“Top Doc” Dr. Merrick Wetzler Talks About What Exactly An Orthopedic Surgeon Does?

Dave Anselmo: [00:01:27] Speaker2: Merrick, what’s known as an orthopedic surgeon from AdvoCare, South Jersey Orthopedic Associates, Dr. Merrick is a board certified orthopedic surgeon. As a fellow of the American Academy of Orthopedic Surgeon, he developed an early interest in sports medicine at Yale University, where during his undergraduate career, he was an all Ivy League wrestler and won a gold medal at the Maccava Games upon earning his medical degree at Temple University School of Medicine. He completed his orthopedic residency at Boston University following fellowships in sports medicine at Thomas Jefferson University Medical Center. The Rothman Institute and Lyceo Hospital and Medical Research Center that Dr. Merrick joined South Jersey Orthopedic Associates in 1995, a former co-director of Virtua Sports Medicine Program, that the water is active in professional schools and community sports at all levels. He has assisted in team medical coverage for the Philadelphia Eagles. Flyers, Phillies and Wings served as medical chairman director for Team USA in the 2009 International Maccava Games. Medical director for Team USA in 2007. European Maccava Games and associate medical director for the Team USA in 2005. International Maccabi Games. As a member of the United States Rugby Union Medical and Safety Committee, and has also served as team orthopedic surgeon for sports teams at Rowan University. Rutgers. Camden University is Eastern Camden County Regional High School, Pemberton Township High School. Cherry Hill West High School. The Jersey Wahoos Swim Team and South Jersey Rugby Football Club. He specializes in sports medicine, shoulder and knee reconstruction, orthopedic trauma and general orthopedics. Dr. Wetzler was voted Top Doc in sports medicine by his peers in 2003, 2004, 2005, 2006 and 2009. Surveyed by South Jersey magazine. He serves as associate editor of the Journal for arthroscopy and Related Surgeries and is a member of the United States Olympic Committee. Sports Medicine Society with Dave Anselmo: arthroscopy, Associate of North America, American Orthopedic Society of Sports Medicine, American College of Sports Medicine and American Medical Association and the Camden County and New Jersey Medical Society. Dr. Wetzler. I want to thank you for coming on the show today. It’s a complete honor for having you on. You have helped me in many ways. And you, your exceptional orthopedic surgeon and my personal friend. And I want to thank you for coming on. You have been on my Sports Doctor show many times over the years, and I had a lot of fun. And it is by no mistake that this is my first. You are my first doctor and what the surgeon to be on my radio show. So I want to personally thank you again for coming on.

Dr. Merrick Wetzler: [00:04:20] Oh, it’s my pleasure, Dave. Thank you very much for that introduction. Oh, it’s I don’t realize how much I’ve done in my lifetime sometimes when you need to hear it.

Dave Anselmo: [00:04:29] It’s a complete honor. And I think these are the people out there who are very lucky to have you on the radio set out here to be answering any questions they may have. So before I get started, all this other stuff, I want to put the phone lines out there. So people, please. You have an expert doctor here, an orthopedic surgeon on the show today. You have questions about anything you might have with any injuries you might have. Call number 856-626-0400. So the show is brought to you by Cross Keys Physical Therapy. We have two locations to serve you. One in Pennsville and one in Washington Township. You can go onto the website, get the numbers, and the directions are at crosskeystherapy.com. So once again, Dave Anselmo: crosskeystherapy.com. So numbers again, 856-626-0400. All right, Dr. Wetzler, I know you also have two locations. I’m going to put you out for that. You have locations at Voorhees at 502 Centennial Boulevard and Turnersville at 901 Route 168. So I’ll give his numbers at the end of the show. So if anyone wants to give me a call. So let me go into a quick question for you Dr. Wetzler. What do you specialize in shoulder and knee reconstruction, orthopedic trauma and general orthopedics? General orthopedics. Does that mean that you treat other joints other than the shoulder and knee?

Dr. Merrick Wetzler: [00:05:52] So being a sports medicine specialist, you know, I’m a little bit of a throwback in some ways in that, you know, nowadays people come out, they just do just knees and shoulders. I’ve been taken care of. So many sports teams have been the sole physician covering them that I’ve just always taken care of all the joints and all the trauma and the injuries to them. And knowing what I can do for myself, myself versus who I need to what specialties I need to send them to. So, yeah, I take care of almost every joint. And if I can’t take care of them, I make sure they get taken care of.

Dave Anselmo: [00:06:30] That’s great. Well, we have a first caller already. Welcome to Cross Keys Physical Therapy. Share your name and your question, please.

Dan: [00:06:38] Yes. Thank you for having me on. My name is Dan. Hello to you, Dr. Wetzler. And of course, to you also Dr. Dave Anselmo.

Dave Anselmo: [00:06:46] Well, thank you for calling. Your question, please, Dan.

Dan: [00:06:49] Yes, I will. I don’t know if I want to refer to you, Dave, or maybe Dr. Wetzler or both of you, but I’m a 55 year old male, pretty active. Back around mid-October, I was at the gym doing overhead presses on a machine that it’s a free weight machine, but it’s a machine. You know, I’m not used it in three weeks. That is not quite 90 degrees. I have to say, it’s probably about 100 degrees. I want it to be a little too heavy. Something kind of popped. Had some pain. The pain continued for weeks, weeks, four weeks, an audible popping sound. We began maybe a month after this happened and went to a party. It was always painful. But through the months, it sometimes was painful. Other times it was a relief. And now it’s to the point where when I have the popular noise and it could happen at almost any time, it would be just a very simple motion. It’s still very audible, but has become much less painful. Am I maybe getting out of the woods or should I be concerned?

Dr. Merrick Wetzler: [00:07:51] Well, I mean, where is your pain? That’ll tell me that.

Dan: [00:07:55] I’m obviously the very top of the show with my left shoulder at the very top,

Dr. Merrick Wetzler: [00:07:58] Not on the lateral aspect of it, but on the top, like where your AC joint is, where that little dubbin on the top is, or is it more to the

Dan: [00:08:07] Right around there? Yes. Yes, sir. I mean,

Dr. Merrick Wetzler: [00:08:09] It could be several things. I mean, you could have caused when you were doing the heavy lift inflammation in the bursa of the shoulder, and that could thicken and scar. And that’s what the popping you feel. And does it affect your quality of life or does it affect your ability to do things?

