EP 668: From the Nipples to the Knees and Beyond: Texas Orthopedics' Dr. Smoot on Common Problems of the Foot, Ankle, and Knee

In this segment, Dr. Mistry and Donna Lee are joined by Texas Orthopedics' Dr. Brannan Smoot. Dr. Smoot is an orthopedic surgeon specializing in treating the foot, ankle, and knee. Today, the docs discuss common foot and ankle injuries as well as the difference between podiatrists and orthopedic surgeons. As we age,  degenerative processes can cause/exacerbate painful orthopedic conditions like plantar fasciitis, arthritis, joint misalignment, and more. Fortunately, orthopedic surgeons have more options than ever for treating them. If you or someone you love has had pain from the nipples to the knees and beyond, please visit Texas Orthopedics online or call today! 

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1 0:00

<silence>

Speaker 2 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 3 0:15

Hello and welcome to the Armor Men's Health Show. This is Dr. Mystery , your host, board certified urologist, men's health specialist, and joined as always by my wonderful co-host Donnel Lee . That's

Speaker 4 0:26

Right. Welcome everybody. If you're lucky, we're gonna talk about my bunions today.

Speaker 3 0:29

Oh, boy. Mm-Hmm , <affirmative> . My , my voice is a little bit husky today. Yeah. A little bit sexy. Is it?

Speaker 4 0:35

Yeah. It's always a

Speaker 3 0:36

Little sexy. So I'm taking over your job, <laugh>.

Speaker 4 0:39

Why? Because I , because I can't walk because of my bunion.

Speaker 3 0:42

That's right. This is a men's health show. Uh, we love to deal with everything between the nipples and the knees. Mm . Which makes today even more special.

Speaker 4 0:49

I know.

Speaker 3 0:49

Because we're gonna go way beyond the knees, the way all the way

Speaker 4 0:52

Down to the ankles, <laugh> and the feets

Speaker 3 0:55

And the feets. We , uh, this show was brought to you by NAU Urology specialist. That is the group that I started in 2007, and now we are worldwide.

Speaker 4 1:03

Worldwide. Hey, speaking of seven. Yeah. It's my seven year anniversary.

Speaker 3 1:07

Well, congratulations, Donna. Mm-Hmm. <affirmative>. You forgot for finding someone that could spend that much time with you.

Speaker 4 1:13

You forgot though. I had to tell you. It was my anniversary.

Speaker 3 1:15

Listen, I have six children. I'm hurt. I gotta remember six birthdays and luckily my wife's birthday and mine are the same, so I remember that one. That's true. Like , that's a lot of dates.

Speaker 4 1:24

I'm still hurt.

Speaker 3 1:26

I'm a board certified urologist. Why don't you tell people how to become our patient and ask us questions?

Speaker 4 1:30

You can celebrate your anniversary with us by calling 5 1 2 2 3 8 0 7 6 2 or visit our website, armor men's health.com. Check out our podcast wherever you listen to free podcast. And we're located in Round Rock, north Austin, south Austin and Dripping Springs, Texas, where they love dripping.

Speaker 3 1:45

And you know what we love? We love guests.

Speaker 4 1:46

We love

Speaker 3 1:47

Guests. And today we are joined by Dr. Brandon Smoot from Texas Orthopedics. Mm-Hmm . <affirmative> . Welcome Brandon. Thanks for joining us. Thank you. So , uh, you are an orthopedic surgeon and , uh, for our listeners, I always like to talk about kind of what that training, you know, entails. Sure. So after medical school, you , uh, applied for and went to residency. Right. And how , how long was residency

Speaker 5 2:06

Residency's? Five years for orthopedic surgery.

Speaker 3 2:08

And you do an internship year, and then you do four years in orthopedic surgery , uh, where you go up the ladder and do increasingly more difficult cases. Correct. Uh , and where did you do yours?

Speaker 5 2:18

Uh , my residency was in Oklahoma City.

Speaker 3 2:20

Okay. And then afterwards you did some additional training. Right.

Speaker 5 2:23

I spent a year in Australia doing fellowship. That

Speaker 3 2:25

Sounds like you were just having fun. It was a great

Speaker 5 2:27

Year . Did

Speaker 4 2:27

You , did you start ending all your sentences with ours ? Like nar

Speaker 3 2:30

R what is it The Pirate Ship Australia?

