FYI from OCIA quarterly publication from the Orthopedic Center of Illinois
January/February/March 2015
Achilles Tendon
Disorders
“Best Orthopedic Care”
Meet Dr. Mulshine • Reducing Pain with Aqua Therapy
OSCI Wins Prestigious Press Ganey Award
OCI Employee of the Year • Upcoming Physician Presentations
Inside this issue:
• Independent Living • Assisted Living• Aquatic �erapy • Rehab-To-Home• Skilled Nursing Care
Blessed to
Provide
3400 W. Washington St. • Spring�eld, IL 62711(217) 787-9600 • www.LewisMemorialChristianVillage.org
Our Rehab-To-Home therapy can help you get over the hump!
�e
“I want to go to�e Oasis at
Lewis Memorial Christian Village!”�at’s all you have to say to your hospital discharge planner to ensure that you will receive a superior experience from the moment you come through our doors to the day you get your life back. At �e Oasis at Lewis Memorial Christian Village, with our quality, compassionate care, we WILL get you over the hump!
lewis memorialchristian village
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Springfield OfficeRonald R. Romanelli, M.D.Board CertifiedOrthopedic Surgeon
Rodney J. Herrin, M.D.Board CertifiedOrthopedic Surgeon
Karolyn M. Senica, M.D.Board CertifiedOrthopedic Surgeon
Leo K. Ludwig, M.D.Board CertifiedOrthopedic Surgeon
Timothy A. VanFleet, M.D.Board CertifiedOrthopedic Surgeon
Barry T. Mulshine, M.D.Board CertifiedOrthopedic Surgeon
Joseph L. Williams, M.D.Board CertifiedOrthopedic Surgeon
Christopher W. Maender, M.D.Board CertifiedOrthopedic Surgeon
D. Gordon Allan, M.D.Board CertifiedOrthopedic Surgeon
O.B. Idusuyi, M.D.Board CertifiedOrthopedic Surgeon
Paul A. Smucker, M.D.Board CertifiedPhysiatrist
John O. Watson, M.D.Board CertifiedPhysiatrist
Doug Eastham, P.A.-CNathan Gregoire, P.A.-CKim Lashway, P.A.-CMarty Wilson, P.A.-C
Jacksonville OfficeBarry A. Werries, M.D.Board CertifiedOrthopedic Surgeon
St. Francis Hospital, LitchfieldTracy Painter, M.D.Board CertifiedOrthopedic Surgeon
• Independent Living • Assisted Living• Aquatic �erapy • Rehab-To-Home• Skilled Nursing Care
Blessed to
Provide
3400 W. Washington St. • Spring�eld, IL 62711(217) 787-9600 • www.LewisMemorialChristianVillage.org
Our Rehab-To-Home therapy can help you get over the hump!
�e
“I want to go to�e Oasis at
Lewis Memorial Christian Village!”�at’s all you have to say to your hospital discharge planner to ensure that you will receive a superior experience from the moment you come through our doors to the day you get your life back. At �e Oasis at Lewis Memorial Christian Village, with our quality, compassionate care, we WILL get you over the hump!
lewis memorialchristian village
Dear Orthopedic Center of Illinois Family,
Happy New Year from the physicians and staff at the Orthopedic Center of Illinois!
If you have made health resolutions for personal improvement in 2015, we are committed to helping you reach your goals. Whether you are injured, in need of surgery, or are on the road to recovery from surgery, our skilled team of surgeons and staff are here to serve you.
While we provide quality care for these challenges, we recognize that our commitment to your musculoskeletal health extends far beyond surgical care. Improving fitness and weight loss is an important part of the equation for healthy bones and joints. At Midwest Rehab, we offer individual and group fitness classes to build strength and jump start weight loss. Whether you are already familiar with working out or if you are just a beginner, we modify our programs to accommodate your skill level. Call today to schedule a free consultation: (217) 547-9108.
Sports are an important part of fitness, one that physicians here at OCI enjoy and are committed to. As the sports medicine physicians of both Memorial SportsCare and St. John’s AthletiCare, we are here for you no matter what the injury. Many of our physicians on staff are athletes themselves, and we know what it takes to make a full recovery to get you back in the game. Let us make the assist, please feel free to call us 24/7 for all of your sports strength and rehabilitation needs: (217)-547-9100.
