Wareham Orthopedic Associates

Runners Injuries

admin — Thu, 26 Feb 2009 14:50:43 +0000

This article deals with the most common injuries that avid runners face during training. Most are not serious and can be treated with rest, appropriate stretching, and possibly anti-inflammatory medications. Since running is an extremely leg dependant sport the easiest way to classify injuries is by body part.

The foot and ankle is where the rubber meets the road, quite literally, and is the most common area of trouble. People who have excessively high arches (cavus feet) or people with low arches (flat feet) are more prone to develop problems. Running shoes are now made to accommodate for these extremes and can be a first line of defense. The foot is a complex interaction of ligament, bone, and tendon and shoe inserts or cushioning that can either pad areas that are overstressed or convert foot mechanics to a more normal range are very helpful.

Plantar fasciitis (heel and sole of foot), Achilles tendonitis, posterior tibial tendonitis (inner foot), and stress fractures top the list of maladies. Each of these is a form of overuse injury and is characterized by pain, swelling, and poor function. Early treatment may be as simple as altering your running style, resting briefly, or wearing the appropriate insert. More difficult cases may require medications, casting or bracing, cortisone injections, or rarely even surgery.

In the knee patellar tendonitis (front of knee), ileotibial band syndrome (outer side), or pes bursitis (inner side) are common overuse injuries. The key to treatment of these problems is early recognition and not ignoring symptoms. Again, rest and stretching tends to help quickly.

Sudden traumatic injuries can also be a problem with the knee. Tears of the shock absorbing cartilage (meniscus) can occur with twisting injuries in the younger runners and with even less force in older runners. These injuries are characterized by swelling not of the muscle and tendon around the joint but by fluid that collects in the joint itself. This may be difficult to distinguish but is important in treatment because many meniscus tears need surgery.

Finally, there are a few less common problems with the hips. Hamstrings tendonitis (back of the thigh), trochanteric bursitis (outer hip), and groin pulls are usually a result of poor stretching and overuse.

It is important to remember that all of these parts are interconnected and that an injury or poor alignment in one area can affect others. This is one reason why it may not be smart to continue running with an altered form to protect one injury at the expense of causing another. This also highlights why it is important to stretch all muscle groups around the foot and ankle, knee, and hip before running.

Useful Links

admin — Thu, 26 Feb 2009 14:33:17 +0000

American Academy of Orthopedic Surgeons
General Information on Orthopedic Surgery, musculoskeletal problems, and surgical treatments.
http://www.AAOS.org

Southcoast Health Systems
Information on Southcoast Hospitals, including Tobey Hospital, where WOA physicians are on staff.
http://www.southcoast.org

Synvisc Viscosupplementation
Info on viscosupplementation, a new non-surgical treatment for arthritis of the knee.
http://www.synvisc.com

Spine Universe
Helpful info on common disorders of the neck and back, including traditional medical treatment, chiropractic, and alternative treatments.
http://www.spineuniverse.com

American Orthopedic Society for Sports Medicine
Information on sports injuries, arthroscopic surgery, and team physician issues.
http://www.aossm.org

Ankle Sprains

admin — Thu, 26 Feb 2009 14:30:43 +0000

Ankle sprains are among the most common injuries encountered by professional and recreational athletes alike and frequently contribute to missed playing time.

An ankle sprain is a tear in the ligaments that support either the inner or outer aspect of the ankle joint. This usually occurs when the athlete rolls the ankle inward after stepping in a hole or onto another players foot. As the foot rolls in (inverts) the ligaments connecting the outer bone of the ankle to the foot are stretched and torn to various degrees. A grade I injury is mild and will limit play for less than a week. Grade II injuries are moderate and last 1-3 weeks, while a grade III sprain is severe and may limit the player for 6 weeks or more. Often bruising of the bones within the ankle can occur simultaneously.

Signs of an ankle sprain include pain, swelling, bruising, inability to bear weight, and a feeling of instability. Initial management should be with the RICE protocol, which stands for rest, ice, compression, and elevation. For minor injuries x-rays and evaluation by a physician may not be necessary, but for any significant problems consult your doctor.

Preventing sprains and returning to sports quickly are related issues. The muscles that control movements around your foot and ankle need to be kept strong to prevent injuries and to rehabilitate an injured ankle. Use of high top sneakers, ankle taping, and brace wear may be indicated in certain individuals.

Occasionally an athlete will develop chronic ankle instability, where long after healing of a sprain (or multiple sprains) the ankle still feels like it gives way or is loose. This is often caused by incomplete rehab of an injury or may be a sign of chronic stretching of the ligaments in the ankle. In some cases the chronically stretched ligament has to be surgically shortened or substituted for.

Dr. Baltz is a fellowship trained Sports Medicine Orthopedist, former assistant team physician to the Boston Celtics and team physician to Massachusetts Maritime Academy.