Speaker 4 2:33

No, but when they talk it's that nar

Speaker 3 2:35

I don't think

Speaker 5 2:36

Rightt . Think so . Yeah. Not so much. No.

Speaker 3 2:37

What was your fellowship in?

Speaker 5 2:38

So I did six month foot and ankle fellowship. I did a six month knee fellowship , uh, with two , uh, relatively well-known guys there, not well known in this country, but , um, and I did , uh, stayed in Sydney, Australia. Um, and it was wonderful , uh, be beyond work. We got to, you know, go to the beach almost every day and swim. And I tried to surf and that

Speaker 3 2:58

Was , and get some shrimps on the, the barbie

Speaker 5 2:59

Shrimps On the Barbie. No, don't do that . <laugh> . I played, I played rugby , uh, at the time, and that was one of the reasons I decided to go, oh,

Speaker 3 3:05

Yeah. Yeah. That's nice. I played rugby in Chicago in a club league for one practice. I broke three fingers, and that was the end of my rugby career. Oh , ouch. But I think anything sponsored by that much of a beer company is probably not the thing that I should do. No . You know what

Speaker 4 3:18

I'm saying? Not when you're a surgeon. Yeah .

Speaker 3 3:20

So, so foot and ankle , uh, surgery, you know , uh, many of us would think of a podiatrist as someone that deals with the foot. Maybe you could go briefly into how the training is different and what is the difference between a podiatrist and an orthopedic foot and ankle specialist? Sure.

Speaker 5 3:34

So a podiatrist go to podiatry school. Uh, orthopedic foot ankle surgeons go to medical school . So we learn, I think more about , uh, the human body and how it works than probably podiatrists do. We also go to school for longer. So , uh, as you said, it was a five year residency, plus a one year fellowship. Most podiatrists do two or three years after their , uh, their, their podiatry school , uh, in training. And so I, I can replace a knee if I want to. I could even operate on your back if I wanted to. I don't, I don't wanna do that. Right . <laugh> . But , but , um, uh, so , uh, I , I think there's , uh, just a little more in depth training , uh, from, from my standpoint, I think there's lots of good podiatrists in town. Uh , and, and we also, you know, refer back and forth occasionally. So we work together just a little higher level of training

Speaker 3 4:18

Probably. So the , you know , the foot and ankle, it , you know, I , I've suffered from some foot and ankle issues and the how debilitating it can be to your general life to not be able to stand , uh, or to, or to walk without pain. We often have people on the show that deal with knee, and we've talked about shoulder stuff in the past. But when it comes specifically to, to foot and ankle issues, what are the most common things that you're gonna see in your practice?

Speaker 5 4:43

Sure. So ankle sprains , uh, are a very common injury, obviously. And I see a lot of folks who have ankle sprains that don't get better. I see a lot of folks with , uh, plantar fascitis. That's, that's heel pain. A typical , uh, symptom is pain when I first get outta bed right at the bottom of the heel , uh, usually gets a little better as you go along. Um , that's common. I see lots of folks with arthritis , uh, who've had either trauma or some malalignment issues over the years that have caused arthritis. Uh , I see lots of people with, you know, tendonitis from overuse, see occasional achilles tendon ruptures.

Speaker 3 5:14

So as people age, I imagine the types of issues that you're dealing with are different. Sure. So, you know, your , your athlete who's like 16 to 25 is gonna have more ankle sprain kind of things. Right? Sure. And then, and then , and then, and then talk about an age progression of like, kind of what, what people normally kind of complain about as they get older.

Speaker 5 5:33

Yeah. So , uh, and the young folks mostly , uh, athletes, they get , uh, acute injuries from sprains or strains. Middle aged athletes are more overuse kinds of things. And then older, older athletes are more degenerative processes.

Speaker 3 5:48

And so , uh, let's talk about specific types of activities and, and , and what kind of injuries could occur. So if you're a runner , uh, what kind of, what , what kind of common injuries are you gonna see if you don't, you know, trip and fall and , and twist your ankle?