If you have been living with pain, resolve to be pain free in 2015. We have an incredible team of specialists who are ready and willing to address any and all of your musculoskeletal issues from head to toe. Through national continuing education, we remain leaders in the field of minimally invasive treatments, providing advanced, cutting-edge care in the comfort of our community. This team has been helping patients with their pain for 40 years now, and can’t wait to serve you. We are always “on call” for you!
Have a healthy and prosperous New Year!
www.OrthoCenterIllinois.com
A Passion for Excellence
4
www.OrthoCenterIllinois.com
A Passion for Excellence
The Achilles tendon is the largest, strongest tendon in the body and when not functioning properly can significantly impair everyday activities. Disorders of this tendon include chronic degenerative changes, overuse injuries and acute complete ruptures.
Anatomy The two large muscles at the back of the calf, the gastrocnemius and soleus, come together to form the Achilles tendon which courses behind the ankle and attaches to the back of the heel bone (calcaneus). When these muscles contract, the ankle plantarflexes, causing the foot to point downward. The power of this muscle-tendon unit is important for pushing off when walking and running, and is essential for rising onto the toes and jumping. Forces of 6 to 12 times body weight are transmitted through the Achilles tendon during running. When the tendon is not functioning properly, these activities will become painful or impossible.
The Achilles tendon does not have a true tendon sheath like most tendons, but instead is surrounded by a thin membrane called the paratenon that provides the blood supply to the tendon. The blood supply is poorest at the midsubtance of the tendon, located approximately at the level of the ankle joint. This is the location most prone to rupture.
Achilles Tendon Disorders
By Barry Mulshine, M.D.
3
www.OrthoCenterIllinois.com
Cont’d on page 6
Midsubstance Achilles Tendinopathy Problems with the Achilles tendon are very common among runners. In fact, 7-9% of elite runners develop some type of Achilles pathology each year. Tendinopathy is most common for middle and long distance runners, but can occur with any running sport. It is thought that alignment and mechanical factors are to blame 60-80% of the time. These could include certain foot deformities, limited joint motion, or training errors such as overly long or intense workouts. Overuse of the tendon can lead to cumulative microtrauma which can cause a cycle of tendon tissue weakening and vascular compromise. Initially, this presents as pain after strenuous activities, and then progresses to pain during everyday activities and even at rest. Classically, for runners this causes pain at the beginning and end of the training session. The tendon will become diffusely swollen and tender. Overtime, the tendon tissue can develop firm nodules. This condition can usually be diagnosed on physical exam alone, although imaging studies such as X-Rays, MRI, or ultrasound are occasionally worthwhile. Non-operative treatment is successful in 70-75% of patients and is directed at relieving symptoms. It is important to correct any training errors and alignment problems. Physical therapy to improve flexibility and strength may also be beneficial. In acute tendinopathy, controlling inflammation is recommended. Modified rest, cross-training, and icing the affected area is important. Anti-inflammatory medications may have a role for acute tendinitis, but are less helpful for chronic tendinopathy. There is controversy regarding the effectiveness and safety of various types of injections. Studies investigating injections of cortisone, sclerosing agents, and platelet-rich plasma (PRP) have not demonstrated convincing benefits.
For the approximately 25% of patients who continue to have pain despite conservative treatment, surgery may be considered. In most cases, the tendon can be debrided through a small incision or even percutaneously. This involves removing adhesions and scarring around the tendon and jump starting the blood supply to the weakened area. This is successful 75-100% of the time. If there is an area of significant damage to the tendon, more invasive surgery may be needed to reconstruct the damaged tissue.
Insertional Achilles Tendinopathy In this condition, the area of weakening is at the Achilles insertion onto the calcaneus at the back of the heel. Most typically, this is a chronic degenerative problem and tends to affect an
older, less active group of patients than midsubstance tendinopathy. This will present as pain at the back of the heel aggravated by exercise, stair-climbing or running. Often there will be pain and stiffness early in the morning. The end of the tendon may become thickened, and a firm bony spur may develop at the back of the heel.
X-Rays will often demonstrate a bone spur at the back of the heel, and sometimes a bony prominence called a Haglund’s exostosis is seen. This can rub on the tendon and thereby weaken it. Initial treatments are non-operative and are aimed at reducing the stress on and strengthening the tendon. Heel lifts or open-backed shoes can be very helpful. Specific stretching and strengthening exercises and icing the heel are also recommended. Since this is a degenerative condition rather than an inflammatory problem, anti-inflammatory medications are not generally effective. This non-operative regimen is successful in 85-95% of patients, although it may take several months for the symptoms to resolve.