Dan: [00:08:28] I want to say at this point, there’s been some relief. It was definitely worse some months back. The recovery time has been much more than I anticipated, but as of late. The pain is not really affected. My, my, my, my daily routines. It’s now it’s really got to the point where it pops and it’s usually not painful whatsoever. So I just figured it out. I’m sorry. Go ahead.

Dr. Merrick Wetzler: [00:08:58] If it’s not painful, then I wouldn’t do anything about it. I mean, okay.

Dan: [00:09:02] But time heals.

Dave Anselmo: [00:09:03] It sounds like an impingement or something. It didn’t sound like you tore anything?

Dr. Merrick Wetzler: [00:09:06] Yeah. I mean, we’ve been doing things for all our life, Dave. You know, if we started treating every popping crack and you know. Yeah. I mean, the popping of joints and popping can happen as long as it’s not painful. And you it’s not there’s nothing affecting your quality of life, your ability to work out and do things. I would do anything about it. I would just observe it.

Dave Anselmo: [00:09:27] You’re still using it, doesn’t it? That’s great. Yeah.

Dan: [00:09:30] Yeah, that’s terrific to hear. That’s kind of where I was hoping for. So I figured I’d ask.

Dave Anselmo: [00:09:33] So then so then a quick thing for you. What did you do during that period of time to try, did you ice it or heat it? I mean, just trying to educate some of these people what they could do if you had something like that before. It gets to the point, the way you need to go see your doctor. Did you do anything like that?

Dan: [00:09:47] I can say early on I felt the moist heat and I also have one of those Tennes units that I use. Got me past the original, more painful part of it. Since then, it’s been just kind of like I would just basically Google different types of exercises, not not resistance, just just the circles turn in the circle was my, my, my, my lip, my arm bending down and doing these circles and then just practicing, doing an imaginary overhead press with no way like just I would just imagine I had a weight in my hand just to get that range of motion back into it. Right.

Dave Anselmo: [00:10:20] And it didn’t get worse,

Dan: [00:10:22] Which was good. It did not get worse. It’s it’s it’s it it’s a slow procedure, I admit that. But it does seem to be going in the right direction. I’m better today than I was in October by a long shot.

Dave Anselmo: [00:10:33] That’s great. I know for a fact that if it does get worse, you know, you need to go see your doctor, obviously, to get it checked out, just, you know, maybe get a referral.

Dr. Merrick Wetzler: [00:10:40] It sounds like he was doing functional exercises. Yes. The one thing when you hurt your rotator cuff or hurt your shoulder. Why the importance of doing exercises such as you did or coming to a therapist and so forth. Is that the way the body heals itself is in the lines of stress. So if you have an injured body part and most body parts, if you just leave it alone, the healing process would be haphazard. The alginate fibers that you go to hearing will be haphazard. But when you put little stress on, it starts with increasing as necessary, that those colliding fibers are scar tissue, whatever you want to call it, will heal in the line of stress, thus being more orderly and preventing further problems such as a shoulder impingement and so forth.

Dave Anselmo: [00:11:27] Right.

Dan: [00:11:28] Understood.

Dave Anselmo: [00:11:29] Right. Well, Dan, thank you for the phone call and thanks for listening in.

Dan: [00:11:33] Hey, Doctor, thank you so much. And once again, Dr. Wetzler, thank you for your time. You took a little bit of a little bit off my shoulders, will say thank you very much for the information.

Dr. Merrick Wetzler: [00:11:43] And that’s what that’s what we do.

Dave Anselmo: [00:11:44] Just another caller taking advantage of a specialty here. Dr. Wetzler, once again, I want to thank you very much for coming on and helping me.

Dan: [00:11:51] Thank you, guys so much. A doctor there being something. Thank you. Awesome show.

Dave Anselmo: [00:11:55] Thank you, Dan. Thank you.

Dr. Merrick Wetzler: [00:11:56] I mean, that’s why. Thank you. I try to see, you know, after Covid and people are inside and then they start to go to the gym and start working out again. They will get back on the train. Yeah. You know, I mean, that’s one thing that for those people who haven’t been working out, have been doing things and they decide to go ahead and start a workout regime that Covid or not Covid. You got to be smart about it. You know, listening to your body starts slowly.

Dave Anselmo: [00:12:23] You can’t go way back the way you were. The people, they then go back and leave in the same way they were, and that they need to kind of start over slowly and build yourself back up and make sure you do your stretching. Obviously, stretching is very, very important before you workout and as well as after. It’s very, very important to do that. I think a lot of people forget that. They just get in there and they just start to

Dr. Merrick Wetzler: [00:12:40] Absolutely. Especially, I mean, in all body parts specially, but especially in low extremities. If you’re going to be walking, riding a bike, jogging or doing the elliptical stretching, stretching is really important.

Dave Anselmo: [00:12:54] Very, very important. I think that’s excellent. Yeah. Yeah. Well, that’s a good thing that we want. I want to go back. I just can’t forget to say this. I want to thank you for helping me in my journey and educating as many people as possible about how orthopedic and physical therapy work together and helping people. And I mean, we’re helping people change their lives. Over the years, I’ve sent you many of my friends, as well as my family members, and to help you help them with orthopedic services. And I just want to thank you for being there for me, as well as my friends. Thank you

Dr. Merrick Wetzler: [00:13:22] So much. Really? You know, you wonder why, you know, I’ve been doing this a long time. Oh, yeah. And one of the reasons why I do what I do and why people ask me, would you still do it is that very fact is for the lives I’ve hopefully made better and the friends I made as well. So it’s been a great, great experience. Great. I wouldn’t change it for anything in the world.

Dave Anselmo: [00:13:48] Well, it’s better it’s very obvious that you’re very passionate about what you do. Like, I’m very passionate about what I do. And it’s very not often that you see that, believe or not. I mean, I’m so it’s really important. And I think that’s another part of what makes you so great at what you do. I think because you obviously can see that you love what you do and that that’s a big part of it and it comes over. So I’m hoping everyone here is listening. Once again, we have Dr. Merrick Wetzler on the show today, an advocate of South Jersey Orthopedic Associates. He has two offices to serve you, one in Voorhees, one in Turnersville. So I’ll be giving the addresses and the number at the end of the show. So if you want to contact them anyway, we’ll give them those things. A number is out at the end of the show. So at this point, we’d like to take a break from the commercial. Oh, we have another caller. That’s great. Ok. Welcome to Cross Keys Physical Therapy. Your name and your question, please.

