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Enhance comfort and productivity with our ergonomics guide! Discover essential items like ergonomic chairs, keyboards, wrist supports, standing desks, monitor risers, and more to improve posture and ease daily tasks at work and home. General Ergonomics Appointments Office & Home Office Heating Pad Purpose: Reduce strain and discomfort with injured area. Examples: Wrist Cushion Purpose: To enhance comfort, supports wrist to reduce the risk of strain or injury during computer use, and encourages a more ergonomic typing or mousing posture. Examples: Mouse Cushion , Keyboard Cushion Home and Kitchen Tools Cordless Electric Scissors Purpose: To help minimize hand and wrist strain while promoting comfortable and efficient cutting for users across various tasks and applications. Examples: Electric Scissors Electric Can Opener Purpose: To provide a more comfortable, accessible, and user-friendly alternative to manual can openers, reducing strain and making the task of opening cans easier and safer Examples: Kitchen Electric Can Opener Ergonomic Jar Opener Purpose: To help people with weak hands or mobility issues open jars easily and safely, without causing strain or discomfort. Examples: Jar Opener , Multi-function Can and Jar Opener, Electric Jar Opener

At Next Journey Orthopaedics, we provide essential guidance on cast care to ensure a smooth recovery. Learn how to keep your cast dry, manage discomfort, and recognize signs of complications. Explore our tips and resources for a safe and comfortable healing process, along with recommended products to support your recovery. Caring for Your Cast Made Simple and Safe Appointments Contact Us for Cast Issues Top of Page Essentials Daily Living with a Cast Cast Appearance and Maintenance Cast Complications Preparing for Cast Removal Castcare Contact Us Cast Items Follow our expert guidelines to protect your recovery and avoid complications Cast Care Guide The Essentials of Casting Care At Next Journey Orthopaedics, we understand that wearing a cast can be a new and sometimes challenging experience. Proper cast care is crucial to ensure a smooth recovery and avoid complications. Below, we’ve answered some of the most common questions patients have about cast care, providing you with the information you need to stay comfortable and safe. Keep Your Cast Dry How do I keep my cast dry while bathing or showering? It’s essential to keep your cast dry to prevent skin irritation or infection. Use a waterproof cast cover, available at most pharmacies, to protect your cast during showers or baths. Alternatively, you can wrap your cast in plastic bags and secure them with rubber bands. Avoid submerging your cast in water. W hat should I do if my cast gets wet? If your cast gets wet, contact our office immediately. A wet cast can lead to skin irritation or infection. We may need to replace your cast or provide additional care instructions. Managing Discomfort How can I relieve itching inside the cast? Itching is a common issue. Avoid inserting objects like hangers into the cast, as this can damage the skin or the cast. Instead, try gently tapping on the cast or using a hairdryer on a cool setting to blow air into it. How do I reduce swelling around the cast? Elevate the affected limb above heart level as much as possible, especially during the first few days. Applying ice to the area around the cast can also help, but be sure to keep the cast dry. Is it normal for my fingers or toes to feel numb or tingly? Numbness or tingling could indicate that your cast is too tight, if you elevate the limb and it does not resolve, please contact us to potentially come in to have the cast adjusted. Ensuring Cast Integrity What should I do if my cast feels too tight or too loose? A cast that’s too tight can restrict blood flow, while a loose cast won’t provide proper support. If you notice your cast no longer provides the support you need, please reach out to us for an evaluation. What should I do if the cast cracks or breaks? A damaged cast cannot provide the support you need. If your cast cracks or breaks, contact our office right away. We’ll assess the situation and replace the cast if necessary. Essentials Daily Living with a Cast Can I walk on my cast, and if so, when? Walking on your cast depends on the type of injury and the cast itself. If your cast is a weight-bearing type, we’ll let you know when it’s safe to start walking. Always follow our instructions closely to avoid injury. Can I drive or operate machinery while wearing a cast? Driving or operating machinery can be risky while wearing a cast, especially if it affects your mobility or reaction time. We recommend not driving while wearing a cast. What activities should I avoid while