“Problems with the Achilles tendon are very common among
runners. In fact, 7-9% of elite runners develop some type of Achilles pathology each year.”
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Why did you decide to go into Orthopedics?I enjoy the hands-on, mechanical aspect of orthopedic surgery that allows me to physically “fix” what is wrong. This allows me to see the beneficial results of my work in a quicker, and usually much more visible way than is possible in other fields of medicine.
Why did you choose your sub-specialty?During my residency, it seemed that the foot and ankle was a somewhat neglected area of orthopedics. I decided that an additional level of fellowship training in this area would allow me to provide better care to my patients with foot and ankle problems. I still enjoy practicing the rest of general orthopedics as well.
What are the most rewarding aspects of your job?Being able to help a patient with a painful, disabling musculoskeletal problem become pain-free and able to resume activities that were previously difficult or impossible is very rewarding. I feel very blessed when I know that I have been able to play a role in helping to improve someone’s life in this tangible way.
What do you do to relax when you’re not in the office?My wife and I have three boys, so when I’m not working I enjoy spending time with my family. I also like reading, biking, and running. In that order!
• Graduated from Southern Illinois University School of Medicine,
Springfield, Illinois
• Internship, Southern Illinois University School of Medicine,
Springfield, Illinois
• Residency, Southern Illinois University School of Medicine,
Springfield, Illinois
• Certified by the American Board of Orthopedic Surgery
• Diplomat, National Board of Medical Examiners
• Member, American Academy of Orthopedic Surgeons
• Member, American Medical Association
Meet Barry Mulshine, M.D.
“ “
5 A Passion for Excellence
www.OrthoCenterIllinois.com
Surgical treatment may be warranted for patients who continue to have persistent pain despite six months of conservative treatment. Surgery involves removing the Haglund’s exostosis and the heel spur. Sometimes, this can be done without detaching the tendon itself and allows for early weight bearing after surgery. However, if the spur is larger, the tendon may need to be elevated off the bone and then reattached with bone anchors after the spur is shaved off. In some cases, the tendon is in such poor condition that a tendon transfer is necessary to strengthen the Achilles and preserve function. Achilles Tendon Rupture A complete tear of the Achilles tendon can occur if the calf muscles quickly contract while the ankle is being forced into dorsiflexion, or flexing the foot upward. This is most common in middle aged men, the so-called “weekend warriors.” Sometimes, this can occur when trying to jump, or during a slip or stumble, and at times, an audible crack or pop can be heard. The pain is usually more severe in the calf than by the ankle. Patients will often report that they thought someone had kicked or struck them in the calf. Initially, walking is difficult and painful, although the pain does gradually improve with time. It is very important that treatment begin immediately after an Achilles rupture, so early evaluation by an orthopedic surgeon is critical. Patients who wait 4-6 weeks to seek treatment because they self-diagnosed an ankle sprain will have a poorer outcome. Acutely, the diagnosis can usually be made without an MRI, except in some equivocal cases. The proper treatment for acute tendon ruptures is somewhat controversial. Traditionally, non-operative treatment was recommended for ruptures in older and less active patients and open surgical repair of the tendon recommended for younger, more active patients. Non-operative treatment consisting of casting and crutches for six weeks had pretty good results, but with a higher rate of repeat ruptures compared to surgical repair. Newer, non-operative protocols involving early motion and earlier weight bearing have– although counterintuitively– yielded better outcomes. In fact,
some studies have shown very similar outcomes compared with surgical treatment, without the risk of wound-healing problems. For more athletic patients desiring surgical treatment, there are newer, less-invasive techniques that reduce the risk of wound problems and allow for earlier weight bearing than traditional, surgical repair. Sutures can be placed into the tendon through puncture holes in the skin and brought together using a special instrument inserted through a small incision over the torn tendon. The sutures can either be tied together to repair the tendon or can be attached directly to the heel bone with bone anchors. The key to obtaining good outcomes with Achilles tendon ruptures is prompt diagnosis, and quickly initiating treatment, be it operative or non-operative.
For details, visit our website: www.OrthoCenterIllinois.com/calendar.html
UpcomingPhysician
Presentations
“Improving Outcomes for Hip and Knee Surgery.”
