at base of right big toe

Hallux rigidus is characterized by loss of motion, pain, redness, and swelling at the base of the big toe. It’s a chronic condition caused by arthritis, often brought on by an old injury.

Doctor’s care may include using pads and an oral medication to relieve the inflammation, or cortisone may be injected directly into the joint.

Surgery is performed in severe cases. Bony spurs and part of the joint at the base of the big toe may be removed. Sometimes the joint is fused, rebuilt, or replaced.

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:

Common Foot Problems: Bunions/Bunionette

Bunion X-ray

A bunion is an unsightly bump at the base of the big toe. Because bunions don’t fit most shoes, the skin in the area can become irritated and swollen.  Bunions, hammer toes, and metatarsalgia often appear together. Although bunions tend to be hereditary, wearing shoes with too narrow a forefoot or too high a heel can bring bunions on years sooner. Sometimes bunions develop with arthritis.

Self-care begins with wearing shoes that have a low heel and don’t cramp your bunion. You may be able to have shoes stretched to fit a bunion.  If your symptoms don’t improve, see a foot specialist.

Doctor’s care may start with recommendations about specific changes to your regular shoes, such as wearing shoes with a wider forefoot or using devices such as pads. If these measures fail, you might consider surgery.

Surgery involves realigning the big toe. Part of the first metatarsal bone may be removed or reconstructed. A wire may hold the new alignment. You may have a walking boot or surgical shoe.


Bunionette is like a bunion, but occurs at the base of the little toe. Treatment may include wearing shoes with a wider fore-foot.

Surgery involves the removal of the bony prominence.

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:

Don’t Let a Fall from a Ladder Ruin Your Holiday Season

Dr. Eric S. Watson, M.D.

The holidays are right around the corner. Do you have your decorations up? If not, you might be tempted to do it soon.

Dr. Eric Watson, a lower extremity specialist with Orthopedic Institute in Sioux Falls, recommends everyone take extreme caution when using a ladder this holiday season.

According to the World Health Organization, the United States leads the world in ladder deaths. Each year, there are more than 164,000 emergency room-treated injuries and 300 deaths in the U.S. that are caused by falls from ladders

“I have worked with patients who fell from ladders on multiple occasions,” said Watson. “It generally takes six weeks for a foot or ankle injury to heal, but that is after the surgery. Most cases are surgical but we have to wait to complete the surgery until the swelling has gone down. A foot or ankle injury could really ruin your holiday season.”

Watson said the most common injuries he sees are broken ankles and feet, but it all depends on how a person falls.

“If you jump off and land on your feet you’re probably going to do some damage to your feet or ankles, but if you land on your hands, you can harm your wrists, hands or arms,” he said. “You could also fall on your back and hurt your head or neck.”

Oftentimes, falls cause injuries in several areas, Watson said.

“There is almost always an associated injury to go with the broken bones,” he said. “A common one is a compound compression fracture in your back, which is very painful.”

Watson offered these tips to avoid injuries while working on ladders:

  • Always inspect the ladder to make sure it is in good working condition. “Make sure there is no excess mud on the rungs that could cause you to slip and make sure all the ladder components are working properly,” he said.
  • Always place ladders on a level surface. “Make sure the hinges are locked out and the legs are as level as possible,” Watson said.
  • Always face the ladder when climbing and wear clothing that allows you to keep a good grip on the rungs.
  • Place the ladder as close to where you’ll be working as possible. “You don’t want to have to reach off the ladder very far,” Watson said. “The further from the center of gravity you are, the more likely you’ll tip the ladder.”
  • If possible, have someone hold the ladder. “This is especially important if you don’t have a good, level surface,” he said.
  • Never step on the top rung or the paint bucket shelf. “Do exactly as the label says and stay off,” he said. “(Ladder manufacturers) really mean it; the warning labels are there for a reason.”
  • Use a job-appropriate ladder. “You don’t need to use a 14-foot ladder to reach up three feet,” he said. “The higher up you are, the more worried you should get because the ladder will be less stable. Make sure your ladder is the appropriate height for the job.”

Some common sense and a bit of planning will go a long way in preventing ladder injuries, Watson said. “The old adage, ‘An ounce of prevention is worth a pound of cure,’ is certainly true here,” he said.

Halloween Safety Tips from Orthopedic Institute


Enjoying Halloween is all about the preparation. Finding the ideal costume, decorating the house, planning the route, purchasing the candy and decorating the perfect pumpkin. But along with the fun, there are numerous Halloween injuries. Orthopedic Institute would like to help you stay safe this Halloween with expert advice and tips.