Anthony: [00:14:36] Anthony?

Dave Anselmo: [00:14:38] Hey, Anthony, how are you doing today?

Anthony: [00:14:40] All right, Dave, how are you? Good. Yeah, I have a lot of issues. You know, of course I came to you. I couldn’t move my shoulder or my arm if it wasn’t for you to fix me up. I won’t be able to have the mobility that I do as of right now if I have back issues and neck issues. And I was told in orthopedics or workman’s comp that there was nothing I could do because of my age with surgery. I mean, that doesn’t make sense to me.

Dr. Merrick Wetzler: [00:15:07] I mean, you know, going along those lines, I mean, I cannot comment on what your ailments are and so forth. I just want to give light to what the, uh, the surgeons airborne were saying. If we as surgeons look at something and don’t feel we can improve your life, do certain surgical methods, then we’ll tell you that. But that doesn’t mean that there’s not methods you can do and so forth. The spine of the cervical, the lumbar spines are very complex. They’re very difficult things to treat sometimes. And it’s not even treating it, trying to figure out what the exact etiology of your pain is. It is coming from the disk. Is it coming from a nerve being a pinch coming from arthritis of the phished joints? Is it coming from mal alignment of the spine and compensation by other muscles and so forth? There’s so much going on with the cervical and lumbar spine that you just can’t point your finger on. And as I said, surgeons, if we don’t think we can, if the risk of doing surgery outweighs the benefit of doing surgery, we would not recommend it. So that’s where they’re coming from. I don’t think they’re trying to blow you off. I just think they’re. I don’t feel like surgery is the answer for you. Yeah.

Dave Anselmo: [00:16:33] Anthony, quick question for you now since this happened. Now, as your symptoms are getting better, they’re getting worse. What’s happening over the duration?

Anthony: [00:16:43] It is getting worse? Well, I think I have thinned out my leg. On My trip I have narrowed it to the spinal canal. I got bulging and degenerated discs in my shoulder to keep it. That is, it’s a torn Librium and a bicep. So now I stole from one doctor, an orthopedic that I can fix and again from another, then it can’t be. So, you know, it’s like I don’t know where, you know, which direction to go in with this.

Dr. Merrick Wetzler: [00:17:10] Mean, for the shoulder, that’s a totally different type of joint, totally different type of mechanism and pain generators. And indeed, I mean, new ways of finding out of what’s giving you pain and so forth. We have the ability to eject and localize different areas of pain generators. And sometimes we can inject that area and it takes away the pain. Then we know the pain is being generated from that. We also have the MRI. The MRI’s of that joint are much more diagnostic and so forth so that we get a lot more information out of the MRI as well. And it depends on what the status of your rotator cuff is, how it was torn, whether it’s atrophied and so forth, what the what your biceps look like and what’s how much arthritis you’re having to shoulder. So there are multiple factors going in there. But again, I would go get another opinion. I think that one person said one thing, one person said the other. You know, they both might be right in their own ways. But, you know, again, I think that you need to seek someone else to show that you’ve done everything in your power to get yourself treated right.

Dave Anselmo: [00:18:35] And you don’t need to live like this. I mean, if you have a problem with that, like you said, that’s the one option that you always have. You always can get a second opinion and let someone else take a look at it. And, hey, check out Dr. Wetzler. I mean, I’ll give you a number at the end of the show, get a second opinion, see what’s going on. It sounds like you have a diagnosis, so you know what’s going on. And if they say you can do surgery and maybe that’s someone to take a look at and I don’t know if it’s possible, but we have an avenue here that you might want to take advantage of. So it goes to your back. No problem is that you’re back. I mean, you know, once again, there’s things that we could do. It sounds like you have a little bit of stenosis, a little bit of herniation. I mean, there’s a lot of things you could do besides, you know, just land therapy. I mean, we have aquatic therapy that can really help you with compression of the spine, maybe to get you out of pain. I mean, you’re looking at getting out of pain. So check us out. Obviously, I’ve seen you for your shoulder. So I know you’re talking about workman’s comp, but it might be a time where you might need to switch out and get care just because they’re telling you they don’t want to treat you, that doesn’t mean that it’s the end of life. I mean, you can do all the things. So having said that, Anthony, thank you for calling in.

Anthony: [00:19:36] Thank you. Thanks for your time.

Dave Anselmo: [00:19:38] Thank you for calling in. Let’s get another caller. Thank you. All right. Let’s take a very quick break so we can get the numbers out. Have a commercial here and we’re going. The next question was. Thank you for calling in.

COMMERCIAL: [00:19:50] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure a prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every means. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They dress back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away and participates in a broad spectrum of insurance plans. 856-374-3707 in Washington Township and 856-678-8000 in Pennsville.

Dave Anselmo: [00:21:02] We are back and Cross Keys Physical Therapy show. Let me get the numbers out again. We could. 856-626-0400. We have the honor of having Dr. Mark Wetzler on our show today. He isn’t orthopedic surgeon from Advocare South Jersey Orthopedic Associates. He has two locations, one in Voorhees and one intern as well. I’ll give you the numbers at the end of the show. You may want to contact him about your future needs in orthopedic care. So, Dr. Wetzler, let’s go to another question here for you. We treat orthopedic trauma. What is that? Can you explain what orthopedic trauma was?

Dr. Merrick Wetzler: [00:21:41] The broad definition of right to be trauma? Is any broken bone fracture, so forth that happens usually when you talk about trauma, you’re talking about motor vehicle accidents, fractures or long bones and so forth. That’s heavy trauma.

Dave Anselmo: [00:22:02] You’re putting them back together.

Dr. Merrick Wetzler: [00:22:03] Right. But, you know, trauma also means fractured ankles, fractured hips, fractured wrist, which comes under the auspices of general orthopedic. So I mean the full gamut from a broken finger to a broken pelvis and femur.

