10 Facts About Microdisectomy for Leg Pain & Weakness

December 10, 2018/in Neck and Spine, Pain Management /by Christopher Holman

A microdisectomy is a relatively common procedure used to alleviate leg pain, weakness and, occasionally, pain in the lower back. For some patients, back surgery can be a frightening concept—so we’ve put together a list of facts that you should know about the use of microdisectomies to correct back pain and weakness.

Read on for 10 facts about microdisectomies for leg pain and weakness.

1. The Procedure Can Be Minimally Invasive

While there are different surgical methods for microdisectomies, they are generally minimally invasive—often utilizing a surgical microscope and performed through a small one inch incision in the lower back.

2. It Removes the Herniated Portion the Disc

After making the incision in the spine, the surgeon removes the membrane over the nerve root and carefully retracts the nerves from the herniated disc in order to remove the source of pressure on the nerve root.

3. It Usually Offers Immediate Relief from Leg Pain

The purpose of a microdisectomy is to remove a small portion of the herniated disc in your spine that is placing pressure on the nerve root. Removing pressure on the nerve root will often completely remove the source of the pain and patients generally feel pain relief immediately following the procedure.

4. Recovery May Take Months for Neurological Symptoms

When the nerve root is damaged by the herniated disc, it may lead to numbness, weakness or other neurological symptoms in the leg or foot. Following the surgery, it may take months for the nerve root to fully heal and for these symptoms to subside.

5. You Should Try NSAIDs and Physical Therapy First

Patients should generally only consider surgical intervention when alternative treatment options, such as oral steroids, NSAIDs and physical therapy have failed to address their pain.

6. The Procedure Is Up to 95% Effective for Sciatica Pain

According to the Spine Institute of San Diego, the success rate of micodisectomies approaches 95% for appropriately chosen patients. This translates to high rate of success and pain relief for those experiencing pain, weakness or numbness in their legs.

7. Most People Leave the Hospital Within 24 Hours

Because the procedure is minimally invasive, many patients who undergo a microdisectomy are able to go home within 24 hours of their procedure—often on the same day.

8. It is Sometimes Referred to as “Microdecompression”

Some people refer to a microdisecotomy as a microdecompression due to the procedure’s decompression of the nerve root.

9. A Microdisectomy is Different Than a Disectomy

While disectomies and microdisectomies are both surgeries involving the partial or complete surgical removal of an intervertebral disc, they are two separate procedures. The “micro” in microdisctomy refers to the use of microscopic magnification, which allows for smaller incisions and a less-invasive surgery overall.

10. Roughly 5% of Patients Develop a Recurrent Herniation

While microdisectomies have an incredibly high rate of success at alleviating leg pain in patients, one of the most common complications is a recurrent disc herniation—which may require another procedure to correct.

If you suspect that you may be in need of a microdisectomy to alleviate pain, weakness or numbness in your legs, make an appointment today to meet with one of the members of the comprehensive spine team at the Orthopedic Institute.

Ice vs Heat: What’s Better for Pain Relief?

November 18, 2018/in Pain Management /by Christopher Holman

Slight to moderate pain doesn’t always require a trip to the doctor’s office. In certain situations, using a cold pack or heating pad at home can help you feel better, faster. The trick is finding the right treatment for your needs—and knowing how to use that treatment without causing yourself further pain or injury.

Ready for some cool tips and hot advice? Read on for the basic on using ice and heat for pain relief.

If you’re treating pain at home, simply remember this quick rule of thumb: Ice is for numbing the inflammation associated with fresh injuries (like if you fall and hurt your knee or ankle) – and heat is for soothing stiff, aching muscles and joints.

Let’s take a quick look at when to use both:

When to use cold therapy:

If you have had a recent injury (within the last 48 hours) where swelling is a problem.
Apply an ice pack, frozen gel pack or even a bag of frozen vegetables wrapped in a towel to the affected area. You should never apply a frozen item directly to the skin, as it can cause damage to the skin and tissues.
Apply cold treatment as soon as possible after an injury.
Use cold therapy for short periods of time, several times a day. Ten to 15 minutes is fine, and no more than 20 minutes of cold therapy should be used at a time to prevent nerve, tissue, and skin damage.
Elevate the affected area for best results.