Speaker 5 6:00

Sure. Uh, so there's , uh, lots of, lots of ways to overuse your body. Running is a , a classic one in Austin has a vibrant running community, as you're well aware. Uh, so Achilles tendonitis is a common one. Uh, you can get tendonitis of any of the tendons in your foot, but , and

Speaker 3 6:14

Is that gonna give you pain at the top of your heel?

Speaker 5 6:17

Uh, at the back of the heel? And, and maybe more proximal than that up , uh, just, just above where the Achilles insertion is on your, on your heel bone. Um, and that can , can be swollen, can be warm, can be read to the , to look at. And so it , but again, it , it kind of hurts when you first get outta bed. There's start pain. That's pretty common with Achilles tendonitis.

Speaker 3 6:35

So with that, you know, relatively common overuse kind of injury besides not using it. <laugh> Yeah. What are some other co common steps that people can take?

Speaker 5 6:43

Well, that's, that's actually the first thing you said is the big one. And it's the hardest one because people who run , uh, you know, more than 15 miles a week, don't want to be told like, you can't run for a while . Right? Mm-Hmm . <affirmative> . Uh , so , uh, actually getting people to stop running is the hardest part. Uh , 'cause they just, they , they, they , they can't do it. 'cause it's, that's, that's what drives them . But beyond , uh, beyond actual rest medication can be helpful. Uh, stress , uh, physical therapy is often very helpful for tendonitis kinds of problems. Uh , those, those are the main things, you

Speaker 4 7:11

Know, this is why I never get hurt because I'm not active .

Speaker 3 7:14

You because the couch is a very difficult place to get hurt

Speaker 4 7:16

From. That's right . Unless I'm falling down and reaching for the snacks, I'm not ever hurt. It's great. So that's my lesson to you all.

Speaker 3 7:22

You know, and I'm not gonna make it a big generalization, but I'm gonna make a small one. <laugh> . The one nice thing about an orthopedic foot and ankle specialist over a podiatrist Mm-Hmm. <affirmative> , is that the podiatrist would just come in and just hit me over the head all the time about not wearing any bare feet. And I'd have to wear shoes all the time.

Speaker 4 7:37

Oh yeah, that's true.

Speaker 3 7:38

What do you think about bare feet and, and Floris ?

Speaker 5 7:41

Well, so I think we were without shoes for much of our history. Right. <laugh>. I , I , we're , we're designed that way. Okay.

Speaker 4 7:50

Good

Speaker 5 7:50

Point. Um, so

Speaker 4 7:52

I ,

Speaker 5 7:52

I don't like it. Yeah. There was a , there's a book that

Speaker 3 7:54

Nike Air Neanderthal <laugh> , there ,

Speaker 5 7:55

There was a , there was a book that came out I had spent 20, 25 years ago that talked about barefoot running and the benefits of that. And gosh, it sure created a lot of business for me. 'cause we were used to wearing skews and then people went to without shoes and with less support, they got these overuse injuries. Um, and some people's feet are okay for , uh, barefoot running some people's feet just, you know, should not be tried to , uh, to run barefoot because they just ,

Speaker 3 8:19

I'm so glad I don't have to see those little finger shoes anymore. Hmm .

Speaker 4 8:23

Right. <laugh> . Thank God,

Speaker 5 8:26

I, I , I think , I don't, I don't have a problem with barefoot unless you have a certain problem. If you have a certain problem, then you have to treat it by maybe wearing , uh, a different shoe or a big more supportive shoe.

Speaker 3 8:35

Right. I think that that is , um, uh, it's so important that there's not, you know, one answer for, for everybody when it comes to , uh, to , to any of those things. So when it comes to plantar fasciitis for, in , in specifically, because I think a lot of , uh, us have suffered from it, can you , uh, mention some preventative strategies that people can go through if they've suffered from it and now healed? Or if they don't want, want it? Yeah .

Speaker 5 8:55

So I , I think stretching is the mainstay treatment for plantar fascitis. Uh ,

Speaker 3 8:58

What's your favorite stretch?