Dave Anselmo: [00:22:17] Well, that’s a lot of stuff that I’m sure you see when you’re on the field with all these athletes, as you did at the high school level or the college level, as well as on the professional level. So you’ve seen it all. So that’s very important. Very good. Hey, we have a caller again. Welcome to Cross Keys Physical Therapy. Your name and your question?

Carla Hall: [00:22:32] Hi, my name is Carla Hall, and I’m here with my husband, Parker. And we go to Cross Keys Physical Therapy.

Dr. Merrick Wetzler: [00:22:57] Dave, you have a fan club. Oh, my goodness. You’re on the radio now.

Dr. Merrick Wetzler: [00:23:07] I think that’s your new jingle. Yeah.

Carla Hall: [00:23:09] Yeah. We got a little jingle. Thank you

Dave Anselmo: [00:23:12] Very much. Thank you very much.

Dr. Merrick Wetzler: [00:23:17] That’s the problem of doing a live show.

Dave Anselmo: [00:23:24] You never know, right? You never know. It’s always a surprise when you do a show with me. You never know.

Carla Hall: [00:23:30] Parker has a call for the doctor. A question for the doctor.

Dave Anselmo: [00:23:38] Very good, Parker.

Carla Hall: [00:23:39] And I have a question for the doctor.

Dave Anselmo: [00:23:40] Very good. Okay, you. First, You’re up.

Parker: [00:23:44] Okay. Six years old. And I’m solving a little bit of grinding in my right shoulder. And I don’t know if I should be going to a therapist or should I be going to the surgeon. What’s your opinion on that?

Dr. Merrick Wetzler: [00:24:02] Are you in any pain?

Parker: [00:24:06] Not really. But just when I like when I take the swim motion, I can hear the grind a little bit of grinding in it.

Dr. Merrick Wetzler: [00:24:16] Do you have any weaknesses?

Parker: [00:24:21] Just a little bit. I’m just starting to notice. A little bit. Yeah, that’s why I won’t be to blame.

Dr. Merrick Wetzler: [00:24:29] Probably would do anything.

Dave Anselmo: [00:24:30] No, don’t don’t sound like you’re having any problem. He’s not coming to me for a shoulder. So that’s the first I’m hearing about. That’s great. Exactly. So. So, yeah, it doesn’t sound like you have any problems.

Dr. Merrick Wetzler: [00:24:39] Parker, do you like to swim? Is that what you do?

Parker: [00:24:43] Uh, no. I don’t swim that much. But, you know, I just you know, I just you know, I sleep on my right hand side and I’ve been sleeping on that side for years. And this is I think maybe because of sleeping on it. 

Dr. Merrick Wetzler: [00:25:03] A little bit, I mean, you have but again, you know, if it’s not a fact, your quality of life. If it’s not stopping for doing anything, I would try to keep it simple.

Dave Anselmo: [00:25:15] He’s coming to me for his hip and his back a little bit. Yeah. So I don’t know whether he’s a little worried he’s on the water with us. So that’s great. So I think that maybe that may be a little worrying. But around that, I mean, I know

Parker: [00:25:31] I do it, I’ll definitely talk to you. Yeah, they want it. I’ll check.

Dave Anselmo: [00:25:37] I’ll check your shoulder. I think you should check your shell. Parker, thank you for calling in. It sounds like you just sleep in awkwardly. You probably impingement. Want to know if you lie on a property where your arm is over your head quite a bit. I see a lot of people coming in and they’re causing irritation. And that irritation can be intermittent. It causes some symptoms. To come on and concerning, but you need to stop the cause, and so if that’s the case, we’ll talk about that on Wednesday and I’ll check you out, OK?

Dave Anselmo: [00:26:03] Okay, thank you very much. Ok, Carla, you’re up.

Carla Hall: [00:26:06] Now, here’s Carla. Here’s Carla with a question. I had my feet operated on and I had my left foot reconstructed and my right foot reconstructed. One was done in November 2020, and the right one was done in April of 2020.

Dr. Merrick Wetzler: [00:26:28] What was it reconstructed? I hate to interrupt, but what was it reconstructed for?

Carla Hall: [00:26:32] I have exaggerated osteoarthritis?

Carla Hall: [00:26:37] Ok, I’m 20 years ago. I had back surgery for my elbow, five feet to the right and impinged my sciatic nerve and titanium rods and screws in my back. And that was due to RCO arthritis also. But anyway, my question is, when I had my surgery, I had my surgery done. Maybe, maybe I shouldn’t say where or I’ll just say let me throw it out. When you have surgery done, let’s say you haven’t done that inspira or pain or rather an answer to the fact that, you know, any of the beginning places when they ask you about physical therapy and they want to sign you up eight weeks after your surgery for physical therapy at that institution. Now for me down here in the boondocks in Salem County, for me to go to say, you know, like to Vineland or whatever you’re talking about, hours travel.

Dr. Merrick Wetzler: [00:27:53] Well, what they’re trying to do, what they’re Carla, what they’re trying to do is make it give you a place to go. The worst thing they can do at any of these places is just give you a script and say, hey, you’re on your own. So what they do is they give you a suggestion where to go and motion it. And, you know, it’s a business here. Yeah. And they try to give you the information and they try to get it there. I mean, the one thing when I give a physical therapy script is I the first two things I look at you have to look at first is where they live. Once I know where they live, I want to go someplace convenient because, you know, it’s like working out in the morning, Dave. You know, when you wake up getting on up, getting to working out is the hardest thing, right. Getting someone in physical therapy can be the most difficult thing. So it’s got to be quite convenient. And then actually we look at the insurance because you have to make sure that whoever takes it and that takes the insurance you have. So I don’t fault them for this. But I mean, you go where you want to go. Don’t feel right. I know patients should feel obligated if they have a relationship with a therapist that they should go to. That’s one. Also, you should ask the doctor who did the reconstruction where he wants to send your show forward and tell them that I have a relationship with a therapist. And so I go there.

Dave Anselmo: [00:29:14] Right. And go there. We talk about this on the other shows as well. I think it’s important that some of these patients understand that they do have an option. They have an option to go.

