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

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.

3 Exercises to Strengthen Your Shoulders and Spine

3 Exercises To Strengthen Your Shoulders & Spine

Our arms and shoulders assist us with almost all of our daily activities, so it’s easy to see why strong shoulder muscles are so important! Weak shoulders can increase your risk for injury at the gym or going about your day lifting kids, household items, grocery bags and more. Poor posture can also lead to neck and back pain.

Don’t let back pain and decreased range of motion sneak up on you. Try these three, easy-to-do shoulder and spine exercises at home. No equipment necessary.

1. Wall Angels

This upper-body mobility exercise not only strengthens the muscles responsible for holding your shoulders back (and improving your posture), it can also help maintain full range of motion. Our physical therapists recommend wall angels for everything from shoulder injury rehabilitation to improving minor back and neck pain.

  • Stand with your feet shoulder-width apart, 6-12 inches away from the wall, and your back against the wall. Your arms should be resting at your sides.
  • Bend your elbows 90 degrees and rotate your arms so that your shoulders, arms and back of your hands are touching the wall in a “hands up” position.
  • Slowly move your arms up and over your head to form a wide “V” while maintaining contact between your elbows, hands and the wall. Only go as high as you can to keep the backs of your hands and elbows in constant contact with the wall.
  • Bend your elbows and lower your arms back to the starting positions by actively pulling your shoulder blades down.
  • Raise and lower your arms like this for two sets of 15 reps. You should feel your muscles working between your shoulder blades.

2. Quadruped Scapular Retraction

Never heard of “scapular retraction?” Essentially, it’s pulling your shoulder blades (scapulae) back to improve posture and strengthen your shoulders. Modern life, and all of our sitting and/or hunching over computers and smartphones, has made us all much more likely to slump our shoulders.

  • Start on all fours with your wrists stacked directly under your shoulders, and your knees stacked directly under your hips. This creates a “neutral” spine.
  • Push into the ground, round your back slightly, and actively pull your shoulder blades together. Try to keep your shoulders relaxed and away from your ears.
  • Repeat 10-12 times for 1-2 sets.

3. Lateral Arm Raise

This simple exercise can be done while standing or sitting, and with or without hand weights. You will strengthen your lateral deltoid muscles on the side of your shoulders, as well as the muscles in your upper back.

  • Stand straight with your feet hip distance apart and your arms down at your sides.
  • With or without weights, raise both arms to the side with palms facing down until they are at shoulder level and parallel to the floor.
  • Hold the position for one second and slowly lower your arms.
  • Repeat for two sets of 10-12 reps.
Essential Strength & Stability Exercises for Female Golfers

Essential Strength & Stability Exercises for Female Golfers

An average golfer makes roughly 50-60 full swings per round. Each swing puts our joints near their end range of motion, particularly in the shoulders, spine and hips. If one does not possess the range of motion or strength to do this, then we put ourselves at additional risk of injury – which is why 46% of women suffer from low back pain and injuries from golfing.

Reduce your risk of injury with these essential strength and stability exercises for all golfers—but especially women.

Working with many golfers, healthy and injured, I notice trends in the physical characteristics between male and female golfers. For example, women tend to have much better mobility while men typically possess more strength while lacking range of motion.

Because of this, female golfers usually benefit from strength and stability exercise routines to help their muscles better protect their body while swinging a golf club. A simple warm-up routine (before you touch a golf club) that activates these muscles will have drastic effects on your body’s capabilities.

Use these two simple exercises to increase stability in your back and core, and to help protect your spine while golfing. If necessary, I recommend a physical screen and swing analysis to determine specific areas of emphasis that can improve your golf game and keep your body healthy.

Arm/Leg Floor Stretch

  • Start in the quadruped position (all fours) with arms and thighs perpendicular to the floor.
  • While stabilizing your spine in a neutral pelvic posture, extend your right leg and left arm simultaneously.
  • Make sure your spine stays neutral throughout the maneuver and repeat with the opposite side.

“Y” Exercise Ball Stretch

  • Lie on your stomach on top of an exercise ball with your arms out in front of you as though you are making the letter “Y.”
  • Raise your right arm and your left leg in the air and hold for 5 seconds.
  • Repeat this with the left arm and right leg. Perform 10 reps on each side. This builds the important muscles in the back that will help protect you during your golf swing.

Adam Halseth is a Physical Therapist and Golf Medical Professional with a Level 3 certification from the Titleist Performance Institute. He specializes in sports medicine and golf rehabilitation, and directs the OI Golf Medicine Program. Adam graduated from Mayo Clinic School of Health Sciences with his Doctorate in Physical Therapy in 2014.

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.

6 Tips for Reversing Your Shoulder Pain

6 Tips for Reversing Your Shoulder Pain

Shoulder pain—for many of us it’s just a fact of life. But when it’s keeping you from enjoying your daily activities, it may be time to try some useful remedies.

Try out some of these options for reversing shoulder pain.


If you have soreness in your shoulder that you suspect was brought on from exercise or physical activity, an inflammation or swelling may have occurred. One way to reduce mild, exercise-related shoulder pain is through stretches. These may include chest expansions by meeting your hands behind your back or across-the-chest stretches, bringing your arm across your chest and pulling your elbow toward it with your spare hand. These are exercises that should be recommended by someone who specializes in functional assessment, such as a physical therapist or athletic trainer.

