Shoulder Pain: Time to See and Orthopaedic Surgeon?

If you have been suffering from shoulder pain, you know what it feels like to struggle through basic tasks of daily life. From the time you get up in the morning until the time you lay your head down at night, you can’t make a move without physical discomfort in you shoulder. If shoulder pain has created inconvenience, loss of mobility and continued suffering, it might be time to see an orthopaedic surgeon.

There are many causes for shoulder pain. From acute trauma to overuse injuries, the shoulder joint is susceptible to a variety of issues. Pulling, pushing, lifting and carrying can become difficult activities. Pain can range from mild discomfort to excruciating. Does your level of shoulder pain require an assessment by an orthopaedic surgeon? See below for a list of the most common types of shoulder pain:

Due to the complex nature of the shoulder joint, there are a number of different reasons you are experiencing shoulder pain. For some, an acute injury is the known cause while for others, the pain may have started out as minimal but escalated over time.

You may have attempted to treat your injury at home with the use of over-the-counter medications, rest, heat or ice. If your discomfort persists or gets worse over the course of several days, you could likely benefit from an evaluation by an orthopaedic surgeon trained specifically in shoulder issues.

The sooner you get a diagnosis, the sooner a doctor can determine the best course of treatment. For some, surgery may be the best route. However, there are other options that an orthopaedic surgeon can recommend to get you on the mend and back to your normal level of activity.

Stress Fractures: Symptoms and Treatment

Stress fractures create a great deal of discomfort and pain. Commonly diagnosed in feet, shins and wrists, this type of injury can significantly impact your daily life. Stress fractures are highly common and can present as a variety of orthopaedic issues.

If you have been coping with a nagging pain in your foot, wrist or shin, you might be avoiding a trip to the orthopaedic surgeon, hoping it will resolve on its own. So how can you tell if the pain you are experiencing is a stress fracture? And if so, what can be done to heal the injury?

Stress fractures are simply small cracks in the bone. They tend to develop as a result of overuse or repetitive motion in a certain part of the body. Running, jumping, or any other repetitive action, especially involving the feet, legs, and ankles, can result in a stress fracture.

One of the primary causes of stress fractures is doing too much too quickly or pushing your body beyond its normal routine. This is especially true with high impact exercises such as running long distances.

So how do you know if your pain is the result of a stress fracture or some other orthopaedic injury? Look at the list of common symptoms below to see if this might be the source of your discomfort.

Symptoms of Stress Fractures:

  • Pain that that increases overtime with continued use
  • Soreness/tenderness that can be pinpointed to a specific spot
  • Noticeable decrease in pain after periods of rest
  • Possible swelling of affected area


If you suspect that you might have a stress fracture, the best thing to do is stop activity involving the injured body part. You might also gain relief by employing RICE (rest, ice, compression and elevation.)

By decreasing activity and allowing the tiny cracks to heal, you may be able to treat this injury at home. If pain persists, seeing an orthopaedic surgeon for proper diagnosis is important.

If you are diagnoses with a stress fracture, you may be advised to use a boot, brace or crutches. Depending on the severity, you may even need to be non-weight bearing for a period of time to allow your bone to heal. Use of anti-inflammatory medications may also help with swelling and discomfort.

Once you begin to experience a noticeable decrease in pain, it is important that you not rush back to full activity level. It is very easy to reverse the healing process if you push yourself too soon. Allowing your body plenty of time to heal is key to a full recovery and getting back to your normal routine, pain-free!

Falling on Ice: Orthopaedic Injuries and Prevention

When the peak of winter hits, temperatures become frigid and weather conditions can become dangerous. As sidewalks, driveways and steps become coated with ice, even stepping outside can be a scary situation. Falling on ice is one of the top orthopaedic injuries physicians seen in the office during the winter months.

How can you protect yourself from a serious orthopaedic injury during icy conditions? There are a few things that are within your control even when the weather makes for some treacherous situations.