Carla Hall: [00:29:23] They do have a choice. Absolutely. There’s a choice. And you can always call it like there’s one right here in our town, which I went to when I first had my first foot done. Right. And then there’s, you know, when I, I didn’t even have my surgery and they were calling me from the institute and I went to the schedule, my physical therapy, eight weeks out at that institution. 

Dr. Merrick Wetzler: [00:29:55] Right. Right. Exactly. But again,

Carla Hall: [00:29:57] Insurance is going to cover, I think, the physical care. I just wish that they made it well, better known to the patients. I guess that they do have a choice. As to whether they can go.

Dave Anselmo: [00:30:10] I think at the time, I think if they do a financial investment in physical therapy, I think they are obligated to tell you that they have a financial obligation, I think.

Dr. Merrick Wetzler: [00:30:17] Yeah, but if you went through in spirit and spirit physical therapy, you really don’t have to tell me you have a financial obligation yet again. Again, I mean, you always have a choice. You have a choice where therapists you go to, you have a choice where a doctor goes to and you don’t. And the best way of doing things and so forth is communication.

Dave Anselmo: [00:30:35] Yes. And my doctor said, if you have a convenience, it’s very important to you. Means are important. But if you have a history and you have a therapist, you have history with it, you feel comfortable with that, that’s where you want to go. I mean, just ask the doctor, tell that’s what you want to do. And they shouldn’t have a problem with that.

Dr. Merrick Wetzler: [00:30:49] No doctor no doctor will have a problem that they want you to get better.

Carla Hall: [00:30:56] I did not have a problem with telling my doctor that, and he ruled out a new prescription and everything for me, so I didn’t have a problem with that. And so glad we got in touch with the magic man, because I am going to be our colleague.

Dr. Merrick Wetzler: [00:31:12] We’re going to be calling you to fight for a new jingle.

Dave Anselmo: [00:31:14] We have our walking down, so that’s very good. Carla, are you and Parker having a good day? Good evening, I should say. And thank you for calling in. And now you never know the variety that they might be calling you up for the song now. I don’t know. Maybe don’t one in particular. Well, thank you, actually. Thanks again.

Carla Hall: [00:31:33] Thank you so much. And thank you, doctor. Have a good outcome. Bye bye. Bye bye.

Dave Anselmo: [00:31:39] Very good.

Dr. Merrick Wetzler: [00:31:40] Ok. That’s the one thing. You know, again, you know, we talk about relationships and so forth. It’s really nice to have a relationship. Your doctor has a relationship with a therapist. We, as you know and I know, communicate back and forth between patients. Right. You know, rather than having the patient call us, I call him and then I call you and you’re not there and so forth. I mean, having a relationship with the doctor and a therapist makes therapy even better.

Dave Anselmo: [00:32:09] It’s huge. I know. I mean, for me, calling you is you calling me right back. I mean, if I try calling someone else, like, for instance, the Rothman Institute or Reconstructive, it might be in two or three days before I get back. And that’s a long time. And it caused a lot of frustration for the patient. And it doesn’t seem like we have good communication in that sense. So I think it’s really important that these people understand the fact that once again, the point is you have a choice and it’s acting on that point. Don’t be afraid to say something. And if the doctor decides to go here, just express your opinion and express what you want.

Dr. Merrick Wetzler: [00:32:41] And Dave and I both want to make sure that we hey, there are a lot of good doctors here. Right. And there are a lot of good doctors, Inspira. Virtua and Cooper, they’re all great doctors. You get to choose who you want to go to. You get to choose where you want to go to therapy. Right. You know, make sure you’re comfortable with it and so forth. And that’s the most important thing.

Dave Anselmo: [00:33:01] Yeah, that’s right. And that’s why, once again, you have a second opinion. We have another call. So welcome to Cross Keys Physical Therapy. Share your name and your question for the doctor, please.

Shirley: [00:33:13] Hi, this is Shirley from Pennsville.

Dave Anselmo: [00:33:15] Hi, Shirley. Your question, please. What can I do for you today?

Dan: [00:33:21] Okay. I had a knee replacement three weeks ago, three or four weeks ago, and I went in. And I want to know, is it normal for it to still be swollen or should I be concerned?

Dr. Merrick Wetzler: [00:33:35] As long as it’s not red, really red, really hot and really painful to move it. You’re going to have some heat to it. You’re going to have some discoloration to it from the bruising and the surgery and so forth. But as long as you’re making progress in physical therapy and your range of motion is improving, I would not worry about it at all. Exactly. But, you know, with that said, you know, if there’s any doubt, you call your physician and you go in and see him. But usually knock on wood that, you know, my patients, I’ve done knee replacements. They call me up, they come in. It’s just natural bruising, natural swelling and so forth. And it’s going to take a while for that swelling.

Dave Anselmo: [00:34:19] Yeah, actually, Shirley is one of my patients and I asked too. She’s doing fantastic. She has a little bit of intermittent swelling. I mean, and it’s got me she asked me, no question. So I just told her, do you have any doubt? Call in and talk to us. Oh, yeah, absolutely. I think she’s doing well. And I think you’re absolutely right. She’s fine. She’s doing well. And it’s not warm. It’s not hot. And there’s no redness around the joint. So she’ll think you’re doing fine. And I’m glad you called in to say, I hope that you feel better in your sleep, better tonight.

Dr. Merrick Wetzler: [00:34:52] I mean, the listeners can, right? Yeah. I mean, total knee replacements, even if we’re doing a quad sparing or minimally invasive that that we do now, even using robotic, total knee replacement, it’s still a major operation in that we make an incision, a knee, we open up the knee. Different techniques, but quite sparing and so forth. We then use a guy or the robot to cut the femur, cut the tibia and remove the remainder of the meniscus and so forth. So there’s a lot going on to do a total knee replacement that will cause pain. Therapy is vitally important again. And working with the therapist, working through the pain is also

Dave Anselmo: [00:35:36] Something that I think of the time before orthopedic surgery told me that any time you’re cutting through bone, I think that helps to increase the amount of swelling you have in the joint. Right?

Dr. Merrick Wetzler: [00:35:44] It helps. I mean, they’re bleeding and blood is always an irritant. Right. That can cause pain and discomfort.

