Winter is really here in central Ohio, albeit a little late. I think we would all agree that we’ve seen some rather mild meteorological activity till now. Spring will come, but not tomorrow, so we have to face the cold, ice and snow (and rain?) before Spring has sprung. Proper footwear in Winter is a must. Moreover, that must in Winter is boots. A truly good pair of winter boots will cost you, so you want to make sure you buy ones that will protect your feet for a while. Here are the factors to keep in mind when comparing your options.

Winter Boots 101 - Dr. Ralph Napolitano

Consider these four important parameters when selecting your new pair of boots:

Hey, nice boots!

Dr. Ralph NapolitanoDr. Napolitano is a double board-certified podiatrist and wound care specialist physician. (CWSP).  He specializes in medicine, surgery and wound care of the foot, ankle and lower leg. He was the first podiatrist in the state of Ohio to earn the board certification Certified Wound Specialist Physician (CWSP).

“I strive to educate my patients thoroughly about their problem and offer a comprehensive and holistic treatment plan both medical and surgical.  I believe healthy feet are the foundation for healthy living and will do my very best at all times to keep you active and moving along life’s journey—whatever your interests and wherever your feet may take you.”

A Step Ahead Blog Series


OrthoNeuro will expand its medical services into Grove City early 2019.

OrthoNeuro’s newest physician office will be in the new office building at the OhioHealth Grove City Methodist Hospital Campus located at 1325 Stringtown Road. This 3,000 square foot space will allow for the addition of physicians and staff to improve patient access and accommodate practice growth. The new medical office will open in January 2019. This new space will allow OrthoNeuro to better serve patients in the community of Grove City and surrounding areas with the best orthopedic care in the areas of: total joint replacement, sports medicine, shoulder, elbow, foot & ankle, hand, spine, and physical medicine & rehabilitation.

“OrthoNeuro is pleased to open our multi-specialty office in Grove City, giving residents a new option for high-quality orthopedic and spine care,” said Dr. Carl Berasi, president and CEO at OrthoNeuro. “This is an important step as we look to provide convenient access to personalized care in the southwest quadrant of the Greater Columbus area.”

OrthoNeuro Physicians  who treat patients at our Grove City Office:

Nicholas Cheney, DO
Paul Eichenseer, DO
David Kim, MD
Ryan Klinefelter, MD
Keith LaDu, DO
Ryan Palmer, DO
Michael Skeels, DO
Scott Stephens, MD

boxers fractureA boxers fracture means you have broken the head of one of the metacarpal bones in your hand (usually on the pinky finger side). Metacarpal bones connect the bones in your finger to the bones in your wrist. You might hear your hand doctor refer to it as a brawler’s fracture. This injury commonly occurs when the hand is in a fist and strikes a hard object such as a wall or another human. 

Symptoms of a boxers fracture:

If you sense that you have fractured your hand you should seek medical attention immediately. An x-ray may be used to confirm the diagnosis.



An untreated Boxers fracture can result in decreased grip strength, limited range of motion of the little finger, and finger deformity.  With proper treatment, complications are not common and usually minor if present at all.

OrthoNeuro is currently offering orthopedic appointments within 24 hours.  Please call 614-890-6555 or click the button below to schedule today.

Schedule Now!

Time to ring in the holiday season!  Are you busy?  I’m sure.  Being mobile is part of the game.  So let’s give thanks to our feet for all their hard work they’ve done for you this year and let’s talk about a couple things to keep them healthy during this busy time.  I’ll begin with a short anatomy lesson about the largest organ in our body: our skin.  You may not think of your skin as an organ.  By definition, it is because it’s a body part made up of an organized group of cells working together to do a job for your body.  Our skin does a lot for us.  It acts as barrier, protecting the body from harmful things in the outside world such as moisture, the cold and sun rays, as well as microorganisms and toxic substances.  Skin also plays an important role in regulating body temperature.  The skin on the soles of your feet is the thickest in order to provide the necessary protection when we walk both with shoes and without.   Keeping our skin hydrated this time of the year is important.  Heat sources in buildings tend to dry out our skin.  Make sure to use good quality moisturizers as needed.  Dry skin is prone to cracking and bleeding and can result in infections.  Having well hydrated, healthy skin on your feet is especially important for diabetics and patients with poor circulation. 

bigstock-Feet-in-wool-socks-near-firepl-109840784-1Cold weather footwear is mandatory and needs to include the right socks.  Socks with an acrylic or merino wool blend breath and wick moisture better than cotton only.  Leather upper shoes and boots are a must for the same reason.  If you’ve followed my blogs you may have heard me talk not only about “foot health” but also “shoe health.”  Taking care of your shoes so they can take care of your feet will pay dividends.  Consider some form of shoe sanitizing process periodically.  Sprays are the most common but UV light shoe sanitizers are also available.   Worn soles on shoes and boots are downright dangerous in the snow and ice and need replaced or the shoes tossed. 