Speaker 5 8:59

So , uh, favorite stretch is sitting with your , uh, affected foot on your other knee and grabbing your big toe with the same hand as the foot that's irritated and pulling the big toe up. And that really does a , is a great stretch for the plantar fascia itself. Oh,

Speaker 3 9:15

Well that's a good one.

Speaker 5 9:16

So that's one. Uh , the other one is standing against the wall with the affected foot back. Uh , you want your heel on the ground, you want your knee straight, you wanna lean into the wall so that you're really stretching the calf muscle, in addition to stretching the plantar fascia

Speaker 3 9:27

Because really stretching that calf muscle that, you know, it mimics the stretch that you're looking for when it comes to plantar fasciitis.

Speaker 5 9:34

Sure. Most people who have plantar fasciitis have some degree of calf tightness as well. So stretching the calf muscle is important.

Speaker 4 9:40

You can tell he's a good educator. 'cause he uses his hands when he talks.

Speaker 3 9:43

Yes. That's good. About his feet. Probably better <laugh> use his hands when he talks about his feet. So , uh, now we're gonna put you on the spot. Yeah . So many of the doctors that come on cannot tell us their phone number or website of their office, which I think is very funny. It's funny . Yes , I can do it. Got it . It's , I got it . He's been there for 20 years. He probably, he probably picked , he

Speaker 4 10:02

Probably knows , he

Speaker 3 10:03

Probably picked the phone number. Well ,

Speaker 5 10:04

Our business has been around for a long time, so we have an easy website, tx ortho.com.

Speaker 3 10:09

And, and , and if , if you want an appointment with Dr . Smoot, a foot and ankle specialist, how do what , what number do they call?

Speaker 5 10:15

5 1 2 4 3 9 1000 .

Speaker 3 10:17

Wow. Well, that's , uh, that's pretty impressive. That's ,

Speaker 4 10:19

That's easier than our number. Alright ,

Speaker 3 10:21

Well we're gonna come back and talk about knee pain here in just a couple of minutes. Donna, how do people get ahold of us? That's

Speaker 4 10:26

Right. You call us right away at (512) 238-0762 . And you can also reach out to us through our website, armor men's health.com, where we have a little button at the top right that says, submit your question. You can submit your questions for Dr. Brandon Smoot from Texas Orthopedics right there, and we'll get them answered for you. And don't forget, we're in Round Rock, north Austin, south Austin Dripping Springs, and listen to our podcast wherever you listen to free podcasts.

Speaker 3 10:48

Hello and welcome back to the Armor Men's Health Show. This is Dr. Mystery , your host joined as always by my co-host Donnelly .

Speaker 4 10:55

Hey everybody, welcome to the show.

Speaker 3 10:56

For those of you that are not , uh, regular listeners , uh, you may not know that this show is brought to you by NAU Urology specialist. That's the group that I started in 2007. Mm-Hmm. <affirmative> . We have six urologists. We have an interventional radiologist that does amazing work with prostate artery embolization. He's a , he's a dynamo.

Speaker 4 11:13

He's amazing. He's great. He's very fun. And he's been on the show several times. So Google, Dr. Preston Smith and our show name. We

Speaker 3 11:19

Have six advanced practice providers. We have two pelvic floor physical therapists. We have a health coach. We do sleep apnea, we do testosterone. We do everything we can to help you take care of your whole body and your whole self.

Speaker 4 11:31

That's right. We're the only holistic urology group that I've ever heard of in the entire universe.

Speaker 3 11:35

And they know about us in Hollywood. We actually had, you know, oh, that's right. Hollywood. Come here. We had h all the way because we're a holistic urology group

Speaker 4 11:43

And several people. What was the guy from Dubai?

Speaker 3 11:45

No, no , we can't . Oh yeah, we had , we can't say who came . No,

Speaker 4 11:47

I , I can't say the name. I work here as a HIPA

Speaker 3 11:49

Person, maybe Michael Jackson.

Speaker 4 11:50

Oh, well , but they , we did have somebody from another country. We did come get a VA vasectomy

Speaker 3 11:55

For vasectomy. That's right.

Speaker 4 11:56

That's not very holli . Well, it's sort of holistic.

Speaker 3 11:58

Yeah. Our , our our mystery luck vasectomy. No needle, no scalpel. IV sedation, vasectomy. Very popular.