wearing a cast? Avoid activities that could damage your cast or put you at risk of injury, such as contact sports, lifting heavy objects, or exposing the cast to water. Focus on keeping the cast clean, dry, and intact. How can I prevent pressure sores or skin irritation under the cast? Keep the cast clean and dry, and avoid inserting objects to scratch your skin. If you notice any unusual discomfort or sores, contact us immediately for an assessment. Cast Appearance and Maintenance Can I walk on my cast, and if so, when? Walking on your cast depends on the type of injury and the cast itself. If your cast is a weight-bearing type, we’ll let you know when it’s safe to start walking. Always follow our instructions closely to avoid injury. Can I drive or operate machinery while wearing a cast? Driving or operating machinery can be risky while wearing a cast, especially if it affects your mobility or reaction time. We do not recommend attempting to drive. What activities should I avoid while wearing a cast? Avoid activities that could damage your cast or put you at risk of injury, such as contact sports, lifting heavy objects, or exposing the cast to water. Focus on keeping the cast clean, dry, and intact. How can I prevent pressure sores or skin irritation under the cast? Keep the cast clean and dry, and avoid inserting objects to scratch your skin. If you notice any unusual discomfort or sores, contact us immediately for an assessment. Monitoring for Complications What signs of infection or complications should I look for? Watch for increased pain, excessive swelling, foul odor, drainage from under the cast, or a fever. These could be signs of an infection. If you notice any of these symptoms, contact us immediately. When should I contact my doctor about my cast? You should reach out to us if you experience any of the following: Severe pain not relieved by elevation or pain medication. Numbness or tingling in the extremities. A wet or damaged cast. Signs of infection, such as redness, warmth, or unusual odors. Preparing for Cast Removal How is the cast removed, and will it hurt? Cast removal is a straightforward procedure done with a special cast saw that won’t harm your skin. While it may feel a bit uncomfortable due to vibrations, it shouldn’t hurt. Once removed, your skin may be dry or flaky, and your limb may feel stiff. We’ll guide you through the next steps in your recovery. Can I exercise or do physical therapy with the cast on? In some cases, we may recommend specific exercises to maintain strength and mobility. Always follow our instructions to avoid injury. Once the cast is removed, physical therapy may be recommended to restore full function. Trust Your Care to Next Journey Orthopaedics At Next Journey Orthopaedics, we’re committed to ensuring that you have the best possible experience during your recovery. Our team is always here to answer your questions and provide the support you need. If you have any concerns about your cast or your recovery, don’t hesitate to reach out to us. Contact Us Phone: 571-416-8244 Address: 8255 Greensboro Drive, Ste 150, McLean, VA 22102 Additional Items Cast Scratcher Relieve itching with our convenient Cast Scratcher. Perfect for reaching those hard-to-access spots under your cast without causing damage. Ideal for patients recovering from fractures or surgeries. Cast Socks Keep your cast clean and comfortable with our premium Cast Socks. Designed to fit snugly over any cast, they protect against dirt and add an extra layer of warmth. Available in various sizes and colors. Comfort Itching and Odor Spray Experience instant relief with our Comfort Itching and Odor Spray. Specially formulated to soothe itchiness and eliminate odors under casts and braces. A must-have for a more comfortable recovery. Cool Air Hairdryer Stay cool and comfortable with our Cool Air Hairdryer. Perfect for drying the inside of your cast and reducing itchiness. Safe to use on all types of casts and bandages. Crutch Cushions Enhance your crutch experience with our ergonomic Crutch Cushions. Providing superior comfort and support, these cushions help prevent soreness and fatigue. Easy to attach and washable. Knee Scooter Move around effortlessly with our durable Knee Scooter. An excellent alternative to crutches, it offers stability and ease of use during your recovery from foot or ankle injuries. Knee Walker Navigate your recovery with ease using our Knee Walker. Designed for patients with lower leg injuries, it provides a smooth ride and maximum comfort. Adjustable and foldable for convenience. Leg Elevation Pillows Promote faster healing with our Leg Elevation Pillows. Ideal for reducing swelling and improving circulation post-surgery or injury. Made from high-density foam for ultimate support. Long Arm