When to use heat therapy:

If you are experiencing joint or muscle pain or stiffness.
Minor stiffness or tension can often be relieved with only 15 to 20 minutes of heat therapy.
Moderate to severe pain can benefit from longer sessions of heat therapy like warm bath, lasting between 30 minutes and two hours.
Local therapy is best for small areas of pain, like one stiff muscle. You could use small heated gel packs or a hot water bottle if you only want to treat an injury locally.
Regional treatment is best for more widespread pain or stiffness, and could be achieved with a steamed towel, large heating pad, or heat wraps.
Full body treatment would include options like saunas or a hot bath.

When NOT to use cold or heat packs:

If you have areas of skin with open wounds or rashes.
If you have areas of skin with poor sensation to heat or cold.
If you have areas of the body with known poor circulation.
If you have diabetes.
If you have an infection under your skin.

If the treatment hasn’t helped much with regular use, or makes your pain worse, see your doctor to discuss other treatment options. It’s also important to call your doctor if you develop any bruising or skin changes while using cold or heat therapy.

8 Reasons Sports Medicine Is Essential for Active Athletes

7 Reasons Sports Medicine Is Essential for Active Athletes

November 14, 2018/in Physical Therapy, Sports Medicine /by Christopher Holman

We all know how important exercise and physical activity are to good health. But if you’re an active athlete looking to up your game, it’s even more important to add specialized sports medicine care to your team. Think injury prevention, performance training … and a whole lot more.

Here are 7 reasons sports medicine is essential for active athletes.

Specialization: Unlike general practitioners or ER docs, sports medicine professionals are specially trained to diagnose and treat athletic injuries – especially when it comes to concussions and repetitive motion injuries.
Rehabilitation: Most sports injuries will require a rehabilitation period with or without physical therapy. This process is vital to recovery, and should never be left to chance.
Prevention: Sports medicine professionals understand how athletes practice and play, and can offer expert advice on preventing injuries and avoiding re-injury.
Personalization: It’s all about you! Sports medicine professionals – like our top-notch physical therapy team – can evaluate your anatomical strengths and weaknesses to make personal recommendations for everything from running shoes to training regimens.
Strength & Mobility: A quality sports medicine program will help athletes focus on individual strength, speed, mobility and agility. Learn more about OI Performance in Sioux Falls.
“Return to Play” Decisions: If there’s anything a sidelined athlete thinks about, it’s “When do I get back in the game.” Trained sports medicine professionals can help you make this all-important decision at the right time, to reduce the risk or re-injury.
Teamwork: Active athletes need a sports medicine specialty team that works together – from physical therapists and athletic trainers to board-certified, orthopedic surgeons.

These days, student athletes start playing younger and younger. Wondering if yours needs to be seen for an ache or pain? Read the 4 Reasons a Walk-In Physician is Beneficial for Your Student Athlete.

When Should You See a Doctor for Neck Pain?

October 30, 2018/in Neck and Spine, Pain Management /by Christopher Holman

Your spine is important and, when you’re experiencing chronic neck pain, it can be scary. How do you know when neck pain crosses the line from being “a pain in the neck” to something more serious?

Check out this quick reference guide for common causes of neck pain and when it’s time to see a doctor.

Common Neck Pain Causes

The tricky thing about neck pain is that it can have a number of causes. Most of the time it’s temporary and could go away with something as simple as a good night’s sleep or a dose of over-the-counter pain medication. Common causes include:

Tension headaches: Tension headaches are an incredibly common brand of headache and they are often associated with pain and tenderness in the neck.
Sleep position: Sleeping in a position where your head lacks support and your neck is strained can often cause neck pain. To avoid neck pain from sleep, try sleeping on your back. You might also need a new mattress or pillow for additional support.
Looking up and down: People tend to hold their cellphones too low and situate their televisions too high. This can lead to looking up or down for extended periods of time, which can cause neck pain.
Using the phone: While pinching your phone between your ear and your might be a convenient way to hold a conversation while keeping your hands free, this practice can put strain on your neck.
Dehydration: The discs in your spine that separate your vertebrae need hydration. If your body is dehydrated, these spongy discs become less spongy, which can lead to neck pain.
Carrying heavy objects: Carrying too much weight in one hand, such as in a briefcase or purse, can put undue strain on your shoulders, back and neck.
Posture: Sitting in a slouched position with your head in front of your shoulders can put a greater strain on your neck.

