Angryorthopod Blog
Instructions for use: read, learn, question, comment, make me angry, repeat.
I am a board certified orthopaedic foot and ankle surgeon with 30 years of experience and I am a bit cynical about medicine today. Actually I am a lot cynical. My mission is to challenge the status quo and in the process help as many people as possible.
You will see no advertising on the AO site. I do this for free and if you like what you find here all I ask is that you tell as many friends, strangers and family as you can, any way you can.
Of note, many of my blog comment responses are very detailed and in essence a blog themselves. So, please use the search function if you can’t find what you are looking for in a blog.
This is why you should pay attention to equinus
A recent AO comment got me thinking, and that is always a dangerous thing. (Found in comments section Calf Stretching: Its the AO Way or the Highway, Kapil, 2022/03/10 at 9:30 pm) The block to the right is most of my response. In summary, the comment/question was...
Do Something Different. Do Something That Works.
Some questions and answers just beg to reach out! "Hello, I’ve been struggling with [Plantar Fasciitis] in both feet for at least 6 years, have done foot and calf massages, cortisone, tennis balls, laser, tens unit and have a Chiro running a vibrating ball over the...
The Sabbatical Is Over: the AO is Back With a Request or Two Of My Own
First, to my request before you stop reading. If you like or feel there is value in the content on the Angry Orthopod please spread the word on social media or any way you feel you can. This is particularly true when you have personally benefited as a result. This is...
What If?
Comment: I have been to several orthopaedic surgeons and they only recommend surgery. They never mention stretches, physical therapy, pain medication, lifestyle changes, etc. It’s very frustrating. Surgery is scary and the...
Calf Stretching: It’s the AO Way or the Highway (There Are No Back Roads)
I know I consistently promote calf stretching to you all, like here, and here, and even here, but thanks to many of your questions, I realized I have never told you exactly how to do it right: my way. True, it is a simple concept itself, but it’s not just “any old”...
Albert Pujols, Looking in All the Wrong Places
Al, Al, Al…it is time to stop listening to your trainers, your team doc, and aunt Bessie and do the right thing. Here is a call to action to everyone in AngryLand. Somebody please get the word to Big Al and many more big leaguers who have plantar fasciitis, that calf...
Hammer Toe and Your Pain
I received a question on Twitter that I've heard before: Question: "Once the 2nd toe has 'crossed over,' can the stretches help to avoid surgery? Would love to walk barefoot again without pain." The short answer is yes, but it...
Plantar plate repairs and the pre-dislocation syndrome: what the f$@% (Part 2)
If you have been reading my crap information on second MTP synovitis you already have a good idea where I am going with this. I have one correction, actually an omission, regarding Part 1. In Part 1 I talked about the notion that the 2nd metatarsal has grown “too...
Plantar plate repairs & the pre-dislocation syndrome: what the f$@% (Part 1)
God bless the Beverly Hillbillies. Doubtlessly one of the best scenes depicting their countryfied ignorance was when the doorbell would ring and Jethro would say to Jed, “Uncle Jed, there goes that bell again, next thing you know someone’s gonna come a-knockin' at the...
Why I Don’t Promote Plantar Fascia Stretching- (Part 2)
Click here to see what we discussed in Part 1. The science backing plantar fascial stretching (PFS) is not convincing to say the least. So, how about a little common sense if you're not convinced yet. Let’s make the isolated gastrocnemius contracture and calf...
Why I Don’t Promote Plantar Fascial Stretching
Plantar fascial stretching for plantar fasciitis is the rage, but it’s not effective. Here is why! (Part 1 of 2) Plantar fascial stretching (PFS) is definitely hot right now. It is all over the internet. In fact, it has attained sexy status. People want to talk about...
The 56 Year Old Female
A couple of years ago in our clinic a rotating 29 year old female orthopaedic resident started to present a new patient to me out in the hall and before she could get much out I interrupted her and said "let me guess, a 56 year old female?". She reacted a bit like I...
Employed Physicians and facility fees: I’m as mad as hell and I’m not going to take this anymore- Part 2
Here is the question that must be asked. Where is all this new money coming from? The Answer: The money is coming from all the employed physicians FACILITY FEES charged by their employers! And the docs are oblivious to it happy they are making more money. The hospital...
Employed Physicians and facility fees: I’m as mad as hell and I’m not going to take this anymore. Part 1
Every weekday I drive down a 13 mile stretch of interstate to get to my office right next to my hospital, or should I say facility. Over the last few years I couldn’t help but notice during my drive to work that of the seven new building construction projects, six are...