Dave Anselmo: [00:35:51] And let it be known that Dr. Wetzler does a total knee replacement. Hip replacement and shoulder replacement. He works for AdvoCare, South Jersey with the business associates at two locations to serve you. So, Shirley, thank you for calling in. And I really appreciate a phone call. And I know you’re going to sleep better tonight and I’ll see you. See you tomorrow.

Shirley: [00:36:11] Tomorrow. She’ll see me tomorrow. Sure. All right. Okay. Thanks. Thank you very much.

Dave Anselmo: [00:36:16] Thank you so much. Yeah, that was the one thing. Another call. And she had two concerns. And obviously I told her, hey, you know, they take my word, but obviously it’s always best to hear from an expert. Absolutely. I appreciate you taking that call and answering.

Dr. Merrick Wetzler: [00:36:29] My wife likes to get second opinions, too.

Dave Anselmo: [00:36:33] Yeah, we all we all go through that.

Dr. Merrick Wetzler: [00:36:35] Exactly. But funny how much my wife has picked up over the years of being married to an orthopedic surgeon. Yeah, she’s been able to diagnose some of our friends.

Dave Anselmo: [00:36:46] Becoming a surgeon. Is that right? She actually understands the words and understands what’s going on. Ok, here we go. We have another caller. Welcome to Cross Keys Physical Therapy. Your call. Your question,

Evan: [00:37:00] Please. Thank you very much for taking my call. This is Evan. Appreciate your coming here, being able to get on there, because one of the problems that I’m having, as you well know, I commend you, Doc, for my neck. And you’ve been treating it very well when it’s coming along. Good. But as it creeps up at 78 years old, I now have a problem with my knee. As you well know, I just started. Yes. Behind me, I’ll get a lot of pain and sometimes on the side. And it was something that I woke up with a couple of months ago. And I recently got it actually told me I had a little arthritis, but I just got an MRI this past week, and I’m hoping to get the results on that. It has helped a little bit of physical therapy that you’ve done. It is able to walk around a little bit. I was really in a lot of pain when I’m sitting. Once I go to get up, once I’m up, I can move around. I can get up, get a little pain like aching, but I can get around. But when I finished it up, the pain is like somebody put a note in the back of my you know, me well. Maybe they thought they would like me a little bit.

Dr. Merrick Wetzler: [00:38:10] I mean, so it sounds like you do have some arthritis. And I’m going to go out on a limb and say your memory is probably going to show a tear of the meniscus, medial, medial, most likely, and it might even use the word degenerative tearing of meniscus. And that goes along with your age and being able to do it all you’ve done in your life and so forth. I mean, at this point, the good news is that you do have stiffness and pain when you’re sitting in it, but it gets better when you get up. I mean, therapy has helped you. Yeah. Mild anti-inflammatory. Yeah. Mild anti-inflammatories such as Aleve might help you. And then, you know, also there are more aggressive things we can do, such as corticosteroids or steroid injections and so forth. I mean,

Dave Anselmo: [00:39:03] If he had a lot of post tightness in his hamstrings as gas prices that come in attaching to the Internet. He is a limitation of getting into extensions. So he’s walking with his knee in a bad position day in, day out. And so as we get him straighter and we get a more into extension, I think a lot of these symptoms, what he’s up I think that he’s definitely has asthma, arthritis.

Dr. Merrick Wetzler: [00:39:26] So, I mean, the thing with that is what happens is that the meniscus is going to use a lot more deeper, a lot more posterior than you think. So you’re irritating not only the meniscus, but the meniscal from a ligament and a capsule. And this is irritating everything behind the knee, resulting in tightness and so forth that prevent you from extending any. So, again, stretching things out, doing therapy, getting the knee straight, keeping the knee strong. Right. The muscles around and show that it takes the pressure off the knee as you walk is vitally important. Right.

Dave Anselmo: [00:40:00] That’s exactly what I think we’re, that’s why he’s getting some relief. So I think that’s a good thing.

Evan: [00:40:06] Yeah, well, the physical therapy is working wonderfully, which is that you’ve done it because before that I couldn’t even walk. I was walking with a limp. Right. Since you started only a couple of weeks ago now, people are walking a little bit. Well, that’s about as bad as it was. At least I can get around. I’m just a little bit done with this. So of hope is that, you know, with the continual physical therapy that it’ll get much better. I won’t have to get anything done to get, you know, Courtney.

Dave Anselmo: [00:40:34] I think you’re right. I think you’re exactly right. You have a lot of tightness in there. As we get this as we get your range of motion back, we’re going to be really starting on doing a lot more, strengthening what you really need. We need to strengthen the muscles around that joint to give you more stability. And I think that’s going to be a whole lot better. You’ll be able to go on your feet and get back a little more normality with your activities. So I thank you for the phone call. Are you coming in and listening today?

Evan: [00:40:58] Hope you’re doing a great job, and I could tell you getting old is not a good thing, but it is not.

Dave Anselmo: [00:41:05] Right. Obviously, I hope there’s a lot of people out there that are listening in today and they might be sitting there saying the sounds like them. I mean, I think this is an important thing to understand what you need and, you know, getting your opinions and seeing people. And like I say, in reference to whether you need to see your orthopedic surgeon to get a diagnosis of what’s going on with your knee, your hip, your shoulder, whatever joint may be. I think it’s very important to get that cleared and make sure you’re heading in the right direction. So there’s a lot of things you could do. As you said, the doctor said physical therapy is important as well as injections. Those are some of

Dr. Merrick Wetzler: [00:41:38] The anti-inflammatories, ice, heat before you do things. I say, I do think

Dave Anselmo: [00:41:42] And stretching stretch,

Dr. Merrick Wetzler: [00:41:43] Stretching sometimes a knee. Every sleeve helps your body, sometimes a brace hinge brace. Right. You know, the important thing is prevention and feeling for people like him is to keep moving. I mean, I think that it’s so important we show a lot when people are sedentary, Covid and come back out and how many pains and aches they add and problems are weaker and weaker, weaker and weaker. So no matter what you do, keep moving, keep moving forward. Doing whatever necessary to do that is vitally important. And that’s what we mean. Therapy is really, really important for that.

Dave Anselmo: [00:42:19] The last thing you need or something like that is to start gaining weight. The last thing you need to do is work hard.