January 28 | Gordon Allan, M.D.
“Sports Related Foot & Ankle Injuries” March 2 | O.B. Idusuyi, M.D. & Barry Mulshine, M.D.
“Cont’d from page 4
6For more information about Dr. Mulshine or other physicians, visit our website: www.OrthoCenterIllinois.com.
Whether you are eighteen or eighty, aches and pains are a fact of life. Exercising can be uncomfortable but necessary for recovery after injuries or surgery. At times, land based exercises are the right treatment. However, sometimes they are just too painful. Aquatic exercise gives an alternative that allows for increased activity with less pain. No matter your age, aquatic based exercises have many benefits. These benefits include improved flexibility and range of motion, improved cardiovascular stamina, and decreased pressure on the joints due to buoyancy. Buoyancy is the property of water that decreases the effects of gravity on the body. This allows for weight-bearing exercise with less body weight creating forces on the joints. The therapeutic pool at Midwest Rehab has an underwater treadmill that can provide further benefits. Research has shown that using an underwater treadmill can help with decreased muscle and joint pain, improved flexibility and
even improved sleep patterns. Even though the winter months are coming, therapeutic pool temperatures range from 90-96 degrees. This warm temperature helps tight muscles relax
and allows for better and more natural movement. Overall, aquatic therapy has many benefits for people of all ages and of all conditions. Even though winter is here, aquatic based exercises
can be relaxing and pain free. If you have any questions about the information in this article or would like to talk with a therapist to see if aqua therapy is right for you, we can help. Call Midwest Rehab today to set up a consultation: (217) 547-9108.
Reducing Pain with Aqua TherapyBy Caitlin York, Physical Therapist AssistantMidwest Rehab at OCI
Caitlin graduated from Indian Hills Community College in Ottumwa, Iowa, with an Applied Associates of Science in Physical Therapy. Her professional interests include geriatrics, vestibular/balance, and athletics.
www.OrthoCenterIllinois.com
7 A Passion for Excellence
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Fill in the given grid with missing numbers observing three simple rules. You have numbers 1 through 3 for a 3 x 3 grid; 1 through 4 for a 4 x 4 grid; 1 through 5 for a 5 x 5 grid; 1 through 6 for a 6 x 6 grid; and so on.
• Rule #1: Each row must contain different numbers. • Rule #2: Each column must contain different numbers. • Rule #3: Each stream must contain different numbers.
Puzzle
Continuing Education
Solution on page 9
8Check out our blog for health tips, articles from our doctors and more! www.OrthoCenterIllinois.com
Ron Romanelli, M.D.American Association of Hip & Knee Surgeons Annual Meeting November 2014 | Dallas , TX
Hospital for Special Surgery Hip & Knee CourseDecember 2014 | New York, NY
Gordon Allan, M.D.American Association of Hip & Knee Surgeons Annual Meeting November 2014 | Dallas , TX
Leo Ludwig, M.D.Transatlantic Orthopaedic Congress Sports Medicine Total Knee & Hip CourseOctober 2014 | New York, NY
Rodney Herrin, M.D.Orthopaedic Summit Evolving Techniques Sports Medicine & Arthroscopic Surgery CourseDecember 2014 | Las Vegas, NV
John Watson, M.D.American Academy of Physical Medicine & RehabilitationRegenerative Medicine for Treatment of Musculoskeletal Conditions November 2014 | San Diego, CA
www.OrthoCenterIllinois.com
id one of our staff members go above and beyond to make your experience at OCI a great one? Please consider nominating him or her for Employee of the Month! You can nominate a staff member online or ask a receptonist for a form.
Did one of our staff members go above and beyond to make your experience at OCI a great one? Please consider nominating him or her for Employee of the Month! You can nominate a staff member online or ask for a form at reception.
Register at OCI for the all-in-one personal health record and patient portal.
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Receive e-mail care reminders
Requestappointments
Request Rx refills
Send and receive secure messages
Rx
Did You Know?
We accept walk-ins at our Springfield office for injuries sustained in the past 48 hours every day during normal business hours!