AAOS Chooses “Choose Wisely”, but Lacks Punch
Question from one of our followers on twitter, DocRockne asked us "Did ortho come up with choosing wisely campaign goals? If not, what would yours be?" Very good question and the AAOS did come up with five practices to be questioned. I must say that while the evidence...
The Bad Rap on Inflammation- Part 2: The Orthopaedic Groundhog Day
The big picture on inflammation, orthopedic inflammation that is Many orthopaedic inflammatory diagnoses are mechanical problems first that create a normal inflammatory response. You might not be getting better because you are treating the wrong thing, the...
The Bad Rap on Inflammation- Part 1
Somewhere along the way the term inflammation got a bad name. Inflammation can’t be good, right? At least this is what most people think.Inflammation is actually an essential part of every reparative process. It is how our bodies heal and fight back. It is how we...
Dangers of the December Deductible Deadline
I would guess most docs, particularly surgeons doing elective surgery and procedures, view this time of year as nothing but good, at least for them. Docs are working long hours trying to fit in all those patients before the end of the year, and more importantly,...
Gaming the system!
Congresswoman Tammy Duckworth(D -IL) is my new hero on many levels. If we had just a few more politicians like her, we would be in a much better place. Having said that, this is still the greatest country because of veterans like her. Thanks to all military veterans...
Anecdotal evidence is alive and well
Anecdotal evidence is alive and well! As a disclaimer, I am all for refereed medical research striving to reach the correct answers so that we can all live healthier and more fulfilling lives. As to qualifications, I am constantly in an academic environment where I am...
Morton’s Neuroma Revisited
Morton’s Neuroma-Revised Rewound Rebuffed Revisited Thank you all so much for your comments and support. I have received a lot of feedback and fantastic questions about Morton’s neuromas (MN) and your problems with diagnosis and treatment of such. This area of the...
Podiatrists and Foot & Ankle Orthopedic Surgeons
This blog addresses a question by one of AO’s readers: Based on surgical outcomes, when should a person see a podiatrist, and when should that person see a foot and ankle orthopedic surgeon? This question is difficult to answer. Of course I would be biased towards an...
On Sever’s Disease
This topic--Sever's disease--was suggested by a reader on Facebook. “Like” me on Facebook here. To be perfectly blunt, Sever’s disease is basically the pediatric form of plantar fasciitis. Both are caused by calves that are too tight, and usually the calf contracture...
The Rescue Patient: Part Two
In my last blog, I coined the term “The Rescue Patient.” While I am not always successful, this experience has given me the insight to make some useful recommendations to the rescue patient who is contemplating “coming in.” Keep...
The Rescue Patient: Part One
First and foremost I am declaring that I am the first to use this term: “The Rescue Patient.” I have now made my mark. My fifteen minutes of fame may be over. If you can't stomach tough love, stop reading here. If you are a rescue patient and you want to get better,...
Six Weeks: Part Two
In the last AO entry, I shared how as much as docs council our patients prior to an elective surgery, patients continue to only hear what they want to hear. Ultimately, I see these misguided -- and unrealistic – expectations time and time again. In this entry, I want...
Six Weeks: Part One
Most of us have heard of two weeks; a fortnight, 9 1/2 weeks; a racy movie, and even 26 weeks, the age of the first born child who is actually 6 months old. These "weekly" designations don't bother me, except for the kid thing. My oldest son is 1,547 weeks old by the...
The Medical Field Gets its Act Together: Part Two
In my last post, I praise the Choosing Wisely® list, which is aimed at cutting down on unnecessary testing by docs. I got into medicine because it is FUN, and, of course, to help people. I think most of my colleagues did so as well. I get up every day and I get to go...
The Medical Field Gets its Act Together: Part One
Finally, the medical field, in general, is getting its act together. Simply put, Choosing Wisely®, the brainchild of the American Board of Internal Medicine (ABIM), is an initiative to help cut down on unnecessary medical testing. The goal behind the campaign: improve...
DMSO, And My Question for the FDA
While DMSO is controversial, and you know I like that, this blog is really an FYI for something you have likely never heard of and you might want to know about... DMSO -- Dimethyl sulfoxide -- is a byproduct of the wood pulp industry discovered in the early 1950's. To...