Cast Covers Protect your long arm cast with our waterproof Long Arm Cast Covers. Perfect for showering and bathing, these covers ensure your cast stays dry and secure. Available in multiple sizes. Moleskin Prevent blisters and irritation with our high-quality Moleskin. Perfect for padding rough edges of casts or braces, ensuring maximum comfort during your recovery. Post-Op Shoes Ensure stability and comfort with our Post-Op Shoes. Designed for post-surgical recovery, these shoes provide support and protection for your feet. Adjustable and available in various sizes. Shoe Lift Balance your steps with our adjustable Shoe Lift. Ideal for compensating height differences caused by casts or orthopedic conditions, ensuring a more natural walking experience. Short Arm Cast Covers Keep your short arm cast dry and protected with our waterproof Short Arm Cast Covers. Perfect for showering and bathing, these covers are easy to use and come in multiple sizes. 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"Next Journey Orthopaedics: Expert Shoulder Care for AC Joint Sprain, Arthritis, Deltoid Strain, Dislocation, Biceps Tendonitis, Frozen Shoulder, Labral Tear, Impingement Syndrome, Shoulder Instability, Proximal Humerus Fracture, Rotator Cuff Tear, and more. Personalized treatments include non-operative care, physical therapy, and advanced surgical options to ensure optimal recovery. Book your appointment today to regain shoulder mobility and comfort. Contact us at 571-425-5390." Lower Extremities Hip osteoarthritis Degenerative wear-and-tear of the hip joint cartilage causing pain, stiffness and reduced range of motion, typically affecting older adults and those with risk factors like obesity or prior injury. Hip pain and stiffness with weight bearing; decreased internal rotation on exam; radiographic joint‘space narrowing. Lifestyle modification, weight loss, physical therapy, NSAIDs, heat/ice and assistive devices. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Greater trochanteric bursitis Inflammation of the bursa over the greater trochanter causing lateral hip, thigh and buttock pain, often worsened by lying on the affected side or climbing stairs. Tenderness over greater trochanter; pain when lying on the affected side; pain with hip abduction. Rest, activity modification, NSAIDs, use of cane or crutches, physical therapy and corticosteroid injections. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Acetabular labrum tear A tear of the hip's labrum causing hip pain, stiffness, clicking or popping and instability; often associated with femoroacetabular impingement or trauma. Clicking/catching with hip movement; positive FADIR or FABER impingement tests; decreased range of motion. NSAIDs, activity modification, physical therapy to strengthen hip muscles, corticosteroid injections. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Femoroacetabular impingement A condition where abnormal bone shape causes the hip bones to rub together, leading to pain, stiffness and limping; may progress to labral tears and cartilage damage. Pain with hip flexion and internal rotation; positive FADIR test; limited hip range of motion. Activity modification, NSAIDs, corticosteroid injections, physical therapy and hip‘strengthening exercises. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Hip flexor strain Tear or overstretching of the hip flexor muscles resulting in pain at the front of the hip, tightness, bruising and difficulty walking. Pain with active hip flexion and stretching; tenderness over hip flexor; muscle weakness or spasms. RICE (rest, ice, compression, elevation), NSAIDs, gentle stretching and progressive strengthening with physical therapy. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Avascular necrosis of the hip Bone death due to loss of blood supply to the femoral head, leading to hip pain, stiffness and eventual joint collapse; associated with trauma, steroid use and alcoholism. Progressive hip pain, limited range of motion, imaging showing femoral head collapse. Early stages: rest, walking aids, NSAIDs, physical therapy and treating underlying cause. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Knee osteoarthritis Degenerative loss of knee cartilage leading to pain, swelling, stiffness and instability; risk factors include age, obesity, prior injury and repetitive stress. Crepitus on movement; reduced range of motion; joint‘space narrowing on X-ray. Weight management, activity modification, physical therapy, NSAIDs, bracing and injections. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Anterior cruciate ligament tear A rupture of the anterior cruciate ligament often due to sports injury, causing a popping sound, swelling, pain and knee instability. Positive Lachman and pivot shift tests; rapid joint effusion; inability to continue activity. RICE, knee bracing, NSAIDs and physical therapy to restore range of motion; long-term bracing for non-athletes. ACL Brace Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Patellar tendinitis Inflammation of the patellar tendon from repetitive stress, causing pain below the kneecap, tenderness and stiffness. Tenderness at the inferior pole of the patella; pain with jumping or squatting; positive decline squat test. Rest, ice, elevation, NSAIDs, knee brace/strap and gradual strengthening of quadriceps and hamstrings. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Patellofemoral pain syndrome Anterior knee pain around the kneecap due to malalignment, overuse, weak muscles or tight hamstrings; symptoms include pain during activity, pain after prolonged sitting and grinding sensation. Pain with patellar compression or squatting; positive Clarke's test; maltracking of the patella. Rest from aggravating activity, strengthening of quadriceps and hip abductors, stretching of hamstrings and calves, use of orthotics or taping. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Medial and lateral collateral ligament sprain Sprain of the knee's medial or lateral collateral ligaments caused by a force pushing the knee sideways; symptoms include pain, swelling and instability; injuries are graded I-III. Pain along the inner or outer knee; laxity on valgus or varus stress tests; swelling and bruising. RICE, bracing to limit sideways stress, NSAIDs and physical therapy; grade I/II injuries heal without surgery. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Ankle sprain Injury to the ankle ligaments, usually on the lateral side, caused by twisting the foot; symptoms include pain, swelling, tenderness and difficulty walking. Swelling and bruising around the ankle; pain with inversion or eversion; positive anterior drawer test. Protection, rest, ice, compression, elevation (PRICE), NSAIDs and early mobilization with physical therapy. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Achilles tendinitis Overuse injury causing inflammation and degeneration of the Achilles tendon, resulting in heel and ankle pain, stiffness, swelling and weakness. Tenderness along the Achilles tendon; pain with dorsiflexion and plantarflexion; thickened tendon. Rest, ice, NSAIDs, calf stretching and eccentric strengthening exercises, supportive shoes or orthotics. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Medial tibial stress syndrome Inflammation of muscles and tissues along the shin bone from overuse, causing pain and tenderness along the inner lower leg with possible mild swelling. Pain along the tibia during running or jumping; tenderness to touch; history of increased activity. Rest, ice, NSAIDs, reducing training intensity, proper footwear, orthotics, calf stretching and gradual return to activity. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Posterior tibial tendonitis/dysfunction Inflammation and degeneration of the posterior tibial tendon that supports the foot arch; early symptoms include pain and swelling along the inside of the foot and ankle and later lead to a flattened arch. Pain on the inside of the foot/ankle; swelling; flattening of the arch; inability to perform single‑leg heel raise. Rest, immobilization with brace or cast, orthotics, NSAIDs, physical therapy and weight management. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Stress fracture Small cracks in the bones of the lower leg or foot caused by repetitive stress; symptoms include focal pain, tenderness and swelling that worsen with activity. Point tenderness over the bone; pain worsening with activity; imaging (MRI/bone scan) confirming fracture. Rest from weight‑bearing activities, protective footwear or boot, low‑impact cross‑training, adequate nutrition and physical therapy. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Plantar fasciitis Inflammation of the plantar fascia, causing heel pain often worst with the first steps in the morning; may take months to a year to heal due to limited blood supply. Heel pain with first steps in the morning or after sitting; tenderness at medial calcaneal tubercle; positive Windlass test. Rest, stretching of the plantar fascia and calf muscles, icing, supportive footwear and orthotics, night splints and gradual return to activity. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Plantar plate tear / metatarsalgia Tear or attenuation of the plantar plate at the ball of the foot causing metatarsalgia; symptoms include forefoot pain, swelling and the sensation of walking on a pebble; healing often takes several months. Pain at the second metatarsophalangeal joint; dorsal swelling; positive toe drawer test for instability. Taping or splinting the toe, stiff‑soled shoes, orthotics with metatarsal pads, rest, ice, NSAIDs and physical therapy. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Hallux limitus/rigidus Progressive stiffness and pain in the big toe joint due to osteoarthritis; symptoms include difficulty bending the toe, swelling and bone spurs; advanced cases are called hallux rigidus. Limited dorsiflexion of the big toe; palpable dorsal bone spurs; pain with dorsiflexion. Proper fitting shoes with wide toe box and rigid sole, rest, ice, orthotics, physical therapy, NSAIDs and corticosteroid injections. Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Meniscus tear A meniscus tear is a tear of the C-shaped cartilage between the femur and tibia. It causes knee pain, swelling, and a feeling that the knee locks or gives way, often after a twisting injury or degenerative wear. Meniscus tears are common in athletes and older adults. Knee pain with twisting or squatting; catching or locking sensation; tenderness along the joint line; positive McMurray test. Follow the RICE protocol (rest, ice for 15–20 min every few hours, compression with a bandage or knee sleeve, elevation); take NSAIDs for pain and swelling; use a knee brace or sleeve for support; work with a physical therapist to restore range of motion and strengthen the quadriceps and hamstrings; avoid impact activities and twisting motions; consider platelet-rich plasma injections or cortisone if symptoms persist. Adjustable knee brace Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Achilles tendon rupture An Achilles tendon rupture is a complete tear of the large tendon connecting the calf muscles to the heel bone. It often occurs during sudden, forceful movements, such as sprinting or jumping, and causes sudden pain and swelling at the back of the ankle. Many people hear a pop and feel like they were kicked in the leg and have difficulty pushing off or pointing the foot downward Sudden posterior ankle pain and swelling, audible pop, inability to plantarflex/push off or stand on tiptoe, positive Thompson test (no foot movement when calf is squeezed) Initial management follows the RICE protocol-rest, ice, compression and elevation-”followed by immobilization in a cast or walking boot with the foot pointed downward for 8-10 weeks. Physical therapy is essential and typically lasts 4-6 months, focusing on progressive weight-bearing, strengthening and range-of-motion exercises. Nonoperative care is reserved for less active individuals when the rupture is recognized early. CAM walking boot Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Peroneal tendinitis Peroneal tendinitis is inflammation of the peroneal tendons that run along the outer ankle and foot. It causes pain and swelling on the outside of the ankle, tenderness behind the fibula, and a warm, thickened tendon. The condition usually results from overuse or repetitive ankle motions and is common in runners, people with high arches, or those wearing unsupportive shoes. Lateral ankle pain and swelling; Tenderness behind the fibula aggravated by resisted eversion and dorsiflexion; Pain during sid-to-side ankle movements Rest and protect the ankle by avoiding activities that trigger pain. Use the RICE protocol-rest, ice applied for 20 minutes every 2 hours, compression with a wrap or brace, and elevation to reduce swelling. Non-steroidal anti-inflammatory drugs relieve pain. A walking boot or ankle brace may be used for immobilization followed by physical therapy to strengthen the peroneal and calf muscles and correct biomechanics. Supportive shoes, orthotics, and gradual return to activity are recommended. Ankle brace Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Hallux valgus A bunion is a bony bump that forms at the base of the big toe when the toe deviates toward the other toes. This deformity gradually widens the front of the foot and can cause pain, redness, swelling and calluses, especially when wearing tight shoes. Risk factors include inherited foot structure, weak tendons and ligaments, rheumatoid arthritis and wearing narrow, high-heeled shoes Visible bump at the base of the big toe; Big toe angled toward the second toe; Pain and swelling at the metatarsophalangeal joint exacerbated by narrow shoes; Limited motion of the big toe Wear flat, well fitting shoes with a wide toe box and avoid high heels. Use bunion pads, toe spacers or splints at night to reduce pressure and slow progression apply NSAID gels or take short courses of anti-inflammatory tablets for pain relief Custom orthotics or shoe inserts can redistribute pressure and walking barefoot on soft surfaces may improve comfort. Seek physical therapy for gait training. Bunion corrector or toe separator Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream Morton's neuroma Morton's neuroma is a thickening of the tissue around a digital nerve between the toes, most commonly between the third and fourth metatarsals. It causes burning or sharp pain in the ball of the foot that may radiate into the toes, often described as feeling like walking on a pebble. High-heeled or tight, narrow shoes and repetitive stress can aggravate the condition Persistent burning or sharp pain in the ball of the foot radiating to the toes; Sensation of a pebble or marble under the foot while walking; Numbness or tingling in the toes that worsens with weightbearing or tight footwear Change footwear to wide, low‑heeled shoes with cushioned soles and avoid high heels. Use custom orthoses or metatarsal pads to separate the metatarsals and reduce pressure on the nervehttps://orthoinfo.aaos.org/en/diseases--conditions/mortons-neuroma#:~:text=,the%20pressure%20on%20the%20neuroma. NSAIDs or other anti‑inflammatory medications can relieve painhttps://orthoinfo.aaos.org/en/diseases--conditions/mortons-neuroma#:~:text=Studies%20have%20shown%20that%20many,and%2For%20corticosteroid%20injections. Corticosteroid injections may reduce swelling and inflammation of the nervehttps://orthoinfo.aaos.org/en/diseases--conditions/mortons-neuroma#:~:text=,from%20sending%20out%20pain%20signals; nerve ablation or shockwave therapy can be considered. Activity modification and physical therapy to stretch and strengthen the foot can also help. Metatarsal pad Over‑Door Shoulder Pulley TheraBand Resistance Bands Ergonomic Side‑Sleeper Pillow Topical Analgesic Cream

Skip the ER! Next Journey Orthopaedics offers expert care for traumatic orthopedic emergencies with after-hours availability and transparent pricing. Reduce wait times and get the treatment you need, when you need it. Tại sao nên chọn Chỉnh hình Hành trình Tiếp theo? 01 cái. Tại Next Journey Orthopedics, chúng tôi cung cấp khả năng tiếp cận nhanh chóng với các nhà cung cấp cấp chuyên gia để giải quyết các trường hợp khẩn cấp chỉnh hình do chấn thương của bạn có thể được xử lý bên ngoài phòng cấp cứu. 02. Dịch vụ của chúng tôi giúp giảm thời gian chờ đợi của khoa cấp cứu và chăm sóc khẩn cấp đối với một số điều kiện nhất định. 03. Tính khả dụng ngoài giờ của chúng tôi đáp ứng bạn ở nơi bạn cần nhất ... ngoài giờ làm việc truyền thống. 04. Chúng tôi đặt giá trở lại tay bệnh nhân bằng cách đưa ra các gói giá toàn diện và được lựa chọn cẩn thận để tạo điều kiện thuận lợi cho quá trình thanh toán. Meet Dr. Scott For Patients Schedule an Appointment

Upper Extremities Appointments Shoulder Arthritis Arthritis in the shoulder joint can result from various causes, including osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. Symptoms typically include shoulder pain, stiffness, swelling, and reduced range of motion. Biceps Tendonitis Biceps tendonitis involves inflammation of the long head of the biceps tendon, which runs from the shoulder to the elbow. Symptoms include shoulder pain, particularly in the front of the shoulder, and may worsen with overhead activities or lifting. Frozen Shoulder (Adhesive Capsulitis) Frozen shoulder is characterized by stiffness and pain in the shoulder joint, often resulting from inflammation and tightening of the shoulder capsule. Symptoms typically progress slowly and may worsen over time, leading to significant limitations in shoulder mobility. Labral Tear The labrum is a ring of cartilage that surrounds the socket of the shoulder joint, providing stability and cushioning. Tears in the labrum can occur due to trauma, overuse, or repetitive shoulder movements. Symptoms may include shoulder pain, clicking or popping sensations, and feelings of instability. Instability of Shoulder This condition involves excessive movement or looseness of the shoulder joint, which can result in frequent dislocations or subluxations (partial dislocations). Symptoms may include a sensation of the shoulder "slipping out of place," pain, weakness, and decreased range of motion. Impingement Syndrome This condition occurs when the rotator cuff tendons become pinched or compressed between the bones in the shoulder. Symptoms often include shoulder pain, particularly with overhead movements, and may worsen with repetitive activities. Rotator Cuff Tear This is a common shoulder injury involving damage to the muscles and tendons that stabilize the shoulder joint. Symptoms include shoulder pain, weakness, limited range of motion, and difficulty with overhead activities. Tendonitis Tendonitis, or tendinitis, involves inflammation or irritation of a tendon, typically due to overuse or repetitive motion