“Unfortunately, every year we see multiple injuries that occur as a result of carving pumpkins,” says Blake Curd, M.D., a fellowship-trained hand surgeon for Orthopedic Institute. “Although fun and enjoyable, it can turn tragic when people are not careful. There are special tools designed for carving pumpkins. Most of them are serrated knives with a plastic handle. I encourage my patients to use those types of tools instead of the standard kitchen knife to avoid raising their risk of injury.”

Statistics from 2007-2011 show the following injuries around Halloween among children 18 years and younger:

  • Children, ages 10-14 sustained the greatest portion of injuries at 29 percent
  • Head injuries accounted for the greatest portion of injuries at 17 percent followed by finger/hand injuries at 14.2 percent
  • Of the finger/hand injuries sustained, 25.6 percent were lacerations and 15.2 percent were Fractures

To help reduce the risk for injury on Halloween, the AAOS and POSNA offer the following safety tips:

Pumpkin carving

  • Use a pumpkin carving kit, or knives specifically designed for carving. These are less likely to get stuck in the thick pumpkin skin.
  • Children should not carve pumpkins unless supervised closely by an adult. Some Halloween carving devices, designed especially for children, may be safe for use with parental supervision.  Younger children can use paint, markers or other non-carving decoration kits. Always carve pumpkins in a clean, dry and well-lit area and make sure there is no moisture on the carving tools or your hands.
  • Beware of sharp carving tools!  If you are cut, apply pressure with a clean cloth and elevate the area above the heart. If bleeding does not stop within 10-15 minutes or if the cut is deep, evaluation by a physician might be needed.  Make sure cuts are cleaned and dressed with clean bandages.


  • Walk on sidewalks and never cut across yards or driveways. Obey all traffic signals and remain in designated crosswalks when crossing the street.
  • Costumes should be flame-resistant and fit properly. The child’s vision should be unobstructed by masks, face paint or hats. Costumes that are too long may cause kids to trip and fall, so trim or hem them as necessary.
  • Wear sturdy, comfortable, slip-resistant shoes to avoid falls.
  • Trick-or-treaters should only approach houses that are well lit. Both children and parents should carry flashlights to see and be seen.
  • Be aware of neighborhood dogs when trick-or-treating. Remember that these pets can pose a threat when you approach their home.
  • Avoid candles in Halloween decorations.  Instead, use non-flammable light sources, like glow sticks or artificial pumpkin lights.
  • Carry a cell phone while trick-or-treating in case of an emergency.

Have a safe and happy Halloween from Orthopedic Institute.

Keith Baumgarten M.D. Receives Sports Injury Research Award

Keith M. Baumgarten MD, Sports Injury Research Award

Keith M. Baumgarten, M.D. was awarded the 2014 O’Donoghue Sports Injury Research Award.

Keith Baumgarten M.D. Receives Sports Injury Research Award

Keith M. Baumgarten, M.D., an orthopedic surgeon with Orthopedic Institute was awarded the 2014 O’Donoghue Sports Injury Research Award.

The prestigious award is given annually to the best overall paper that deals with clinical based research or human in-vivo research.

This year’s winning research was entitled “Revision Anterior Cruciate Ligament Reconstruction Graft Choice Impact on Outcome in the Multi-Center ACL Revision (MARS) Cohort.”

The study, which analyzed the impact of using a patient’s own autograft tissue verses a cadaver graft for ACL replacement, demonstrated better patient reported outcomes and a decreased retear rate if a patient’s own tissue was utilized.

Baumgarten Repeats as Research Award Winner

This is the third research award for Dr. Baumgarten and the MARS group in four years.

The Multicenter ACL Revision Study (MARS) was established in 2006 and consists of 87 surgeons from over 52 sites across the United States and Canada who are interested in outcomes following an ACL revision surgery.

About the O’Donoghue Sports Injury Research Award

The O’Donoghue Sports Injury Research Award was named after Don H. O’Donoghue, MD who is known as the Father of Sports Medicine in the United States. His early work on knee injuries led to the development of the subspecialty and started the interest in the care of athletes.

The awardee is selected by the AOSSM Awards Subcommittee with recipients receiving $2,000. AOSSM annually provides more than $350,000 to research initiatives and projects around the country.

The American Orthopaedic Society for Sports Medicine (AOSSM) is a world leader in sports medicine education, research, communication and fellowship, and includes national and international orthopaedic sports medicine leaders.

The Society works closely with many other sports medicine specialists, including athletic trainers, physical therapists, family physicians, and others to improve the identification, prevention, treatment, and rehabilitation of sports injuries. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids.