Speaker 4 12:05

Mm-Hmm. <affirmative> Good times. I had one the other day. <laugh> .

Speaker 3 12:09

Well , we're joined to get by a wonderful guest, Dr. Brandon Smoot from Text Orthopedics. Thanks a lot for joining us again, Brandon . Good

Speaker 5 12:15

Morning. Thank you.

Speaker 3 12:16

So , uh, in the last segment we talked about some common conditions , uh, that affect the foot , uh, how we might prevent them and treat them. We talked about Achilles tendonitis and plantar fasciitis. What's different from a , you know, from my own, you know, feelings is that an orthopedic surgeon is going to be trained to go above the ankle and the foot and go to the knee. Where as , as someone who understands that the thigh bone is connected to the hip bone and the most important bone, the penis bone , uh, I know that everything is connected. So, so, so we know that erectile dysfunction and urinary issues can be affected by back issues and, and pelvic floor issues. So that connection for us is, is, has been well known . Talk to us about up things that can affect down things when it comes to orthopedics.

Speaker 5 12:59

Sure. Uh, so , uh, as, as you mentioned, the , the thigh bones connected to shin bone, et cetera , and, and if you've got any malalignment in your foot,

Speaker 3 13:06

Is that what you learn in five years of residency? That's right.

Speaker 5 13:09

<laugh>,

Speaker 4 13:10

<laugh> always are technical.

Speaker 5 13:13

Touche ,

Speaker 4 13:14

Your

Speaker 5 13:15

Wits , your , if, if there are , uh, mal alignment issues , uh, anywhere along the chain, it can affect other parts of the chain. Certainly if you've got an over pronated foot, you may have more knee pain because of that. And sometimes an orthotic in your shoe will correct the over formation and actually make your knee feel better. Um, true for , uh, back and hip as well. If you've got a very stiff hip, you may have back pain because , um, you're , uh, not able to move your hip properly and it's gonna make you move your back more when you walk. And that can create problems.

Speaker 3 13:44

So, you know, if somebody's complaining of knee pain, you know, when , when they get evaluated, I'm sure you look at how they're standing and their gait and if the foot is, is contributing. But if you're just a listener out there and you're wondering if, you know, going to the Good Feet store , uh, or in step Mm-Hmm .

Speaker 4 13:58

<affirmative> our friends at it stuff ,

Speaker 3 13:59

Which our friends, our friends at which they , they don't sponsor us, but , uh, they don't, they did take care of me with some Birkenstocks that really helped my That's right . My plantar fasciitis. They're lovely. So , um, if, if someone's out there and sees a commercial on say, knee pain and they're wondering if it's their foot and they need an orthotic, are there any kind of symptoms or a , a particular pattern or a particular type of person that's more likely to have, you know, knee pain caused by foot and ankle issues?

Speaker 5 14:24

Sure. If, if you get outta the shower and you , uh, step on a, with a wet foot , a a a paper towel and, and your footprint looks like a box, then you probably have an over pronated foot. Okay. Uh , and maybe, maybe an orthotic is a good idea. I love in step love caravel for those kinds of things. That's a , that's a reasonable test to look for. If you look down at your feet and your toes are not pointing at the wall, you're , they're pointing away from each other. Maybe that's another sign that you have over pronated feet.

Speaker 3 14:54

That's exactly the kind of stuff that's perfect. Like, you know, it it , it's great to be able to see that when you're looking down at your toe Yeah . And

Speaker 4 15:01

Then sinking. Oh , that's

Speaker 3 15:01

What I have. No , you have that bunion thing. Your , your , your , your

Speaker 4 15:04

Toe. Oh , that because my bunion goes

Speaker 3 15:05

That points up , up and then to the left. Yeah,

Speaker 4 15:08

It goes down over to the right.

Speaker 5 15:09

Well, so that, that may be an angular deformity through the toe joint, not through the hind foot per se.

Speaker 4 15:14

Oh, I see. Y'all are talking about other stuff. Yes . Yeah . It's not my bunion. I gotcha . <laugh> continue.

Speaker 3 15:19

So when it comes to just plain old knee pain Yeah. What are the most common causes of plain old knee pain? Mm .