Morton’s Neuroma: Controversial to Say the Least
What really pushed me over the edge when it came to Morton’s Neuroma (MN) was watching Steven Tyler on OWN. During his interview with Oprah (okay, I saw it with my wife – her idea!), I realized one, that he’s an awesome dude, but two, he is mislead in thinking his...
Your Foot’s Asleep While Exercising? Then STRETCH!
Ever had numbness in your toes when exercising? Patients of mine who use the Stairmaster (probably the worst offender), elliptical, bicycle (including spinning), and even those involved in outdoor sports come to me concerned about their “sleepy foot.” Before I get to...
Shooting Yourself in the Foot – When WebMD Becomes “Dangerous”
I just hate it when patients shoot themselves in the foot. In my particular case, being a foot and ankle orthopedic surgeon, this might be closer to fact than fiction. What I am talking about here are the more low-key diagnostic and treatment decisions in general, but...
The Big Day
Over the past few years I have become increasingly aware that when a patient visits the doctor it is a BIG DEAL. Even the simple visits. I should not have realized this, but I did and I am glad I did. If you have had an illness of any note you will surely identify...
Shockwave? For Foot Pain?!
Many of you have asked me about potential treatments you’ve heard about about for chronic plantar fasciitis and other foot ailments. Two that continue to come up in conversation: GS surgery and ESWT. In short, here is what my experience shows: Gastrocnemius Slide (GS)...
My Pet Peeve: NOT Sticking To Stretching
(…Or just about anything else we tell ‘em.) Patients are predictable I'm sorry to say. Non-compliance is a very large problem with patients. I give approximately 85% of my patients explicit, written directions to do calf stretching and – even with the most compelling...
MYTHS ABOUT THE DIABETIC FOOT: PART ONE
First, a disclaimer: I want you to know I love my diabetic patients. If I sound demeaning at any point discussing this, it’s not the diabetic patient making me angry. My anger stems from the medical profession's poor treatment of the diabetic foot, especially the lack...
Too Damn Expensive: What Just Treating the Symptoms Costs You
Here I go again. I hate to start sounding like a broken record, but sometimes a topic just needs revisiting. There are multiple products and so-called treatments that just address the aches and pains of plantar fasciitis but never treat the underlying cause of it....
Medical Merchandising: The Same Old Crap, Repackaged
“Evidence based medicine.” Just think about it for a second. This means now we actually practice medicine based on bona fide evidence? What the hell have I been doing for the past 25 years? Making it all up? And who wrote those thousands of articles I’ve read? Dr....
PRP: Pure Rubbish, People!
I get angry when I see people falling for flashy procedures that fool them into thinking they’re fixing their problems. One of the most searched for heel pain treatments online over the last two years is one often featured in the sports section. Recent stories on...
More Of The Same Old News…
As mentioned before, 20% of my patients come to me seeking relief from plantar fasciitis. After I came across this TV news piece on the subject, I knew I had to address it because it’s filled with the kind of flawed, “easy fix” information I’m fighting. (Thanks to...
The Good, the Maybe, and the Ugly: Shoes
This is a new segment I’ll be writing every so often. The idea is simple and the majority of you need no further explanation, but for my fellow surgeons who over-analyze, here are the details… I will review and categorize three different products that I’ll classify as...
DVT Epiphany: The Battle Over Blood Clots
The practice of medicine vs. the business of medicine So, a medical malpractice attorney and an orthopaedic surgeon are on a golf trip… This sounds like the worst joke of all time, but it’s actually the story of my brother and I 20 years ago. Amidst the rough, he laid...
Insurance Gets a Slap on the Wrist
Does anyone understand the Affordable Care Act? If you’re among the few who do, then you’ll agree with how KevinMD sees things… “Health insurance companies seem to be pretty happy with the Affordable Care Act. Health reform has left the private insurance industry in...
MRI Abuse
MRI overuse and misuse really makes me angry. Did you know that a growing number of doctors don’t even read the tests themselves? Another shocking aspect of this industry is that some doctors will order an MRI because it’s quicker than doing an in-depth history or a...
The Most Expensive Pair of Heels
There are nearly 2 million cases of plantar fasciitis in the United States every year. As an orthopaedic surgeon, I’m quite familiar with this issue since nearly 20 percent of my patients come to me about plantar fasciitis. Although there is a surefire way to fix the...
Welcome!
I’ve been an orthopaedic surgeon for over 25 years. I specialize in foot and ankle, but I'm interested in other areas of medicine as well. In short, I’m passionate about medicine, as well as the truth... That’s why I’ve taken to the web. I’m going to use this as a...