The OI Way: Proven Weight Loss Support for Optimal Joint Health

The numbers are staggering according to the Centers for Disease Control and Prevention one third of all adult Americans are obese, while the National Institutes of Health state that another third are considered overweight. This condition often leads to serious and chronic health issues, including heart disease, stroke, Type 2 Diabetes and certain types of cancer, as well as disabling joint degeneration. For Dr. Matthew J. McKenzie, a board-certified orthopedic surgeon at Orthopedic Institute in Sioux Falls, consulting with patients who have chronic or severe joint issues is his specialty. What has always concerned him, however, is the sheer number of his patients that have joint problems simply because they’re overweight. “Easily 30 percent of my patients have joint issues as a direct result of their weight,” McKenzie says. “I’ve struggled with my weight my whole life and when I grew up I was one of three kids in my school that had a weight problem. Now 20 to 30 percent of kids have a weight problem. I feel that it’s imperative as a healthcare professional to address the problem for my patients even though that isn’t the primary reason they’re making an appointment with me.”

In the past, Dr. McKenzie and his colleagues would refer overweight patients to local weight-loss facilities for help. However, because there was no way to follow up with their progress, there was also no way to encourage or guarantee weight-loss success and ultimately a better outcome for their joints.

“I wanted to know that I was doing everything I could to give my patients the help they needed, and that’s why we are now offering an incredibly effective weight loss solution called The OI Way within our clinic. This isn’t mandatory and not everybody is going to do it, but we wanted to have the means to help them if they chose to do it. This is a solid solution that gives people tools to control their weight,” McKenzie says.

The OI Way combines professional consultation and support from a Health Coach along with FDA label-approved food and recommended supplements. Depending on the amount of weight loss desired, most patients can expect to be on the program for three months or less.

“With this weight-loss program, we’re advocating a proven and highly-effective solution for our patients. I see many people that feel hopeless about losing weight because they are unable to exercise, their body is literally breaking down and they feel helpless,” McKenzie says. “When we address the original problem about their weight, I believe it will solve other health issues. Patients can come in to achieve not only a solution for their bad joint, but improvement of their overall health. This program is strict but foolproof, if you follow it.”

To schedule an appointment, or for more information about The OI Way, contact a health coach at 605.330.2416 with Orthopedic Institute in Sioux Falls.

Acupuncture: An Alternative Treatment for Pain Relief

Wielding a very fine needle, Dr. K.C. Chang locates the precise point and very gently, painlessly, inserts it into the skin. Professionally tapping the specific site within the body’s trouble-some meridian, Dr. Chang’s treatment introduces a stimulation of endorphins through the art of Medical Acupuncture. Used as an alternative treatment option, acupuncture can deliver pain relief and renewed life energy.

As one of a few board-certified physicians in South Dakota licensed in electrodiagnostic medicine, K.C. Chang, MD, Orthopedic Institute, specializes in nonsurgical treatment of the spine. As a physiatrist, Dr. Chang’s treatment methods often include the use of acupuncture. He adds, “After my residency training and during my practice, I became disillusioned with the conventional treatment options for some of my neck and back patients. I have used acupuncture on patients for over 14 years and I find amazing pain control results.”

Dr. Chang says acupuncture is based on the theory that an essential life energy called QI flows through the body along invisible channels called meridians. When the flow of QI is blocked or out of balance, illness and pain results. He adds, “According to Chinese theory, stimulation of specific points along the meridians can correct the flow of QI and result in pain relief.”

Noting a rise in the popularity of medical acupuncture, Dr. Chang adds, “Approximately 10% of the American population has tried acupuncture for pain on improving the functioning statuses control due to neck and back problems. in life. Most patients ask for acupuncture after pain control of common musculoskeletal problems, such as neck and low back physical therapy, back surgeries, pain, joint problems or muscle problems, or injections. My specialty focuses and improving everyday life functions.”

“More and more patients are seeking alternative treatments for musculoskeletal problems.”

Also within the field of medical acupuncture is the use of electroacupuncture. Dr. Chang explains, “Electroacupuncture is the use of electrical currents to induce stimulation directly to the needles at certain acupoints. After the needle as been placed in the skin, it is hooked up to electrical pulses; the electroacupuncture uses low frequency of 2-4 hz and high intensity. It involves endorphinergic mechanism, generates a slow onset of analgesia, and has longer lasting results.”

Documented as safe and reputable treatment, Dr. Chang adds, “The use of acupuncture and electroacupuncture has been recommended by the World Health Organization for 40 medical conditions ranging from asthma to chronic pain. In 1999, the National Institute of Health found it to be acceptable treatment for many pain conditions, including fibromyalgia and general musculoskeletal pain.”

How would you rate your pain level on a scale of 1-10? The question is routinely asked during a visit with Dr. Chang. He shares details about the positive responses he receives from acupuncture treatment. “Once you provide needle treatment 1-2 times per week, typically up to 10 treatments, the patient usually begins to use less medication, walks better and is able to find relief from pain.”

In closing, Dr. Chang says, “I am excited that more and more patients are seeking alternative treatments for musculoskeletal problems. My hope is that acupuncture is used as one treatment option for musculoskeletal pain.”