Tips for preventing falls

  1. Avoid going outside unless absolutely necessary if you know surfaces will be ice covered.
  2. Wear proper footwear such as snow boots with good traction.
  3. Watch your step. Such a simple and obvious suggestion can mean the difference between a nasty fall and safely making it to your destination. Even a path that seems to be clear can have small patches of ice or even black ice. Take precaution when walking and look carefully with each step.
  4. Take small steps and try to shuffle your feet as much as possible.
  5. If you do start to fall, try to control how you land. Prevent injury to your arm, wrist and hand by resisting the instinct to break your fall by reaching out. Trying to bend your knees and falling to the side is your best bet for avoiding injury. If possible, it is also beneficial to tuck your head.

What are the most common types of orthopaedic injuries that result from falling? There are a number of common injuries that orthopaedic surgeons see in the winter as a result of a fall on ice.

Common injuries resulting from falling on ice

  1. Wrist sprains and fractures
  2. Hip fractures
  3. Torn meniscus
  4. Head injury
  5. Dislocated shoulder
  6. Torn or strained anterior cruciate ligament (ACL)
  7. Lower back pain
  8. Rotator cuff injury
  9. Bruised or fractured coccyx

The best advice to take when winter weather hits…stay inside and stay warm as much as possible! If you do suffer an injury from a fall on ice, be sure to consult your orthopaedic surgeon.

Platelet-Rich Plasma (PRP) Injection: Is it Right For You?

When it comes to the latest and greatest health trends, platelet-rich plasma (PRP),has created a significant amount of buzz. PRP is a type of injection that has been known to accelerate the body’s natural healing process using platelets from the patient’s own body. This non-surgical procedure targets the injured area, bringing about relief and healing with little downtime.

How Does PRP Work?

The non-invasive nature of platelet-rich plasma injections makes this procedure a desirable option for many patients. The process begins with drawing blood from the patient’s body and then running it through through a centrifuge. What results is a concentration of platelets that is injected directly into the patient’s injured area. The platelets contain hundreds of proteins called growth factors that stimulate reparative cells for healing. Therefore, the healing process is accelerated by using a more concentrated amount of platelets from the patient’s own blood.

When is PRP Used?

PRP can be used in a variety of ways including a number of orthopaedic issues. Orthopaedic surgeons commonly find success treating the following injuries:

  • Tendonitis
  • Partial tendon tears
  • Osteoarthritis
  • Muscle and ligament injuries
  • Back and spine conditions including herniated discs
  • Nerve damage including sciatica and carpal tunnel syndrome

Is PRP Right For You?

When it comes to treating an injury, patients are often looking for the quickest path to relief with minimal downtime. PRP can be a good option for patients that wish to avoid a surgical intervention.

One patient at Agility Orthopaedics recently had a great experience with PRP.

“As an avid distance runner, I was devastated when I found out that I had a tear in my Achilles’ tendon.  I feared I might never run again.  After seeing Dr. Nadaud and discussing my options, we decided that a PRP injection would best help my recovery.  I knew that I wanted a strong, but speedy recovery.  The platelet rich plasma injection helped to do just that.  After much hard work with physical therapy, I am back to running pain free just 4 months after my injection.  Dr. Nadaud made me feel comfortable with the procedure and answered any questions I had along the way.  I have been able to return to my normal life thanks to Dr. Nadaud and his team. “

If you have been suffering from an orthopaedic injury and want to explore non-surgical options, talk to your surgeon about platelet-rich plasma injections as a possible intervention. This type of treatment will not be applicable for all injuries but could be beneficial for a variety of orthopaedic conditions.

Cortisone Injection: Plantar Fasciitis Treatment

If you suffer from plantar fasciitis, you know how painful and irritating simple daily activities can be. From the first steps out of bed in the morning, the discomfort is difficult to ignore. You have likely tried a variety of non-surgical treatments in an attempt to gain some relief. Stretching, orthotic inserts and physical therapy are sometimes enough to address the painful symptoms of plantar fasciitis. However, some people benefit from a nonsurgical technique called a cortisone injection.

