3. Elevator Podiatrist - Podiatrist vs. ER, Urgent Care, or Orthopedic Surgeon - Dr. Andrew Green
Dr. Andrew Green was featured on the Elevator Podiatrist podcast and offered insight on podiatrists vs. a visit to the ER, urgent care or orthopedic surgeon.
Joe Crosby (JC)
Welcome to the Elevator Podiatrist, the show where we ask common foot and ankle questions to top podiatrists from around the country. There’s no appointment or co-pay required for this one-on-one Q&A, only free advice from individuals who have devoted their lives to all things feet.
A lot of people think of a podiatrist as someone who only deals with diabetic wounds and ingrown toenails, but that just scratches the surface of what a podiatrist is capable of. They deal with sports injuries of the feet, ankles and toes, including sprains, strains and fractures. Today we’ll be discussing a podiatrist’s ability to perform surgical and non-surgical treatment options compared to the ER, urgent care facility or orthopedic surgeon. I’m your host Joe Crosby, and today I’m joined by Dr. Andrew Green, podiatric surgeon out of Palm Coast, Florida.
Before we get started, tell us a little bit about your background and what you specialize in.
Dr. Andrew Green (AG)
I’m a podiatric surgeon like you stated. I’ve been practicing now for 17 years. My main focus of practice is sports medicine, surgery and diabetic foot care.
We’re kind of coming up on back-to-school season and fall sports will be kicking into full gear pretty shortly. What are some common injuries that you see this time of year, you know from late summer to early fall?
The biggest injury I see mainly in kids especially is something called Sever’s Disease, which is an injury to the growth plate in their heel. That’s probably the number 1 injury we see. Number 2 being just kind of classic tendonitis pain just kind of overuse and then of course ankle sprains are extremely common as well.
What are the common treatment methods for these injuries, whether that’s surgery, orthotics, therapy, for the ones you kind of just mentioned?
Well, the first 2 I mentioned there, Sever’s Disease, of course is a growth plate injury, and tendonitis, those are both overuse injuries. The first thing we do when someone comes in for overuse, we can either number 1 get them resting. Number 2, a lot of times we’ll immobilize them, whether we do a cast or a walking boot, ice, anti-inflammatories, sometimes physical therapy if it’s an ankle sprain. After the sprain is calmed down we might give it some therapy. And then, ofcourse, look at their shoe gear if they have some underlying problem whether they overpronate, which means they flatten too much when they run or walk, or their achilles tendons are tight, we’ll address that with orthotics, shoe gear, stretching and other modalities.
So some of the other common injuries you might see, a broken bone, a bad sprain, we’re often kind of trained to immediately think a visit to the ER or an urgent care, or something like that. Why should I also think of a podiatrist for these type of injuries?
Well we are the number 1 providers of all lower-extremity care throughout the nation. I think we provide 38 to 40% of all lower extremity ailments and disease and injury. So we are the experts in that. That’s what we specialize in. That’s just kind of our wheelhouse if you will. Unfortunately, maybe we haven’t done a great job of educating the public on what we do all the time. But in our office, it’s a one-stop shop. We can x-ray, we can do an ultrasound image, we can put you in a cast, we can put you in a boot, we can do an injection, we can do a procedure, you know a minor little procedure if it’s a foreign body or something like that. So we’re kind of a one-stop shop. When you go to the emergency room, they might rule out a fracture, but they won’t treat it. They’ll just send you off to somebody else. So we can not only make an assessment but also treat it at the same time.
For more comprehensive injuries, orthopedic surgeons kind of often come to mind. A lot of people don’t really know that many podiatrists are also trained surgeons. So what are some surgeries that podiatrists can perform, and when should I see a podiatrist instead of going to an orthopedic surgeon or another specialist?
Mainly for surgeries, the main thing we do is reconstructive surgery of most foot deformities, the classics being your bunion, hammertoe, flat foot reconstruction. Of course, we do traumas like ankle fractures, calcaneal fractures, metatarsal fractures. And again, like I said before we do a lot of diabetic care. But for the most part, reconstructive surgeries I would say are the main part of the surgeries we perform.
It’s very common that patients do not know that we perform surgeries; any surgery an orthopedic can do. The only thing we can’t do is anything the knee and above, so if it’s ankle or foot, we can address all of that, so that’s pretty much it. Just let the patients know that we’re out there to do the same procedures that any orthopedic would do, and a lot of times it’s better because we specialize in it. We do it day in and day out.
Even though some injuries are inevitable, things are going to happen, especially with contact sports, what is some advice you can give to kids, parents and coaches on preventing foot and ankle injuries?
Definitely properly training. Make sure they stick to a system with a thorough warm up, significant stretching routine every day, and again wearing appropriate shoe gear. You don’t want to wear a soccer cleat if you’re playing baseball or vice versa.