Speaker 5 15:24

So depending on the age as we talk about in the first segment , uh, this could be arthritis, a degen , a degenerative process. You may have injured the knee, you might have torn meniscus , um, or even a ligament in your knee if you have had a specific injury going on. Some people get a, a , uh, a tendonitis, just like we talked about in the foot ankle. You can get a patella tendonitis. Uh, you can get a , a pez bursitis that's , uh, inflammation of the tendons that come just below the knee on the inside. And those are, those are probably the most common causes of knee pain.

Speaker 3 15:52

So, so I think most of our listeners and, and , and most even doctors that aren't orthopedic surgeons Yeah. We know that if it's really bad you can get a knee replacement. Sure. But I imagine there's a lot of steps before somebody gets their knee replaced. Sure.

Speaker 5 16:05

<laugh> . Yeah. <laugh> . So oftentimes there are , uh, mechanical issues , uh, that can resolve with , uh, either orthotics as we talked about, or physical therapy is often helpful if there's any imbalance in the muscles. Uh, strengthening the thigh muscles or the muscles that cross the knee is very helpful for most things. Uh , so physical therapy is often a starting point for, for knee pain.

Speaker 4 16:24

You have physical therapy on site . Sure . Yep .

Speaker 5 16:26

Okay . Therapy at all of our offices, there's seven of 'em across, across central Texas. Oh ,

Speaker 3 16:30

See, there you go. Now , now you commercial. Now , now she's doing it. Now's doing it commercial.

Speaker 5 16:33

Thanks Don . <laugh> . So,

Speaker 4 16:34

So,

Speaker 3 16:35

So like , uh, I find that some patients feel that physical therapy is not a legitimate hocus course of action. Like they , I , it happens to me all the time. Mm-Hmm . I'll get a 30-year-old guy who has classic pelvic floor related urinary urgency. Mm-Hmm. <affirmative> . And I'll say, you need to have physical therapy. And he'll look at me like, what ? Like what are you talking about on my knee? Like , you need to operate on me or give me a pill. Do you get some of that?

Speaker 5 17:00

I get that a lot. I get that a lot. Uh, I , I think

Speaker 3 17:03

Even in or orthopedic surgery where physical therapy seems like the most obvious thing for so many things.

Speaker 4 17:07

Right . We had a patient that yelled at us about that and said, I don't wanna learn about that yoga <laugh> . I was like, what? That's not it. That

Speaker 3 17:14

Yoga ,

Speaker 5 17:15

Uh , it , it is, it is time consuming and it's expensive. And, and as Americans, we want, we want it now. We , we don't wanna have to work for it. We want it , uh, yesterday. So , um, but I, I , I agree with you . Physical therapy is very valuable for many, many conditions that I treat. And , uh, sometimes you have to talk people, patients into it and

Speaker 4 17:33

It can sometimes prevent surgery for both of your type patient types. Sure. It's amazing.

Speaker 3 17:38

And so , um, you know, when it comes to , uh, arthroscopic surgery and, and total knee replacement, we have that now. If has , has anything really changed in the last like 15 years? Is anything different today than when I would've been, you know, like helping my orthopedic colleagues when I was training?

Speaker 5 17:55

Uh , great question. I , when I first came outta training, if you , uh, had an MRI that showed a meniscus tear, you were gonna get a surgery to take that meniscus out. And we've, we've come to learn that it doesn't work out that well for folks that have degenerative meniscal tears versus an acute meniscal tear. Uh, where, you know, most 20 year olds who tear the meniscus know exactly when it happened. Versus a 60-year-old who comes in with knee pain and

Speaker 3 18:16

Has an you find a meniscus. Yeah .

Speaker 5 18:18

Has , has an MRI that's already been ordered by the primary care doctor despite they're already having arthritis. Uh, and, and they come in with a meniscus tear and they expect surgery and, and , and we've figured out that that doesn't work very well. And so we counseling those folks. Look, we need to try some other things before we take your meniscus out because we Wait, wait,

Speaker 3 18:34

Wait, wait, wait. You're operating less,

Speaker 5 18:36

Operating less.

Speaker 3 18:36

That doesn't sound good at all.