Monday- Friday, 8am to 5pm | Saturday, 8am to 12pm
OCI Employees of the Month
October:Valerie LovelaceMedical Assistant
November:Duane Meyer Physical Therapist
December:Diana VestalPACS Administrator
Puzzle Solution
9 A Passion for Excellence
www.OrthoCenterIllinois.com
Raising Money for a Good Cause to Celebrate Five Years in New Location
Choose well. We all have things we live for. Family, friends, our goals and dreams — the simple everyday moments that bring us joy. At Memorial, we’re proud to be chosen as a part of so many of those moments. After all, when it comes to healthcare, more people choose the expert, compassionate care at Memorial. What do you choose to live for?
BEING GRANTED A SECOND CHANCE ISN’T TO BE TAKEN FOR GRANTED.
Visit ChooseMemorial.org
Sign up for our new patient portal, FollowMyHealth, at our offices!
www.OrthoCenterIllinois.com
Orthopaedic Surgery Center of Illinois Wins Prestigious Press Ganey Award
By Leo Ludwig, M.D.
As the medical director of the Orthopaedic Surgery Center of Illinois (OSCI), it is my pleasure to present to you our yearly quality report card. OSCI is located across the street from the Orthopedic Center of Illinois in the Koke Mill Medical Center. On a yearly basis, we evaluate our case types and volumes, certain quality reports, as well as patient satisfaction. This data is analyzed with the goal of providing our patients with the best quality outpatient experience and outcomes. The Affordable Care Act (Obamacare) is drastically changing the landscape of medical practice in the United States and is more closely monitoring healthcare facilities to provide the highest quality care at the lowest price. OSCI is excelling at this goal. OSCI utilizes the nationally recognized Press Ganey satisfaction survey to measure patient satisfaction. I am proud to announce that OSCI, for the second year in a row, has been
awarded the 2014 Press Ganey Guardian of Excellence Award. Press Ganey has more than 10,000 clients nationally and less than 5% received this award, which is given to healthcare facilities that rank above the 95th percentile in patient satisfaction for 12 consecutive months.
OSCI is the only facility in Central Illinois to receive this designation. This award is a tribute to the care provided by the staff and physicians at OSCI. More than 3,000 patients annually receive healthcare services at OSCI. As you can see in the graph, the most common surgical procedures performed are arthroscopic procedures of the knee and shoulder. Various hand surgeries, as
well as fixation of bone fractures, are other common procedures. Newer procedures such as hip arthroscopy and outpatient spine surgery continue to grow in volume. Additionally, our pain management physicians are busy performing lumbar and cervical epidural steroid
11 We’d love to hear from you! Fill out a patient comment card or leave your feedback onlineat www.OrthoCenterIllinois.com
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Employee of the Year
Congratulations to Duane Meyer on his nomination for Employee of the Year! Mr. Meyer is a Physical
Therapist at Midwest Rehab and has been with OCI for five years.
Congratulations, Duane!
Mr. Meyer accepted his award from Dr. Romanelli at the OCI employee holiday party.
injections. In 2014, we began to offer cataract surgery and the program has been very successful with 225 cataract surgeries completed. From a quality standpoint, 100% of the patients undergo a safe surgery checklist, 100% receive appropriate and timely antibiotics to help prevent infection, the complication rate is less than 1%, and the infection rate is less than 1%. In addition, the cost of providing care for these procedures at OSCI is significantly less expensive than the services provided in a hospital outpatient surgical department. As you can see, providing high quality care in a lower-cost facility is exactly what is necessary in today’s healthcare environment. If you, a family member, or friend requires one of these outpatient procedures, please talk with your physician about the possibility of having your procedure at OSCI. I wish you a healthy 2015.
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Discetomy
Ganglion Cyst Removal
Hardware Removal
Knee with ACL
Hip Arthroscopy
Fixation of Fractures
Carpal Tunnel/ Trigger Finger
Cataract
Shoulder Arthroscopy
Knee Arthroscopy
Pain Management Procedures
Top Surgical Procedures FY2014
Dr. Leo Ludwig is Medical Director at OSCI and a surgeon at the Orthopedic Center of Illinois. His special areas of interest are shoulder surgery, arthroscopic surgery of the shoulder and knee, and minimally invasive total joint replacement.
12Sign up for our new patient portal, FollowMyHealth, at our offices!