What is a cortisone injection

Cortisone injections are shots given to a specific area of the body in attempt to reduce inflammation and pain. While results vary from one person to the next, most people enjoy a decrease in pain for several months. The relief is not immediate but will gradually start to take effect within a week after being administered.

Plantar fasciitis impacts the simplest of daily activities. Standing, walking and running are painful almost constantly. Once the effects of the cortisone shot are felt, patients usually report that these activities are much more tolerable.

Patient testimonial:

Plantar fasciitis is not something you should learn to live with. Take it from an actual patient that suffered for an entire year before taking action to finding relief with treatment from a cortisone injection.

“I had been dealing with the pain of plantar fasciitis for a year before I made an appointment to see Dr. Nadaud. I was hoping for pain relief so I could start enjoying running again, and walk without pain. After speaking with both him and his Physician’s Assistant, we decided on a plan of action tailored specifically to me. I am happy to say, that I am pain free now, and enjoying running again for the first time in a year! Not only am I feeling better, but my experience with Agility Orthopaedics was superb. Everyone I interacted with was friendly, professional, and, of course, very knowledgeable! I would highly recommend Dr. Nadaud and his staff anytime!”

If you are tired of suffering with pain in your feet or foot, consider talking to your foot and ankle orthopaedic surgeon about a cortisone injection as an option.


Biologic Therapy: Treatment Options for Healing

If you are suffering from an injury impacting your tendons, joints or other musculoskeletal tissue, you are likely exploring options for the best treatment. Historically, surgery, rest, casting and physical therapy would be the best options to help heal and find long term relief. But have you considered Biologic Therapy? Perhaps this is a term you have heard of but are unsure what it is or if it is right for you.

What is Biologic Therapy?

Biologic Therapy is a type of treatment that uses substances made from living organisms to treat disease. It is designed to heal injuries in tendons, joints, and musculoskeletal soft tissues.

 Why Choose Biologic Therapy?

Biologic Therapy offers an alternative to surgery and traditional pain management. It enhances the body’s ability to heal using your platelets and stem cells to repair muscles, tendons, ligaments, and cartilage. This treatment option is low-risk and minimally invasive.

 How Biologic Therapy May Help You

Agility Orthopaedics uses biologic therapy to treat a variety of orthopedic conditions and injuries, ranging from knee pain to heel pain. The conditions we treat include arthritis and cartilage damage as well as tendon, ligament, and muscle disorders. Some common diagnoses that can benefit from biologic therapy are: plantar fasciitis, achilles tendonitis, knee arthritis, peroneal tendonitis and posterior tibial tendonitis.


Treatment Options


Amnion Therapy:

Amnion therapy is an off-the-shelf option that helps stimulate the healing of tendons, muscles, and soft tissues for patients that prefer a non-invasive biological option.  Amnion helps provide supplemental support, protection, and growth factors to assist in the healing process.


Platelet-Rich Plasma (PRP) Therapy:

Platelets are rich in growth and healing factors that activate stem cells to regenerate new, healthy tissue. Utilizing the body’s natural healing process, PRP therapy is a concentration of platelets that are injected into the damaged ligaments, tendons, and joints. These injections promote tissue repair and accelerate healing.


Because Biologic Therapy is still investigational, most insurance companies do not cover these procedures. This form of therapy is not for everyone, and surgery may be the best choice. Contact Agility Orthopaedics to schedule an appointment and find out which option is the best for you.

Plantar Fasciitis: Treating Heel Pain Effectively

Do you suffer from unexplained pain in your heels? Does this pain seem to be markedly worse when you get out of bed in the morning? If you answered yes to these questions, it is possible that you are suffering from plantar fasciitis.