Serious Neck Pain Causes

While neck pain often results from less-serious conditions such as slouching or dehydration, there are a number of serious medical conditions that can cause neck pain as well. If you’re experiencing serious neck pain, you may want to consider seeing a spine specialist at the Orthopedic Institute.

Worn joints: Just like other joints in your body, the padding between your vertebrae can wear down with age. This can cause bone spurs which can affect your joint motion and cause pain.
Injuries: Rear-end auto collisions can result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck. Strains or sprains to the neck after an auto accident may not be immediately evident. Symptoms may start or intensify in the days after the accident but generally are short lived and treated with simple conservative measures such as ice, heat, over the counter anti-inflammatories, muscle stimulation or a exercise/therapy program.

Disease: Certain diseases such as rheumatoid arthritis, cancer or other inflammatory conditions can cause pain and stiffness in the neck. If you have persistent symptoms and family history of auto-immune diseases you may want to contact your physician.
Nerve compression: The disks in your spine that separate your vertebrae are soft on the inside with a tough exterior on the outside. A herniated disk occurs when the softer inside ruptures through the tougher exterior. A herniated disk in your neck may also cause pain in your shoulder or arm. Herniated disks, along with bone spurs in the vertebrae of your neck, can press on the spinal nerves or the spinal cord, resulting in pain, weakness or numbness and tingling

If you have severe, lasting pain, and signs that may indicate one of the more serious causes of neck pain mentioned above, it’s time to Stand Up For Your Spine. Learn more about our experienced neck and back team.

5 Signs You May Need a Hip Replacement

October 23, 2018/in Hip, Pain Management /by Christopher Holman

Many people managing rheumatoid arthritis, osteoarthritis, osteonecrosis and other general joint health issues struggle with whether or not they should seek hip replacement surgery. They have pain, but it can be hard to decide if the pain is significant enough to warrant a hip replacement.

Check out our list of 5 signs that it’s time to consider a hip replacement.

1. Hip Pain

The first, and perhaps most obvious, sign that you should consider a hip replacement is hip pain. Do you walk with a limp or depend upon a cane because of your hip pain? Hip pain shouldn’t interfere with your ability to live your life. If your pain affects your daily life, disrupts your sleeping habits or both, the damage may be serious enough to consider a hip replacement.

2. Limited Mobility

Simple tasks such as standing up, walking or taking the stairs can be incredibly difficult and painful for someone in need of hip replacement. Some people remain unaffected by their limited mobility, but if your hip pain limits your mobility to the point of interfering with your daily life, consider speaking with a physician about your options.

3. Stiffness

Does your hip stiffen up while sitting? Stiffness in a hip joint is a telltale sign that a hip may need to be replaced. Many patients in need of hip replacements will also experience stiffness when attempting to simple tasks, such as putting on shoes or gardening.

4. Grating or Rubbing

A grating or rubbing feeling in your hip joint, especially in combination with the other issues listed here, is another indicator that you may want to look into hip replacement. The hip joint is lined with smooth cartilage that prevents your thigh bone from rubbing against your hip bone. When you experience grating or rubbing, these bones are rubbing together, which can be painful and may be a sign that your hip joint should be replaced.

5. Nothing Else Works

Hip replacement surgery is never the first option. Before looking into a hip replacement, try other pain treatment options such as medication, injections, stretching and exercise. If these more moderate pain management approaches do not work, then a hip replacement may be your best solution.

If your hip pain doesn’t limit you from doing normal activities or you get relief from less invasive treatments, you may not need a hip replacement. If you are still unsure whether or not you should look into a hip replacement, come in to the Orthopedic Institute and speak with one of our hip specialists about your options.

Hip replacement can return you to a higher quality of life. Check out these Orthopedic Institute hip replacement success stories!

Top 5 Knee Injuries for Kids and Teens

September 25, 2018/in Knee /by Christopher Holman

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

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

1. Sprains

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

Common signs of a knee sprain include:

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

2. Strains

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

3. Cartilage Tears

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

4. Fractures

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

5. Tendonitis

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

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

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

4 Reasons a Walk-In Physician Is Beneficial for Your Student Athlete

September 21, 2018/in Sports Medicine, Walk In Clinic - OI Now /by Christopher Holman

Being a parent to a student athlete makes for an exciting, busy and sometimes nerve-racking life. Watching your athlete run past home plate, catch the winning touchdown or spike the ball over the net is exciting—but when it comes to sudden injury, your heart probably skips a beat.