Dr. Merrick Wetzler: [00:42:24] Yeah, I’ve told many, many patients, you know, weight is a problem. You know, every time we step up, we put three to five times our body weight through.

Dave Anselmo: [00:42:36] Covid didn’t help that.

Dr. Merrick Wetzler: [00:42:37] Know. And losing weight, losing weight is never easy. If it was, we would all be skinny.

Dave Anselmo: [00:42:42] That’s it.

Evan: [00:42:43] And that’s true. Yeah, that’s right. Well, thank you very much. I appreciate the information. Keep up the great work. It’s a great show, and I wish you luck with it. Tony, I’ll see you on Tuesday.

Dave Anselmo: [00:42:55] Thank you very much for calling in and taking advantage of the special on behalf of Dr. Wetzler one today. He’s the orthopedic surgeon at AdvoCare, South Jersey Orthopedic Associates. He has two locations serving you, one in Voorhees and one in Townsville. I’ll be giving you a name and the addresses and the numbers shortly. But by the end of the show. So once again, let’s go on next. The next question, Dr. Wetzler, do you see a lot of knee injuries? What are the most common things you see for knees?

Dr. Merrick Wetzler: [00:43:23] I mean, meniscal tears are probably the most common going from the meniscal tears I see in my high school. Yeah. Younger athletes due to more degenerative type tearing in the older athletes I’ve been seeing. We’ve been lately. They ought to be the community. We’d be doing more, which is what they call the meniscal root tears. What happens is that we’ve been diagnosing it more. The meniscus has two attachments, the anterior and the posture. And many times, what happens is that a person will tear the posterior way and they’ll get acute pain. They’ll be tried with shots and so forth. And still that works by having that tear of the root. The meniscus functions as a shock absorber of the knee and also acts as stability. But having that router, they lose that and so forth. And we’ve been doing a fair amount of surgeries on these to do it. A lot of the patients you described will feel a pop in their knee, suddenly increase in pain and so forth. They’ll look at the x-rays or say they get arthritis or get a shot. They still have pain and discomfort. And it turns out they have a root tear that we can definitely fix.

Dave Anselmo: [00:44:38] So what are you doing with that? Are you?

Dr. Merrick Wetzler: [00:44:39] A lot of people, even with some generic arthritis, fix it because what we’re doing is restoring the anatomy, restoring the shock, absorption and stability of the knee. And they do pretty well. It doesn’t doesn’t. They’ve already developed some authorizing a knee, but it doesn’t seem to prevent them from later needing a total knee replacement. But I’ll put it off more and more.

Dave Anselmo: [00:45:02] So you don’t have to do a surgery or?

Dr. Merrick Wetzler: [00:45:03] Surgery at all as well. But it’s something that wasn’t really diagnosed 10 years ago. But now I’ve heard of it. Yeah. Now it’s been diagnosed. It’s someone who’s been out there and they have an acute injury or acute pain and knee felt a pop in it and had increased your knee. So that’s one thing that has been interesting. You know, how even in my long career that things have changed, things evolved and so forth.

Dave Anselmo: [00:45:26] But you see some injuries with a meniscus. So people understand the fact that I mean, this is the fibrous cartilage, and there’s two of them and one’s in the top attachment. It’s a shock absorber between your femur, which is the upper thigh bone in your tibia, which is your low bone. And people don’t tend to shock absorber. This is your shocks in your car. Absorb the weight of the car as you’re going down a road, your meniscus, a shock absorber, the weight of your body as you’re bending, squatting, kneeling. I mean, yeah.

Dr. Merrick Wetzler: [00:45:51] The femur. Think of it as a ball, right? I think as a table, have you put the ball on the table? There’s only one point of contact between the ball and the table. If you now cup it with the meniscus, which is a C shaped circular type thing that cups it, now, you have all the forces distributed across that. And it reduces the incentive for injuries and reduces the pain and so forth. 

Dave Anselmo: [00:46:14] We got a little. I learned a lot about that today as well. It’s great. We’re getting the latest and greatest things that are happening here with the meniscus. It’s great information. People can learn and say, hey, if you’re having some symptoms and your knee like popping sensations or, you know, having increased swelling, I definitely don’t see it. Don’t live with it. You know, there’s things you could do about that. That’s what the show is all about. They’ll teach you to learn what you could do. Don’t sit in your chair. Get up. Go find. Go see your doctor. Get a diagnosis and find out what’s going on. Ok, don’t live with these type of things. So. Ok, let me get the numbers out again. Area code 856-626-0400. Once again, this is a Sports Doctor. I’m Dave Anselmo of Cross Keys Physical Therapy. I am a sports doctor here with Dr. Mark Wetzler. He’s from AdvoCare, South Jersey Orthopedic Associates. He’s an orthopedic surgeon. So please take advantage of his expertise and give us a call and ask your question. So the number again, once again, 856-626-0400. We’re going to take a short break and we’re right back with you.

COMMERCIAL: [00:47:19] Cross Keys Physical Therapy and Sports Medicine Center is celebrating 30 years of excellence. Our programs are designed to ensure prompt return to sports work and or your active lifestyle with hands-on care by our licensed therapist. We are committed to providing high quality rehabilitation services to meet every need. Cross Keys Physical Therapy is one of the region’s only providers of full service aqua therapy. They have back neck athletic, orthopedic and joint replacement rehabilitation therapy and so much more. Our services are tailored to meet individual needs of our patients with programs that address all types of injuries, such as sport work, auto fractures, neck nerve and arthritis, just to name a few. Cross Keys Physical Therapy provides individual one on one skilled physical therapy customized for your special injury with two locations Washington Township and Pennsville. Help is only a phone call away and participates in a broad spectrum of insurance plans. Date five six three seven four thirty seven 07 in Washington Township and eight five six six, seven, eight eight thousand and Pennsville.

COMMERCIAL: [00:48:24] Cruising ninety two point one.

Dave Anselmo: [00:48:32] And we’re back. Welcome back to the Cross Keys Physical Therapy Show. We’re here today with Dr. Mark Wetzler from Advocare, South Jersey Orthopedic Associates. And I’m Dave Anselmo from Cross Keys Physical Therapy. I’m a physical therapist and owner of Cross Keys Physical Therapy. So we have another caller, Dr. Wetzler, so let’s get to it. Welcome to Cross Keys Physical Therapy. Your caller, please. Your question?