What exactly is plantar fasciitis? This term refers to a condition that results when the plantar fascia (a thick band of tissue on the bottom of your heel) becomes inflamed.

Risk Factors

There are a number of factors that can contribute to plantar fasciitis. Runners frequently report suffering from this condition. But you don’t have to be an endurance athlete to experience plantar fasciitis. People that spend a lot of time on their feet are also at risk to experience this painful issue. People who are overweight and people that wear shoes without the proper type of support, have a higher likelihood of developing plantar fasciitis as well. Foot mechanics can also play a role in developing this type of foot pain. Having a high arch or inversely, having flat feet, can lead to developing plantar fasciitis.

Treatment Options 

  • The first step to getting proper treatment is getting an accurate diagnosis from an orthopaedic surgeon. Surgeons with training in the area of foot and ankle orthopaedics have focused training in foot issues.
  • Working with a physical therapist can bring some relief. Doing some stretching exercises in addition to massage and contrast baths can result in healing.
  • Non-steroidal Anti-inflammatory drugs (NSAIDS) can help reduce some of the inflammation in the heel region.
  • Steroid injections can help decrease both the inflammation and pain in your plantar fasciitis. Consult with you orthopaedic surgeon about whether or not this could be a viable option for your specific case.
  • Shoe inserts can help change the weight distribution on your feet therefore alleviating the strain on your plantar fascia. Consult with your foot and ankle orthopaedic surgeon about getting a custom set of orthotics for your shoes.

Don’t let the chronic pain associated with plantar fasciitis impact your daily life. Make an appointment with an orthopaedic surgeon today to get an accurate diagnosis and to formulate a plan for treating the underlying issues.

Physiatrists: What Can a Physical Medicine Doctor Do For You?

Physiatry can be defined as Physical Medicine and Rehabilitation (PM&R). It is a medical specialty that focuses on diagnosis and treatment of chronic and acute pain, weakness and numbness. Physiatrists are doctors that have completed four years of medical school with a specialty focus in physical medicine and rehabilitation. Individuals suffering from bone, joint, muscle, ligament, nerve and spinal cord impairments may benefit from working with a physiatrist.

Once you have been diagnosed either by a medical doctor such as an orthopaedic surgeon or primary care physician, a physiatrist can offer a number of non-surgical interventions to treat your symptoms. What exactly can a physiatrist do to treat your physical impairments?

Treatment Services Offered by a Physiatrist

  • Injections (spinal and other types) using fluoroscopic guidance
  • Spasticity management
  • Joint injections
  • Trigger point injections
  • Nerve conduction studies (NCS) and electromyography (EMG)
  • Medication prescription
  • Prosthetics
  • Orthotics

In addition to medical interventions, physiatrists also work with a team of other medical and non-medical professionals to ensure the best treatment plan. Focused on improving the overall quality of life of their patients, physiatrists aim at restoring the patient’s functional ability. Physiatrists often work with orthopaedic surgeons, social workers and physical therapists to coordinate a comprehensive approach to treatment.

Benefits of Working With a Physiatrist

  • Treatment is focused on the whole person, not just the symptom
  • Coordinated approach to take into consideration the treatment recommendations of other professionals
  • Address pain and weakness with non-surgical interventions

Whether your physical impairments are the result of an injury, medical condition or disability, a physiatrist can help develop a treatment plan to meet your individual needs. Be sure to check with your insurance provider to see which physiatrists in your area will be covered under your plan.

Looking for a Physiatrist in the St. Louis area? Click here for more information on Dr. Andrew Wayne of Agility Orthopaedics.

Physical Medicine and Rehabilitation: Improving Quality of Life

With hundreds of specialties and subspecialties in medicine, it can be hard to determine whom to see when you have a medical issue. There are several overlapping specialties, especially when it comes to treating conditions of the bones, joints and muscles. Physical Medicine and Rehabilitation is one area of medicine that focuses on many parts of the body.

What is Physical Medicine and Rehabilitation?