Luckily, the services of an orthopedic walk-in clinic can be a big help in remedying this. Here are four reasons why.

At-the-Moment Convenience

Having kids can fill up a schedule fast, but having student athletes can fill up a schedule even faster—especially when it comes to injury. Luckily, orthopedic walk-in offices are often available to you when injuries occur—after regular clinic hours. Orthopedic Institute’s (OI) walk-in hours range from 3 to 7 p.m., weekdays and 11 a.m. to 4 p.m., on Saturdays, so you can rest more easily that specialists are ready to care for you student athlete in a timely manner. OI also hosts morning student-athlete clinics on the third floor of its facility Saturdays through Oct. 21, 9-11 a.m. You can check in your student athlete between 8:30 and 10:30 a.m.

Prevent Emergency Room Bills

Having student athletes can get expensive—from paying for equipment to the gas to drive them to practice or attend games—but injuries don’t have to be. Emergency room bills are an expense you can sometimes cut by seeing a walk-in physician for non-emergency situations. Sprains and fractures are not uncommon for student athletes and can be treated by one of OI’s walk-in physicians and can save you the ER visit.

Cut the Middleman

While an ER is always available, moderate or non-severe injuries might not get preferential treatment on being seen when emergency medical situations are present in other patients. If you are not the highest-risk patient in the waiting room, you will likely see a longer wait time. And if your student athlete is referred to a specialist, an appointment may not be available for a few days following your ER visit. OI’s walk-in clinic is designed to handle these types of injuries and offer direct contact with an orthopedic specialist when you stop in.

See a Specialist

Speaking of specialists… Two common injuries athletes suffer from are sprains and knee injuries—physicians at OI are specialized in sport injuries, with physicians that can treat ACL and other knee injuries, as well as foot, ankle, hand, wrist, elbow, back, neck, shoulder and knee injuries. When your athlete gets hurt, go somewhere that offers specialization to ideally see a faster recovery time.

What Is DRG Stimulation and How Can It Help Your Pain?

September 21, 2018/in Neck and Spine /by Christopher Holman

Chronic pain in the lower body is a relatively common problem, especially among patients with neuropathic pain, or pain caused by damage to the nervous system. DRG Stimulation is a revolutionary form of pain management that can target and prevent pain signals from being transmitted.

Learn more about your DRG (yes, you have one) and this revolutionary new treatment option for pain.

What is the DRG?

The dorsal root ganglion, or DRG, is an easily accessible group of nerve cell bodies in your spine that is tasked with transmitting pain signals from the lower half of your body to your brain. Damage to your DRG can cause serious and persistent neuropathic pain that does not respond to traditional treatments, such as spinal cord stimulation (SCS). DRG stimulation is a way to specifically target and manage this pain.

What is DRG stimulation?

DRG Stimulation is a form of targeted neuromodulation similar to spinal cord stimulation (SCS) procedures. Neuromodulation is the strategic electrical stimulation of certain parts of your nervous system to modify any abnormal neural pathways. The key difference between spinal cord stimulation and DRG stimulation is that, while spinal cord stimulation targets the spinal cord, DRG Stimulation targets the dorsal root ganglion in particular.

DRG stimulation is performed by implanting thin wires connected to a generator on your DRG. The generator is controlled by the patient and sends electrical pulses through the wires to specific regions of your DRG. This signal interrupts pain signal transmission to your brain and helps to alleviate pain.

How Can DRG stimulation help my pain?

For people with neuropathic pain, DRG stimulation can effectively block pain signals without the need for medication. The key benefit of DRG stimulation is that it provides specific and targeted pain relief to the lower body. Compared to spinal cord stimulation, DRG stimulation is associated with fewer instances of paresthesia, or tingling in the lower body. Additionally, pain relief through DRG stimulation doesn’t diminish over time, and – because DRG stimulation requires less energy – there’s more time between generator charges.

Sheku’s story

As a lifelong athlete and former University of Sioux Falls lineman, Sheku Bannister (shown here with his wife Amanda) was no stranger to powering through pain. But nothing prepared him for life with chronic pain.