Sleep Differently

One common cause of shoulder pain, particularly when it’s experienced first thing in the morning, is sleeping habits. A potential way to reduce this pain is to try out a new sleeping position. If you favor one side over the other, it might be an indication of where your pain is coming from. Use pillows or remove pillows to determine the best amount of cushion to avoid pain if you favor sleeping on your back or stomach. According to our experts, it’s best to sleep on your back with your hands below chest height. AVOID SLEEPING ON YOUR STOMACH. This can cause even more shoulder pain when you wake up.

Diversify Your Exercises

Another frequent reason for shoulder pain is found in athletes or otherwise physically fit people—especially when they tend to exercise or engage in sports with highly repetitive shoulder movements. The best way to combat this is to keep your regimen diverse. Select a variety of exercises that don’t put undue strain on your shoulders as compared to the workout your other joints are receiving.

Try Massage

Massage therapy can very often be beneficial for shoulder pain, because it can release muscle tension and increase range of motion in the joint – which in turn can improve function and help reduce pain. Best of all, you can give yourself a neck and shoulder massage almost anywhere and at anytime for temporary relief. If you still feel stiff and sore, talk to your doctor about other therapy options.

Apply Heat or Cold

Just like when you’re nursing an injury, applying heat or cold can go a long way toward reversing your shoulder pain. Use heat to soothe stiff joints and relax muscles after a strain or when recovering from an injury. Ice packs are typically used to numb sharp pain and reduce inflammation immediately following an injury. Whichever option you need, remember to protect your skin – and only apply the hot or cold therapy as directed.

Obtain Physical Therapy

There’s perhaps no better way to reverse your shoulder pain, particularly when it’s ongoing or chronic, than being seen by a physical therapist or orthopedic physician. It’s the best way to determine if your condition is diagnosable and how best to treat it.  Contacting Orthopedic Institute for an appointment is a good place to start.

When to See a Doctor for Your Shoulder Injury

When to See a Doctor for Your Shoulder Injury

Whether you’re an avid athlete or do a lot of heavy lifting, shoulder pain isn’t always such an uncommon symptom for many of us. (And since each and every one of us is aging, it becomes increasingly more likely as we get older.) But when does pain merit a visit to an orthopedic physician?

Here are a few signs that it might be time to make an appointment.

Swelling and Redness

Physical symptoms that go beyond just “feeling sore” can be a sign that you should seek out medical assistance. (Depending on the severity and whether or not it was spurred by an injury, immediate attention might even be in the cards.) If your shoulder joint is visibly swollen or if it is tender or warm to the touch, you should strongly consider having it looked at – particularly if symptoms persist over long periods of time.

Home Remedies Failed

When you experience joint pain in an area of the body like the shoulder, your first instinct is likely to try out some home remedies to help the symptoms subside. But if over-the-counter pain reducers, a nice long nap or applying cold or hot compresses don’t seem to be doing the trick (or if they only offer a temporary reprieve), it’s probably a good plan to set up an appointment at OI.

Lifting Pain

Many injury-related shoulder pains can be linked to harm to your rotator cuff. That’s why one surefire way to determine whether your pain is something that needs a physician’s care is to try lifting your arm over your head. If this or other everyday activities, like getting dressed in the morning, increase your pain level, you may be experiencing a tear or strain that needs to be treated. (Just make sure that you stop at the first sign of pain – there’s no need to overdo your arm-lift test and risk making the condition worse.)

Lengthy Symptoms

Some temporary, home-treatable conditions will last a day or two and subside. However, if your shoulder pain prolongs over several days or even weeks, regardless of the pain level, it may be the result of something chronic such as osteoarthritis, tendinitis or bursitis. If you’re experiencing even moderate symptoms that last longer than a week, consider scheduling an appointment with an OI physician or physical therapist.

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!

The Physical Effects of Training on Your Body

The Physical Effects of Training on Your Body

You can feel it every time you engage in physical activity. Something is happening, physiologically speaking, when you train or work out. But what exactly is it doing, and what are the positive effects of the visual effects of change in breath patterns, muscle fatigue or a pounding heartbeat?

Here are some of the physical effects your body undergoes when you’re training.

Joints & Bones

If bone density is a priority for you (it starts to decrease once you reach your maximum in early adulthood) training can actually have a positive effect on your joints and bones. Inactivity is the quickest route to brittle bones – weight-bearing exercise helps build up your bone mass and staves off bone disease and weakness of joints.


So you’ve heard the phrase “get your blood pumping” when it comes to exercise, but what does that even mean? Well, when you’re working out or training, your bloodflow is redirected to the most pressing areas of need, namely muscles, where the increase of oxygen and decrease of waste and acid buildup improves flow efficiency in the long-term.

Brain Function

One of the bonuses of improved bloodflow is improved brain function – exercise and fitness actually has positive physical effects on your brain power. You might notice your ability to focus and recall facts is improved immediately following a workout. It’s a direct result of improved bloodflow.


Bloodflow is pretty much a wash without the heart, another element of the body that undergoes distinct physiological effects during training. With frequent physical activity, your heart becomes better over time at pumping more blood to the most effective locations in the body. This means a more efficient distribution of blood with a lower heart rate, something virtually impossible in a body devoid of frequent exercise.

Lung Capacity

The fact of the matter is, when you’re working out, you’re pushing your lungs to their maximum breathing capacity – often requiring as much as 15 times as much oxygen than when you’re sitting still. There’s a reason this has positive long-term effects. Each time you reach your maximum oxygen intake you’re building up the level at which it normally rests. The more you exercise, the more this level increases and improves your fitness.


When your muscles are in action, they require more oxygen and blood vessels expand to allow this intake. And the more they’re used, the more nutrients are delivered, spurring growth and ability. The process of working out delivers the right hormones and other elements to your muscular system to improve your athletic prowess over time.

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.