Physical Medicine and Rehabilitation (PM&R) is an area of medicine that focuses on restoring and  improving an individual’s functional ability. With a focus on improving quality of life, PM&R can be used to treat a wide range of physical impairments. These impairments include but are not limited to conditions of the bones, joints, muscles, ligaments, brain, spinal cord and nerves.

What is a Physiatrist?

A Physiatrist is a medical doctor that has a trained focus in the speciality area of Physical Medicine and Rehabilitation. A Physiatrist has completed four years of medical school beyond an undergraduate degree. Further, a physiatrist completes a four-year residency in the area of Physical Medicine and Rehabilitation.

Physiatrists offer a variety of procedures to help patients suffering from bone, joint, muscle and nerve issues. These issues could be the result of an injury or medical condition/disease. Some of services offered by a physiatrist include:

  • Spinal injections
  • Joint injections
  • Nerve conduction studies (NCS) and Electromyography (EMG)
  • Spasticity management
  • Trigger point injections for muscle disorders

In addition to specific medical procedures, physiatrists often work in conjunction with a team of medical professionals to develop a comprehensive treatment plan for each individual. Physical therapists, occupational therapists, orthopaedic surgeons, primary care doctors and neurologists often work closely with physiatrists to ensure optimal care for the patient. In addition, physiatrists often involve non-medical professionals in the development and execution of the treatment plan. These professionals often include: social workers, therapists and vocational counselors.



Summer Sports Safety: Top Ten Tips

With summer fast approaching, excitement is in the warming air. This is the time of year when people are itching to get outside and get active. Whether through sports, summer camps or just hitting the playground, kids and adults are increasing activity levels. But don’t get sidelined with an injury before the season gets underway.

An increase in physical activity also means an increase in injuries, especially orthopaedic injuries. Visits to urgent care and emergency rooms tend to spike as people are spending more time outside, engaging in athletic activities. You can help prevent the most common summer sports injuries by following some simple tips.

Top Ten Tips for Summer Sports Safety

  1. Hydration: Make sure you are drinking plenty of liquids. Water is great but it is also good to take in fluids that contain electrolytes.
  2. Wear a helmet: Helmets aren’t just for contact sports. If you are riding a bike, scoot, roller blades or a hover board, make sure to protect your head with a helmet.
  3. Wear gear that fits: It might seem obvious but you would be surprised how many people wear protective gear that does not fit properly. Gear that is too big or too small may not adequately protect your body in a collision or a fall.
  4. Sun Safety: Pads and helmets are great for protecting your bones but what about your skin? Be sure to apply sunscreen all over and to reapply every few hours.
  5. Know your limits: While playing sports in the heat of summer, your body is more prone to fatigue easily. Be sure to take breaks and listen to your body. This might mean cutting a practice short or sitting out more than normal.
  6. Check playground equipment: Do not trust that all playground structures are safe. Faulty equipment as well as structures that are not age appropriate can be an issue. Cruise the playground for a safety check before letting your kids loose.
  7. Swimming safety: There are many safety concerns if you plan to swim or your kids plan to swim this summer. Make sure a lifeguard is on duty, wear a life vest if needed and never leave children unattended near the water.
  8. Stretch: No matter what sport or physical activity you enjoy during the summer months, be sure to properly stretch, warm up and cool down.
  9. Know when to stop: If you start to feel pain during an activity, STOP! What might start as a small injury, strain or sprain could get worse if you push yourself. If you experience pain that worsens or does not get better, seek an evaluation by a doctor.
  10. Proper footwear: What you put on your feet is very important, especially during the summer. Do not wear sandals or attempt to go barefoot if you plan to exercise or engage in a sport.

Don’t let an injury slow down your summer fun! Take precaution and avoid preventable injuries so you and your family can get the most out of this fun time of year. As always, if you do sustain an injury, be sure to see a qualified physician such as an orthopaedic surgeon.