It all started in 2015 when Sheku fell three stories off a roof and severely injured his right foot and ankle, resulting in plates and pins—and chronic pain. Over one year after surgery he still didn’t have relief and was beginning to lose hope.

“I was in a dark place. The medication wasn’t working. It was a nightmare,” he said.Sheku was referred to Dr. James T. Brunz at the Orthopedic Institute. “I was fighting to get back to normal,” he said. But fighting didn’t include taking long-term pain medications, especially after watching several family members struggle with drug addiction. When Dr. Brunz suggested DRG Stimulation, Sheku considered his options. “I didn’t want another surgery,” he said. “But I decided to take things into my hands and talk to the physicians I could trust. Dr. Brunz was one of them.”

“I would recommend DRG Stimulation to anyone—it’s a very good option.”

In March of 2018, Sheku underwent DRG Stimulation. “I don’t know how to express the increase in quality of life, let alone the reduction in pain,” he said. “It’s a day and night difference from before.”

“Dr. Brunz is amazing, but so is the OI staff across the board. Nurses, therapists, office staff… everyone I came in contact with gave me nothing but acceptance and care. They were always willing to find an answer. I’d given up on myself, but they never did.”

“The pain didn’t just affect me—it affected my family, friends… everything. It’s so nice to get back to being Sheku again.”

Since the DRG Stimulation procedure, Sheku has been able to get back to life with his wife and kids. He’s also passionate about his motivational YouTube channel dedicated to helping others overcome obstacles.

If you have had chronic pain in your lower body for six or more months, you may be an ideal candidate for DRG Stimulation with Dr. James Brunz.

10 Causes of Leg Cramps

September 18, 2018/in Pain Management /by Christopher Holman

Leg cramps are a pain, literally! It may not always obvious what causes them, but the pain associated with leg cramps makes them nearly impossible to ignore. The Orthopedic Institute team has compiled a list of 10 common causes of leg cramps to help you understand and avoid this pesky problem.

1. Dehydration

Have you been drinking enough water? Dehydration is one of the most common causes of leg cramps. A cramp is an involuntary contraction of a muscle. The fluids in your body allow your muscles to relax, but—when those muscles are dehydrated—they get irritable and prone to cramping. Staying hydrated, especially during physical activity, is an excellent way to avoid leg cramps.

2. Overuse

In addition to dehydration, leg muscles can also cramp from overuse. When doing particularly intense physical activity, the nerves in your spine can become overexcited and fire involuntarily, contracting your muscles and causing a cramp. Those with more sedentary lifestyles may experience muscle overuse from more mild activities such as walking, hiking, gardening. Resting your legs and stretching often will help you avoid cramps from overuse.

3. Fatigue

Your muscles need time to recover. If you use them for extended periods of time without proper rest, the potential for leg cramps is greatly increased. As the muscles in your leg become tired, they become less efficient and require more nutrients than they would if they were rested. Avoid muscle cramps from fatigue by giving your muscles proper rest and conditioning them for any prolonged use.

4. Excessive Sitting or Standing

Bodies are meant to move, so staying in one position, regardless of whether you’re sitting or standing, puts you at greater risk for muscle cramps. Standing for too long can cause your muscles to fatigue, which will increase the likelihood of a cramp. Sitting can leave muscles in the same position for an extended period of time, which can lead them to spasm and cramp. If you sit or stand all day for work, try to alternate between sitting and standing so your body is not in one position for too long.

5. Medications

Certain medications prescribed to treat Alzheimer’s, high cholesterol, asthma, Parkinson’s and osteoporosis have a tendency to cause muscle cramps. If you’re experiencing leg cramps due to medication, talk to your doctor about your pain and possible medication alternatives.

6. Potassium Deficiency

Potassium in the cells of your leg muscles helps the brain tell the muscles when to start and stop contracting. When you have a potassium deficiency, these signals are not relayed properly, and muscle contractions may be prolonged, causing a cramp. Bananas are high in potassium, so adding them to your diet will help maintain proper potassium levels and avoid cramps.

7. Poor Circulation

Poor circulation in your legs can prevent your leg muscles from getting all the oxygen they need to function. This can lead to leg pain, muscle spasms and cramps. Walking, stretching, and wearing compression stockings can all help manage poor circulation in your legs and prevent cramping.