 Is that snow?

undefined-270426-editedDr. Napolitano is a double board-certified podiatrist and wound care specialist physician. (CWSP).  He specializes in medicine, surgery and wound care of the foot, ankle and lower leg. He was the first podiatrist in the state of Ohio to earn the board certification Certified Wound Specialist Physician (CWSP).

“I strive to educate my patients thoroughly about their problem and offer a comprehensive and holistic treatment plan both medical and surgical.  I believe healthy feet are the foundation for healthy living and will do my very best at all times to keep you active and moving along life’s journey—whatever your interests and wherever your feet may take you.”

A Step Ahead Blog Series

Your TFCC, or triangular fibrocartilage complex consists of a disc made of cartilage and two sets of ligaments on the “pinky” side of the wrist. It serves a load-bearing function, distributing weight across the wrist, and also helps to stabilize the ulnar (outermost) and radial (inner) bones of the lower arm and wrist. The TFCC can become torn or injured easily during sports, heavy-duty work with hands, or a fall on an outstretched arm/hand.

nurse checking man's wrist for TFCC injury

Its All in the Wrist

The wrist is a complicated assembly of bones, muscles, connective tissues and cartilage that enables the intricate and varied movements of the hand and fingers. The TFCC connects the bones of the hand and arm to effectively form the wrist, so when it is ripped, torn or otherwise injured, this can seriously impact the ability of the wrist to function properly or bear weight.

Early diagnosis and treatment are critical to help minimize additional injury and facilitate efficient healing. Often after TFCC tear or injury, the patient must undergo weight and stress tests to determine the severity of the injury. This subsequently dictates the type of treatment and the length of the healing time period. For athletes, particularly those playing baseball, golf, basketball or other sports where weight is put onto the wrist regularly, this type of injury can have extremely detrimental effects on performance. Most of us know someone, or we ourselves have experienced some type of TFCC tear or injury. TFCC tears are most often sustained from: 

Young and old are susceptible to TFCC injuries and related hand and wrist pain. Classically, TFCC tears are associated with athletes, but many older adults experience degradation or wearing away of TFCC cartilage and subsequent pain and discomfort. And while TFCC tears are relatively common wrist injuries, diagnosis and treatment can be somewhat trickier.

Because the wrist “assembly” is so complex with many moving parts, diagnosing and treating injuries to the wrist can be challenging. TFCC is just one component among a group of “hand-wrist assemblies” that, when injured or worn thin, contribute to “ulnar sided” wrist pain, or pain on the side of the hand and wrist near the pinky finger.

Some non-athletes may report little pain associated with a TFCC tear, while others may have significant pain and discomfort, and may shun non-surgical stabilization methods. This can extend the life of the symptoms and prevent healing. In their 2017 review Ulnar sided wrist pain in the athlete, Stanford University researchers Eric Quan Pang and Jeffrey Yao refer to ulnar sided wrist pain as “the black box of the wrist.”

man with wrist pain taking a break in the gym

Wrestling with Wrist Pain

Because the TFCC connects, protects and cushions the wrist and hand while gripping, a TFCC tear or TFCC injury can lead to chronic pain unless properly treated. Repetitive motions in sports, athletic training or work setting can aggravate an already painful injury to the point that it becomes chronic. Wrist injuries from falling can vary in severity as well. But, with a TFCC injury, the patient most often experiences:

Wrist Watch: Treating TFCC Injuries 

There are several diagnostic tools that help orthopedic physicians determine the level of trauma or the extent of a tear, even when the patient feels little or no pain. TFCC is sometimes less painful than it is insidious, and some rather sophisticated diagnostic techniques are employed to help identify and treat injuries as well as age-related degradation of the wrist.
Diagnostic tools range from weight-bearing “tests” to a variety of imaging methods:

Doctor examining an older man's wrist for TFCC tear and painful positions-1

Treatment includes the following:

OrthoNeuro has a number of orthopedic physicians in Central Ohio that are hand specialists, skilled in treating ulnar sided wrist pain. Because our practice sees so many different cases, our hand doctors are skilled in identification, diagnosis and treatment of the various injuries to the wrist, enabling athletes and non-athletes alike to begin the healing process as soon as possible. Wrist pain can be a complicated issue, and we are focused on treating our patients in a comprehensive way.
This treatment includes:

OrthoNeuro is a top Central Ohio orthopedic center with unparalleled and comprehensive orthopedic sports medicine services. If you or someone you know has ulnar sided wrist pain, click the button below for a consultation, and begin the healing process today.

Schedule Now!

herniated discDo you have a herniated or bulging vertebral disc?

According to many studies, up to 85% of people in the United States will suffer from low back pain.  Low back pain is second only to upper respiratory infections (the common cold) as a reason for missed work time!

The bones (vertebrae) that form the spine (backbone) are cushioned by small, round, flat discs. When these discs are damaged from an injury, normal wear and tear, or disease, they may bulge abnormally or break open.  A herniated disc occurs when small tears form in the wall of an injured disc.  The injury often compresses a nerve root, causing pain.