Privacy Policy

admin — Thu, 26 Feb 2009 14:23:22 +0000

This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Understand Your Health Record/Information

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

Basis for planning your care or treatment
Means of communication among the many health professionals who contribute to your care
Legal document describing the care you received

Means by which you or a third-party payer can verify that services billed were actually provided
A tool in educating health professionals
A source of date for medical research
A source of information for public health officials charged with improving the health of the nation
A source of data for facility planning and marketing
A tool with which we can assess and continually work to improve the care we render and the outcomes we achiev

Understanding what is in your record and how your health information is used helps you to:

Ensure its accuracy
Better understand who, what, when, where, and why others access your health information
Make more informed decisions when authorizing disclosures to others

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

Request a restriction on certain uses and disclosures of your information as provided by 45CFR 164.522
Obtain a paper copy of the notice of information practices upon request
Amend your health record as provided in 45 CFR 164.528
Obtain an accounting of disclosures of your health information as provided in 45 CFR 164,528
Request communications of your health information by alternative means or at alternative locations
Revoke your authorization to use or disclose health information except to the extent that action has already been taken

Our Responsibilities

Wareham Orthopedic Associates is required to:

Maintain the privacy of your health record
Provide you with notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
Abide by the terms of this notice
Notify you if we are unable to agree to a requested restriction

Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us.

We will not use or disclose your health information without your authorization, except as described in this notice.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact the director of health information management at 508-295-5100.

If you believe your privacy rights have been violated, you can file a complaint with the director of health information management or with the secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Example of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his expectations of the members of your healthcare team. Members of your healthcare team will the record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you’re discharged from the hospital.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations.

For example: Members of the medical staff, the risk or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Permitted or Required Uses and Disclosures

Business Associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology and certain laboratory tests. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that Person’s involvement in your care or payment related to your care.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fund raising: We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to valid subpoena.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Effective Date: March 1, 2003re or treatment

Means of communication among the many health professionals who contribute to your care

Legal document describing the care you received

Means by which you or a third-party payer can verify that services billed were actually provided

A tool in educating health professionals

A source of date for medical research

A source of information for public health officials charged with improving the health of the nation

A source of data for facility planning and marketing

A tool with which we can assess and continually work to improve the care we render and the outcomes we achiev

Understanding what is in your record and how your health information is used helps you to:

Ensure its accuracy

Better understand who, what, when, where, and why others access your health information

Make more informed decisions when authorizing disclosures to others

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

Request a restriction on certain uses and disclosures of your information as provided by 45CFR 164.522

Obtain a paper copy of the notice of information practices upon request

Amend your health record as provided in 45 CFR 164.528

Obtain an accounting of disclosures of your health information as provided in 45 CFR 164,528

Request communications of your health information by alternative means or at alternative locations

Revoke your authorization to use or disclose health information except to the extent that action has already been taken

Our Responsibilities

Wareham Orthopedic Associates is required to:

Maintain the privacy of your health record

Provide you with notice as to our legal duties and privacy practices with respect to information we collect and maintain about you

Abide by the terms of this notice

Notify you if we are unable to agree to a requested restriction

Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. Should our information practices change, we will mail a revised notice to the address you’ve supplied us.

We will not use or disclose your health information without your authorization, except as described in this notice.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact the director of health information management at 508-295-5100.

If you believe your privacy rights have been violated, you can file a complaint with the director of health information management or with the secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Example of Disclosures for Treatment, Payment and Health Operations

We will use your health information for treatment.

For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his expectations of the members of your healthcare team. Members of your healthcare team will the record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you’re discharged from the hospital.

We will use your health information for payment.

For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for regular health operations.

For example: Members of the medical staff, the risk or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Permitted or Required Uses and Disclosures

Business Associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology and certain laboratory tests. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that Person’s involvement in your care or payment related to your care.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fund raising: We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.

Law enforcement: We may disclose health information for law enforcement purposes as required by law or in response to valid subpoena.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Effective Date: March 1, 2003

Policies

admin — Thu, 26 Feb 2009 14:20:53 +0000

Payment of all co-pays is expected at the time of your office appointment. Insurance and federal regulations now prevent physicians from waiving the co-pay for any patient, regardless of relationship.

Insurance referrals and workers compensation referrals must be in place at the time of the office visit or your appointment will be rescheduled or delayed.

Prescription refills or renewals, appointments, or non-emergent questions will only be handled during office hours. The on-call physician will be available for emergencies during weeknights, weekends, and holidays. The on-call physician may or may not be your personal physician and cannot put you in contact with your personal physician during on-call hours.

Braces, orthotics, inserts, and other durable medical goods are given because your physician feels they will be helpful for your condition. Wareham Orthopedic Associates cannot accept any returned products once they are fitted and taken out of the office.

If you are unable to make a scheduled appointment please reschedule with our office as early as possible. Patients who consistently miss appointments without rescheduling may be referred elsewhere for their care.

It is our highest priority to see patients in a timely fashion however hospital emergencies occasionally arise which make it necessary to rearrange the office schedule.

Insurance Info

admin — Thu, 26 Feb 2009 13:20:38 +0000

All of our physicians accept the following insurance plans:

- HMO Blue including Network Blue, Blue Choice, Commonwealth PPO, HMO Blue for Seniors, Managed Blue for Seniors, Blue Care Elect, Healthcare First
- United
- Tufts
- Pilgrim
- Cigna
- Health Care Value Management
- Workers Compensation
- Private Health Care Systems
- Aetna
- Medicare
- Mass Health
- BMC Healthnet

In Addition:

Dr. Johnson accepts First Health, One Health, and US Healthcare. Not a provider for Secure Horizons, Neighborhood Health Plan.