8. Excessive Alcohol Use

The nerves in your leg can be damaged by alcohol abuse. Excessive drinking can alter the levels of thiamine, folate and vitamins B6, B12, and E, which are all needed for your nerves to function properly. This is called alcoholic Neuropathy and can be the cause of leg cramps. Avoiding alcohol can restore the nutritional health of your muscles and stop your legs from cramping.

9. Pregnancy

Women in the third trimester of pregnancy often experience leg cramps, especially in the evening hours. In this case, cramps can be caused by the additional weight of the baby, changes in circulation, and pressure from the baby placed on the nerves in your legs. Regular exercise, leg and or foot massages, and stretching are all ways to prevent leg cramps.

10. Multiple Sclerosis

One of the symptoms of multiple sclerosis is spasticity, a condition which causes certain muscles to be continuously contracted. Multiple sclerosis causes damage to the central nervous system, which can cause spasticity and lead to cramping in the legs. You can manage leg cramping caused by multiple sclerosis through maintaining a healthy diet, stretching and massaging your legs and treating them with hot and cold therapy.

Discussing ”Avocado Hand“ with Dr. David Jones

September 11, 2018/in Hand and Wrist /by Christopher Holman

To say the avocado is “having a moment” is bit of an understatement. What’s brunch these days without a little bit of smashed avocado on a piece of toast? The fleshy fruit rich in healthy fats is more popular than ever, but in addition to surging prices, avocado fans may have one more thing to worry about. The number of injuries caused by improper handling and cutting of avocados is on the rise.

More people injure themselves while cutting avocados more than any other food. Why? Because people think it is a good idea to swiftly bring the largest blade in their home down toward their open palm to remove the avocado’s pit.

It looks easy, but obviously isn’t. If it were, #avocadohand wouldn’t be trending. No guacamole is worth stitches or an ER visit. But that doesn’t mean you have to stop eating the green delicacy. We’ve got a Q&A below with one of the region’s top hand specialists, Orthopedic Institute surgeon, Dr. David Jones, who will help us navigate the proper way to cut an avocado (and other fruits) and what to do IF you do cut yourself:

1. Have you seen an increase in your clinic of patients with #AvocadoHand?

Yes, unfortunately it is not rare to see individuals with significant cuts to their hand or fingers as a result of carelessly cutting avocados.

2. What is the proper way to safely cut an avocado and other fruits?

Probably the most important tip is to avoid holding the avocado while cutting toward your hand. Keep the avocado on the cutting board, keep your fingers clear and rotate the avocado while cutting it. Give thought to where the knife will plunge if it slips. Use an appropriate medium sized sharp knife so that you don’t have to press hard to cut the avocado. Avoid stabbing the pit to remove it, but rather quarter the avocado and then remove the pit with a spoon.

3. If you find yourself with a nasty cut, what should you do?

Hold pressure to control the bleeding. The hand has a robust blood supply so the bleeding can often be dramatic. Wash the hand with soap and water. Apply a Band-Aid or gauze wrap. If the cut extends all the way through the skin you should seek medical attention.

4. How can I tell if I should head straight to the ER, or can wait and call to make an appointment with you?

If there is difficulty controlling the bleeding or certainly if the tip of the finger is white and does not pink back up after you press on it, you should seek immediate care in the ER. Otherwise, if the finger has good blood flow and the bleeding is controlled seeking care in an urgent care or walk-in clinic is appropriate. A common problem we see with these injuries is a relatively minor appearing cut on the surface can damage major structures like nerve, arteries and tendons which are just beneath the skin in the hand and fingers.

So the cut gets neglected and there is delay in recognizing that one of the deeper structures has been injured which makes the repair and recovery much more difficult. So if you have the misfortune of sustaining a cut to the hand or fingers make sure you check that you can feel light touch along both sides of the finger tips and bend each knuckle of the finger that was cut. If there is any doubt, it is better to be evaluated sooner rather than later so that if surgery is necessary to can be done in a timely fashion.

5. Final question…do you prefer your guacamole smooth or chunky?

Definitely chunky!

Our fellowship trained hand surgeons can help you with “avocado hand” and other hand problems. Make an appointment with Dr. Jones or Dr. Curd today!