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1705
0 200 400 600 800 1000 1200 1400 1600 1800
Discetomy
Ganglion Cyst Removal
Hardware Removal
Knee with ACL
Hip Arthroscopy
Fixation of Fractures
Carpal Tunnel/ Trigger Finger
Cataract
Shoulder Arthroscopy
Knee Arthroscopy
Lumbar & Cervical Epidural Injections
Top Procedures FY2014
OCI is committed to supporting community groups in the Springfield area to improve the landscape of where our patients live and work.
www.OrthoCenterIllinois.com
Ingredients• 1 lb. turkey breast tenderloin, cut into 1” pieces• 28 ounce can diced tomatoes, undrained• 15 ounce can black beans, rinsed and drained• 8 ounce can tomato sauce• 1 C. peeled, seeded, and cubed butternut squash/pumpkin• 1/2 C. chopped onion (1 medium)• 1/2 C. chicken broth• 1/2 C. frozen whole kernel corn• 1/2 C dried cranberries• 1 fresh jalapeno pepper, seeded and finely chopped• 1 T. chili powder• 1 clove garlic, minced• Chicken broth (optional)• 2 C. shredded fresh spinach • 1 C. Monterey Jack cheese with jalapeno peppers, shredded (optional)
Did you
Directions1. In a 5-quart slow cooker combine turkey, tomatoes, beans, tomato sauce, squash, onion, the 1/2 cup broth, the frozen corn, cranberries, jalapeno pepper, chili powder, and garlic.
2. Cover and cook on low-heat setting for 10 to 12 hours or on high-heat setting for 5 to 6 hours. If desired, stir in additional broth to reach desired consistency.
3. To serve, stir in spinach. If desired, sprinkle servings with cheese.
New World ChiliFrom www.recipe.com
I’m POSSIBLE150 years ago, Hanger Clinic was founded by the first amputee of the Civil War as a local company specializing in prosthetic devices. Today, in addition to embracing our heritage, Hanger Clinic is the premier provider of orthotic and prosthetic services and products in Illinois and the US. Offering the most advanced technology available, combined with unsurpassed customer service, Hanger Clinic provides the following solutions:
• Cranial Remolding Orthoses • Functional Foot Orthoses• Insignia™ Scanner System • Pediatric Orthoses• Orthoses • Lower Extremity Prostheses• Upper Extremity Prostheses • Scoliosis Treatment• Diabetic Therapeutic Shoes and Inserts • WalkAide® – Technology for Foot Drop
Always accepting new patients. Visit or contact us for an appointment and free evaluation.
355 W. Carpenter Street, Suite B, Springfield, IL 62702217-789-1450 • HangerClinic.com
1 VISION760+ CLINICS150 YEARS
14-HGRM-12787_Springfield IL 4C Ad.indd 1 11/19/14 5:03 PM
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Above: OCI employees sponsored 17 children through the Salvation Army Angel Tree. Left: A team from OCI participated in the Jingle Bell Run/Walk for Arthritis.
Did you receive treatment at OCI and have a great outcome? Submit your success story on our website: www.OrthoCenterIllinois.com
I’m POSSIBLE150 years ago, Hanger Clinic was founded by the first amputee of the Civil War as a local company specializing in prosthetic devices. Today, in addition to embracing our heritage, Hanger Clinic is the premier provider of orthotic and prosthetic services and products in Illinois and the US. Offering the most advanced technology available, combined with unsurpassed customer service, Hanger Clinic provides the following solutions:
• Cranial Remolding Orthoses • Functional Foot Orthoses• Insignia™ Scanner System • Pediatric Orthoses• Orthoses • Lower Extremity Prostheses• Upper Extremity Prostheses • Scoliosis Treatment• Diabetic Therapeutic Shoes and Inserts • WalkAide® – Technology for Foot Drop
Always accepting new patients. Visit or contact us for an appointment and free evaluation.
355 W. Carpenter Street, Suite B, Springfield, IL 62702217-789-1450 • HangerClinic.com
1 VISION760+ CLINICS150 YEARS
14-HGRM-12787_Springfield IL 4C Ad.indd 1 11/19/14 5:03 PM
PROUD TO BE AFFILIATED WITH ORTHOPEDIC CENTER OF ILLINOIS
Providing our community with the most advanced sports medicine
to athletes of all ages
HSHS St. John’s AthletiCareTM
SPRINGFIELD • DECATUR • LITCHFIELD
(217) 744-PLAY (7529)
Athletic Training • Acceleration® ProgramNon-Operative Sports Medicine • Orthopedic Surgery
HSHS St. John’s TherapyCareSPRINGFIELD • CHATHAM • ROCHESTER • VIRDEN
(217) 535-3685
Physical Therapy