Dr. Heacox is not a provider for US Healthcare, Secure Horizons, Neighborhood Health Plan.

Dr. Baltz accepts US Healthcare. Not a provider for Secure Horizons, Neighborhood Health Plan.

Patient Forms

admin — Thu, 26 Feb 2009 13:19:39 +0000

Filling out the PDF Form below will save time during your visit.

You should be able to fill it out on your computer, print it out when you are done and bring it to your appointment.

[Download the Health Form Here]

Hours

admin — Thu, 26 Feb 2009 13:16:58 +0000

Monday 9:00am - 5:00pm
Tuesday 8:00am - 5:00pm
Wednesday 9:00am - 5:00pm
Thursday 9:00am - 6:00pm
Friday 9:00am - 5:00pm
Saturday Closed
Sunday Closed
All time in Eastern Standard Time

Office Closed Noon-1pm for Lunch

Map + Directions

admin — Thu, 26 Feb 2009 13:15:28 +0000

Call us at (508) 295-5100

[Click for Map]

From Cape Cod:
Cross the Bourne Bridge and travel on Rte 25 to Rte. 195. Follow 195 West to exit 21. At end of ramp turn Right onto Rte. 28 North and follow for 1/4 mile to the Wareham Industrial Park. Turn Right into the Industrial Park onto Kendrick Road and immediately turn Right onto Recovery Road.

From North/West:
Take 195 East or West to exit 21. Turn onto Rte. 28 North toward Carver/Middleboro. Follow for 1/4 mile to the Wareham Industrial Park. Turn Right into the Industrial Park onto Kendrick Road and immediately turn Right onto Recovery Road.

Our Staff

admin — Thu, 26 Feb 2009 13:15:02 +0000

Gregory Johnson, MD
Orthopedic Surgeon

Dr. Johnson received his M.D. from Georgetown University and completed his residency in orthopedic surgery at Tufts New England Medical Center. He had extensive training in joint replacement surgery and sports medicine at the New England Baptist Hospital in Boston. He is Board Certified in Orthopedic Surgery. Dr. Johnson has over 26 years of experience in general orthopedic surgery at Tobey Hospital and is the founder of the Sports Medicine Center in Wareham. He currently serves as a team physician for Massachusetts Maritime Academy.

Stephen A Heacox, MD
Orthopedic Surgeon
Dr. Heacox received his M.D. from Temple University in Philadelphia and completed his residency in orthopedic surgery at Temple University and Shriner’s Hospital for Crippled Children. He is the past president of both the Medical Staff and the Department of Surgery at Tobey Hospital in Wareham. Dr. Heacox has over 24 years of experience in general orthopedic surgery at Tobey Hospital and is Board Certified in Orthopedic Surgery. Dr. Heacox is a team physician for Massachusetts Maritime Academy.

Matthew S. Baltz, MD
Orthopedic Surgeon
Dr. Baltz received his M.D. from the University of Connecticut Medical School and completed his residency in orthopedic surgery at the Medical University of South Carolina in Charleston, SC. In addition he completed a one year fellowship in sports medicine at the New England Baptist Hospital in Boston. He is a member of The American Orthopedic Society for Sports Medicine and is Board Certified in Orthopedic Surgery. He served as an assistant team physician for the Boston Celtics and Northeastern University from 1998-99 and is currently a team physician for Massachusetts Maritime Academy and the Wareham Gatemen. Dr. Baltz has 8 years of experience in practice at Tobey Hospital and has served as the Chairman of the Department of Surgery.

Jeanna Polonchek, Ed.D, LATC, CSCS
Clinical Assistant
Jeanna Polonchek is a certified athletic trainer and functions as a clinical assistant to the physicians of Wareham Orthopedic Associates. She has had extensive training in diagnosing and treating high level athletic injuries. She has served as a trainer during the Pan Am Games, the 1994 and 1996 Olympic Games, The Bay State Games, and the Boston Marathon. In addition she was the head athletic trainer for both Bridgewater State College and The New England Blizzard, a Women’s Professional Basketball team in the ABL. At Wareham Orthopedic Associates, she performs a variety of functions both in the office and in the operating room such as suture removal, cast application and removal, and most importantly one on one instruction on home exercise programs. In addition she is a certified pedorthist and is involved in construcion of orthotics and brace fitting.

Nancy Enos
Office Manager
Nancy Enos serves as the office manager for Wareham Orthopedic Associates and as a liason to Tobey Hospital. She began her training in management by raising four children. She then worked in medical offices for several years before joining Wareham Orthopedic Associates eleven years ago. She is integral in the daily management of the office and considers it her primary goal to ensure patients have a satisfying experience at Wareham Orthopedics. She will assist in expediting patient referrals, obtaining timely appointments, scheduling and pre-certifying surgery, establishing payment plans, and answering any peri-operative questions.