Herniated or bulging vertebral discs are common injuries of the neck and low back.  These injuries may be asymptomatic (no symptoms) and are more prevalent as we age. According to a study in 2008 from the Cleveland Clinic, 25% of all asymptomatic adults have at least 1 herniated vertebral disc and as many as 60% with no back pain have degenerative changes in their spines.

If you have back pain and any of the following signs, you should be seen by a spine doctor for an evaluation.

5 Common Signs You Have a Herniated Disc:

Test and Diagnosis:

Usually all that’s needed is a physical exam and medical history.  X-Rays: Don’t detect this type of injury but can rule out tumor, broken bone, or alignment issues. Myelogram: Test can show pressure on spinal cord or nerves due to bulging discsMRI: Test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. A herniation may be seem on MRI.

Treatment & Drugs:


Body Mechanics Book OfferWant to perform day to day tasks in a manner that will protect your back? Click on the image to the right to download our E-Book.


Do you have an injury that needs to be seen by an orthopedic specialist today? 

% Reasons to Visit an Orthopedic Urgent Care

Injuries are not only painful but can limit your ability to function with day–to-day activities. Getting treatment for orthopedic injuries can be particularly difficult after hours and on weekends when your regular physician isn’t available.

Choose OrthoNeuro+NOW Orthopedic Urgent Care for quick access to orthopedic care for you and your family!

5 Reasons to Visit an Orthopedic Urgent Care

  1. No Appointment Necessary! You can be seen same day!
  2. Evening and Weekend Hours available!  No need to take off work, our centers are open until at least 7pm Monday – Friday and on Saturday mornings from 8am-12pm.
  3. Specialized Care! See a medical professional specifically trained to treat your muscle, bone, and joint injuries and conditions.
  4. Wait Minutes not Hours! Our patients are typically seen within an hour of arriving at the center.
  5. Healthy Waiting Rooms!  Don’t get stuck sitting next to a person with the flu! 

Common Conditions/Injuries Treated at our Orthopedic Urgent Care:

OrthoNeuro+NOW Orthopedic Urgent Care is the place for children and adults to see a specialist now. There are no long emergency room visits or lengthy waits for follow-up appointments. Waiting rooms with healthy not contagious patients make the visit a safer experience for everyone. 

Patients are typically seen within the hour. If an injury requires additional care or more extensive testing, our more than 28 specialists appropriately treat patients in a timely manner. We make follow up easy on you. Our specialists provide state-of-the-art evaluation and treatment to meet all of your orthopedic needs.

Don’t Wait, See a Specialist Today! Walk-in or call ahead to let us know you are on your way. (614) 839-2145

Learn more about our  Orthopedic Urgent Care

ACL Injuries in WomenThe slightest mention of an ACL tear strikes fear in the hearts of even the toughest athletes, and for a good reason. The career ending injury occurs in 1 of every 3,000 individuals each year, and it has been reported to occur upwards of 9 times more often in women than men. We have all heard that ACL injuries are more common in females than males, but why exactly is that the case?


Not surprisingly, female anatomy has been called into question as the culprit of increased rates of knee injuries. Women have a wider pelvis, which causes the femur to descend at a much sharper angle inwardly than men. Medically, the angle of the femur is called the “Q- angle”, and a greater Q-angle can give what is often known as a knock-knee appearance. This alignment of the female femur puts more pressure on the inside part of the knee, which is thought to contribute to ACL tears.

Besides the width of the pelvis, another contributing factor is an imbalance in the strength of female leg muscles. Women tend to have stronger quadriceps muscles (located in the front of the thigh), and relatively weaker hamstring muscles (located in the back of the thigh). This imbalance causes additional stress to be placed on the ACL, leading to an increased risk of tear. 

The construct of the ACL itself may be a cause of increased tears in women. Females generally have smaller ligaments compared to men, which makes even the smallest tears detrimental to their physicality. On top of that, women have more lax ligaments, meaning they have more give. This increased laxity allows for more joint mobility, which predisposes women to ACL tears.


More recently the contribution of neuromuscular control and biomechanics as predisposing factors has been studied. To explain, researchers have looked at the way females jump, cut, land, and rotate during sporting events. Compared to men it was found that women tend to bend their knees less upon landing, meaning they allow their joints to take on most of the force of impact. Women also buckle their knees inward when landing and making cuts, which puts even more stress on the inside part of their knees. Furthermore, women’s feet flatten out upon impact which adds to the mounting stress on their ACLs.

How to prevent ACL tears?

Females should keep in mind the ideal athletic stance during physical activity. This includes having bent knees, their butts down, and their weight on the balls of their feet. Exercise programs targeted at strengthening the hamstrings, reducing the impact of landing from jumps, and proper cutting techniques are absolutely recommended.



Dr. Mark Gittins, OrthoNeuro Orthopedic Surgeon spoke to a group on Wednesday at Wesley Glen Retirement Community about the common causes of knee and hip pain including arthritis and the available treatment options.  Thank you to all that attended!

Dr. Todd spoke with Robyn about low back pain and current treatment options. No one ever wants to see a spine surgeon.  Millions of individuals suffer from back pain every year.