Jean: [00:48:55] Yes. Good evening. Thank you for taking my call. Appreciate it. Thank you for calling. Absolutely. My name is Jean and I’m from Cherry Hill. And Dave you actually treat my parents. My father, Jean and my mother, Diane don’t have last names. Yes. Yes. Yeah, my helper. And Dr. Wetzler, the pleasure. I know you’re from the JCC. There you

Dr. Merrick Wetzler: [00:49:19] Go.

Dave Anselmo: [00:49:20] Yes. Yeah. Jean, thanks for calling. So I’m calling on behalf of y’all.

Jean: [00:49:24] No, absolutely. Thank you for taking my call. Really appreciate it. So, Dr. Mark, I’m calling on behalf of my father. He’s 93, both osteoarthritis, extreme in the knee, bone on bone. And he had an aortic valve replacement a couple years ago. And obviously his cardiologist does not recommend him to get a knee replacement. Pain is extreme, uses a walker. And we’re trying to see what other kinds of options other than anything exercise, mobility wise, we can do for my trainer. So whatever I can do to help him. But I don’t know what your thoughts are on that and your thoughts, too, on I don’t think you deal with it, but prolong therapy.

Dr. Merrick Wetzler: [00:50:12] Well, I mean, so let’s just start out with what we can do for you. If I see a threat. He sounds like he’s not a surgical candidate. So he sees Dave. I’m sure the aquatic therapy keeping the knee is strongest possible, keeping any flexibility as possible. You know, decompressing. It makes sure the patellofemoral joint moves nicely are important things to reduce pain and discomfort. These aren’t a valves are probably as blood thinner. So we can’t take any inflammations.

Dave Anselmo: [00:50:45] Well, I’m actually not treating him now. I’m actually treating his wife, though, and she’s asked me the question. So I told her to call and ask you. I know he’s having these symptoms and I. Oh, yeah,

Dave Anselmo: [00:50:54] He should. I think I told her the same thing. I think the therapy was very helpful for him.

Dr. Merrick Wetzler: [00:51:00] Also just so just getting, you know, at his age, 94, God bless him, just getting out there and just moving a little bit, get it rather than sitting on a couch.

Dr. Merrick Wetzler: [00:51:12] Exactly. Benefits. So let’s talk. That’s item number one he could do right now. Number two, there are things we can do. There’s corticosteroid injection. There’s what we call PRP platelet rich plasma injections. And there’s also hyaluronic acid injections and so forth. And all these are tools that we have to use and treat someone like your father. What prolotherapy is, is good to treat tendonitis, a muscle injury and so forth. Were prolotherapy, does it actually just eat you do something, inject saline into an area to stimulate an inflammatory response with your dad? What are you trying to do? A lot of things reduce the inflammatory response, not increase the inflammatory response. So I’m not sure that’s a perfect thing for them. But again, you know, this is me as someone who I don’t use prolotherapy. I would speak to the physician you trust and you can bring up these concerns to him and let him answer your questions. I think that if he feels good results in his hands, I think it’s worth a chance because it’s really not. The risk is not great, where the benefit could be substantial. So as long as it’s low risk and has as a possible benefit, you know, anything to do to keep your dad moving and pain, pain, less pain is really important.

Dave Anselmo: [00:52:51] I totally agree. And as he knows, his parents live right behind here. So it’s very convenient. I think that I thought of Diane, the other day when I came in and evaluated her for her shoulder, she has a frozen shoulder. She’s doing well. I think that your father would definitely benefit from our recovery program. And one thing about that, once we get them moving, even at 94, I think we have something here called the transitional program with him being so immediate from being here. After we get to the point where he’s able to move and we get the information down, he can continue to do that on an education exercise program. You can come in on his own and we utilize the pool. So I think it’s very, very. Important he could do that.

Dr. Merrick Wetzler: [00:53:31] They’re thinking about aquatic therapy. That is so beneficial. Is it decompression or takes the stress of the joints and allows you to go through a functional range of motion with less pressure on those joints, allowing you to regain motion, regain flexibility and so forth, and then gradually transition to land where you can gradually get stronger and so forth? Yes.

Dave Anselmo: [00:53:54] Awesome. By the way, you hear me here at the location, so I’m going to show you the pool before you leave. You haven’t seen it?

Dr. Merrick Wetzler: [00:53:59] I haven’t. I’m sure.

Dave Anselmo: [00:54:01] Have you seen this before? So that’s really good. Hey, listen, thank you for calling. And it was a great question. Anything else you got to ask?

Jean: [00:54:09] No, that’s just something my mom said, that my father had many of his other treatments that were steroids and some of those. And I guess it didn’t take hold to a point. So I listen. But yeah, I’ll definitely listen.

Dave Anselmo: [00:54:20] I want to thank you. I want to thank you and away from personal training and helping a lot of these people out there, because a lot of people really need to exercise and they don’t know how to exercise properly. People like you really help in a reference of getting people a little more knowledge about exercise and getting itself moving again. So I want to thank you for doing what you do. And because I talk to people all the time that really don’t know what to do and they don’t know where to go. So thank you for being out there and helping people.

Jean: [00:54:46] No, I appreciate that. Thank you for the kind words. I love what I do, and thank you for what you guys are doing. And thank you for your time tonight. Thank you.

Dave Anselmo: [00:54:53] Thank you for calling in. Ok, here we go. Thank you very much for the call. We had a great time and we had a great show today. I really appreciate you once again coming on. It was a great, great, great show. Let’s turn this thing up here. Let’s get a conclusion here. I would like to thank all my callers for today’s show. I think Tommy T, our engineer for today’s show. Tommy, thank you very much for putting this together and helping us out. I really appreciate it without you taking the calls and buttons altogether. I appreciate it. And thank you, Dr. Wetzler, for coming on. Once again, my guest and first doctor and orthopedic ever was on my show. Thank you. It’s been great.

Dave Anselmo: [00:55:35] All right. Thank you. And Tony, nervous, thank you very much for again. God bless and God bless America. See you next show. We’re taking a holiday off. We’re not going to be here next week, so we’ll be here to finally show what you give me on September 12th, five p.m.. Thank you very much.