Speaker 4 18:38

<laugh> not for

Speaker 3 18:40

That sounds like the opposite. <laugh> . No ,

Speaker 5 18:41

We're, we are a holistic practice. Oh

Speaker 3 18:44

My lord. Wow . I don't know about tech orthopedics taking over our used

Speaker 4 18:48

It against us <laugh> . That's funny. That's funny.

Speaker 3 18:51

How about , so, so, so a less interventional tone is , uh, for c for certain, for certain conditions.

Speaker 5 18:56

So injections are often helpful and there's , uh, corticosteroid injections. Uh , steroid shots is , as everybody knows about, there's , uh, viscous supplementation , uh, which is a put job

Speaker 3 19:05

For the knee. So you can , you can put a lube job in the knee. Now

Speaker 5 19:08

Lube job in the knee that's been around for 20 years. Okay.

Speaker 3 19:10

Yeah . Wow . And that's done with an ultrasound guidance in the office. You

Speaker 5 19:13

Know, some doctors use ultrasound, some doctors just , uh, a knee, the knee joint is a large structure. It's not hard to get a needle in the knee. I, I, I personally have never used ultrasound to inject knees because I don't think I, you need to , um, I , I think there are other joints that are harder to hit that require some help. Uh, but, but for the knee, I haven't made that . He's

Speaker 4 19:31

A pro practice. A

Speaker 3 19:32

He's a pro . So who's the patient that's gonna be the best candidate for a lube job?

Speaker 5 19:35

Yeah, so somebody with mild to moderate arthritis has 300 bucks

Speaker 3 19:38

And some roses.

Speaker 4 19:39

That sounds dirty. Go ahead. Sorry.

Speaker 5 19:42

Mild to moderate arthritis , uh, with, you know, some stiffness, maybe a little swelling. Um, and, and not really mechanical symptoms. Really sharp, catchy kind of pain doesn't respond as well to the lube job. I

Speaker 3 19:53

Gotcha . So if it's more like when they're just, even just , just, just, just Yeah . Regular walking. They're having some knee pain as opposed to the person that feels like it's catching when they're Sure . Walking upstairs or something like

Speaker 5 20:02

That . Yeah . Du throbby achy pains is , is arthritis. Uh , and , and the more you do, the more it hurts. Sounds like arthritis as well.

Speaker 3 20:08

Hmm . And if somebody gets one of these things, how long can they , uh, you know, expect to have some, some relief? Yeah.

Speaker 5 20:13

Typically lube dive , the viscus supplementation shots last about six. I

Speaker 3 20:17

Like lube job .

Speaker 5 20:17

Lube job better. Okay.

Speaker 4 20:18

<laugh>. Of course you do . Fair enough. Of course

Speaker 5 20:21

You do . It's interesting that this , uh, this technology came from veterinary medicine. They started this in racehorses. Uh , and it's actually made from , uh, the original lube job shot was made from Rooster comb. The , the stuff that jiggles down the chin of the, of the rooster.

Speaker 3 20:35

That was my nickname in , call it Rooster.

Speaker 4 20:37

Rooster Comb . Rooster Comb . Mystery <laugh> .

Speaker 3 20:40

Yeah. I I don't think they were complimenting me. No.

Speaker 4 20:42

<laugh> .

Speaker 3 20:44

If they want an appointment with you, Brandon, at Text Orthopedics, Dr. Brandon Smoot , uh, what's the website and what is your phone number?

Speaker 5 20:50

Sure. Uh, website , uh, www.txortho.com. Uh, cell , the , the phone number is five one two four three nine 1000 .

Speaker 3 20:59

And Donna, how do people get ahold of us Right . And , uh, ask us questions and become a patient of ours because we are open for business. That's

Speaker 4 21:05

Right. We're open for business and for that different kinda lube job, you call us at (512) 238-0762 our website, armor men's health.com. And you can submit your questions right there at submit a question. Top right . Don't forget, we're in Round Rock, north Austin, south Austin and Dripping Springs, Texas. And listen to our podcast. Wherever you catch podcast,

Speaker 2 21:23

The Armor Men's Health Show is brought to you by NAU Urology specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.