Discover a range of lower extremity braces designed to support and stabilize injuries from the pelvis to the toes. Explore options including hip and knee braces, ankle supports, and specialized footwear for effective recovery from conditions like arthritis, tendonitis, sprains, and post-surgery needs. Whether you need a cam boot for fractures or a plantar fasciitis brace for foot pain, find the right solution to aid your healing and enhance mobility. Lower Extremity Braces Appointments Pelvis and Hip Neoprene Sleeve Purpose: To provide extra support and help ease pain. They're great for healing from hamstring injuries or protecting your muscles during activities. Use: Hamstring strain Example: Thigh Brace Hip Brace Purpose: To provide support, stability, and compression to the hip joint. Use: hip arthritis, hip dislocation, hip labral tear, hip bursitis, or hip tendonitis Example: Hip Brace Four Legged Cane Purpose: To provide support and stability when walking when there is a hip injury. Use: hip arthritis, hip dislocation, hip labral tear, hip bursitis, or hip tendonitis Example: Four Legged Cane, Four Legged Cane Tip SI Joint Belt Purpose: To provide stabilization and support to the sacroiliac joint, reducing pain and discomfort associated with SI joint dysfunction. Use: SI joint dysfunction, pelvic instability. Example: Serola Sacroiliac Belt Hip Flexor Brace Purpose: To provide support and stability to the hip flexor muscles, reducing strain and discomfort. Use: Hip flexor strain, hip flexor tendonitis. Example: Mueller Hip Flexor Brace Thigh and Knee Knee Hinge Brace Purpose: To provide support, stability, and protection to the knee joint, particularly after injury or surgery Use: Patellofemoral Syndrome, Arthritis, ALC injuries, MCL injuries, LCL injuries Example: Sparthos Knee Hinge Brace, Body Prox Knee Hinge Brace Knee Immobilizer Purpose: To restrict movement of the knee joint entirely or to a limited range to provide stability. Use: Patellar Dislocations, Meniscus Tears Example: Knee Immobilizer Knee T-Scope Brace Purpose: To provide postoperative support, stability, and controlled range of motion following knee surgery, particularly procedures involving ligament reconstruction or repair Use: Post-Operative Knee Surgery Example: Breg T-Scope Knee Brace J-Brace Purpose: To provide support and stability to the knee joint Use: Patellofemoral Syndrome Example: BraceAbility J-Brace Patella Strap Purpose: To alleviate pain and discomfort associated with patellar tendonitis or runner's knee by providing targeted compression to the patellar tendon. Use: Patellar tendonitis, runner's knee. Example: Cho-Pat Dual Action Patella Strap Knee Compression Sleeve Purpose: To support, stabilize, and provide pain relief for the knee joint Use: Arthritis, Iliotibial Band Syndrome, Patellar Tendonitis Example: Copper Knee Compression Sleeve IT Band Strap Purpose: To alleviate pain and friction along the iliotibial (IT) band, reducing symptoms of IT band syndrome. Use: IT band syndrome, runner's knee. Example: Mueller IT Band Strap Patellar Stabilizer Brace Purpose: To provide additional support and stability to the patella (kneecap), reducing patellar instability and improving knee function. Use: Patellar instability, chondromalacia patellae. Example: DonJoy Tru-Pull Lite Patella Stabilizing Knee Brace Leg and Ankle Short Cam Boot Purpose: To provide support and immobilization for foot and ankle injuries Use: Foot sprains, Ankle sprains, Foot fractures Example: United Short Cam Boot Tall Cam Boot Purpose: To offer support, stability, and immobilization for more severe foot and ankle injuries, typically extending higher up the leg Use: Ankle fracture, tibia fracture, post-op recovery Example: United Tall Cam Boot Ankle Lace Up Purpose: to provide support, stability, and compression to the ankle joint, helping to prevent or alleviate injuries such as sprains, strains, and instability Use: Ankle sprains, ankle instability Example: Sparthos Ankle Lace Up Fracture Boot Sock Purpose: To provide comfort, padding, and moisture-wicking properties while wearing a fracture boot Use: with short cam boot, tall cam boot, or ankle lace up Example: BraceAbility Cam Boot Sock Ankle Stirrup Brace Purpose: To provide rigid support and protection to the ankle joint, preventing excessive inversion or eversion movements. Use: Ankle sprains, ankle instability. Example: Aircast A60 Ankle Brace Ankle Support Socks Purpose: To provide compression and support to the ankle joint while also offering the benefits of a sock for comfort and moisture-wicking. Use: Ankle stability, prevention of ankle injuries. Example: McDavid Ankle Support Compression Socks Achilles Tendon Brace Purpose: To provide support and compression to the Achilles tendon, aiding in the treatment and prevention of Achilles tendonitis or Achilles tendon strains. Use: Achilles tendonitis, Achilles tendon strains. Example: Achilles Tendon Brace Foot and Toes Plantar Fasciitis Brace Purpose: reducing tension on the plantar fascia, the brace can alleviate pain, inflammation, and discomfort associated with plantar fasciitis Use: Plantar fascia Example: Plantar Fascitiis Brace Toe Gel Caps Purpose: to provide cushioning, protection, and support for toes Use: Corns, calluses, blisters, or ingrown toenails Example: Zentoes Toe Gel Cap Post-Op Shoe Purpose: Help to minimize movement of the foot or toes. Provides a cushioned and stable platform to reduce pressure on the affected area Use: post-operative surgery, foot fractures, soft tissue injuries Example: BraceAbility Post-Op Shoe Metatarsal Pads Purpose: To alleviate pressure and discomfort on the metatarsal heads, reducing pain associated with conditions such as metatarsalgia or Morton's neuroma. Use: Metatarsalgia, Morton's neuroma. Example: Dr. Frederick's Original Metatarsal Pads Bunion Splint Purpose: To alleviate pain and discomfort associated with bunions by gently realigning the big toe and reducing pressure on the affected area. Use: Bunion pain, bunion correction. Example: Bunion Corrector and Toe Straightener

Compassionate care for fracture complications starts here. At Next Journey Orthopaedics, we provide expert solutions for delayed unions, malunions, infections, and chronic pain. Let our skilled team guide your recovery with personalized treatments, advanced therapies, and unwavering support to help you heal and thrive. Complications and Management At Next Journey Orthopaedics, we understand that the road to recovery after a fracture can sometimes present unexpected challenges. Our compassionate team is here to support you every step of the way, providing expert care and guidance to help you overcome any obstacles and achieve the best possible outcome. Below, we explore some common complications that can arise during fracture healing and how they can be effectively managed with personalized treatment plans. Delayed Union and Nonunion Healing takes time, but sometimes fractures take longer than expected to mend. When a bone heals more slowly than anticipated, it’s referred to as a delayed union. In cases where the bone does not heal at all, despite medical intervention, it’s called a nonunion. These challenges can occur due to factors such as insufficient blood supply, infection, or underlying medical conditions like diabetes or osteoporosis. How We Help: Personalized treatment plans including bone stimulation therapy to encourage healing. Nutritional guidance to ensure your body has the essential nutrients for bone repair. Surgical options such as bone grafting or fixation techniques to provide additional stability and support. Our team will work closely with you to monitor progress and make adjustments to your care plan, ensuring you feel supported and informed throughout your recovery. Infections Although rare, infections can occur after a fracture, particularly if surgery was required. Symptoms such as redness, swelling, warmth, persistent pain, or drainage from the wound site can indicate an infection that needs prompt attention. How We Help: Comprehensive evaluation to identify the cause and severity of the infection. Antibiotic therapy tailored to your specific needs. In some cases, additional surgical intervention to clean the affected area and promote healing. We are committed to providing timely and effective treatment to prevent complications and help you get back on track safely and comfortably. Malunion A malunion occurs when a fractured bone heals in an incorrect position, which can affect the function and appearance of the affected limb. This can result in pain, limited mobility, or difficulty with daily activities. How We Help: Careful assessment of your symptoms and imaging studies to understand the extent of the malunion. Non-surgical options such as bracing or physical therapy to improve function. Surgical correction, when necessary, to realign the bone and restore proper function. We’ll work with you to develop a personalized approach, focusing on restoring your mobility and quality of life with compassionate, patient-centered care. Chronic Pain Management While most fractures heal successfully, some individuals experience ongoing discomfort long after the initial injury. Chronic pain can stem from nerve involvement, joint stiffness, or changes in muscle function. How We Help: A holistic approach that includes physical therapy to improve strength and flexibility. Pain management strategies such as medications, nerve blocks, or regenerative therapies. Lifestyle modifications, including ergonomic adjustments and low-impact exercises, to help you stay active without aggravating pain. We understand how frustrating persistent pain can be, and our goal is to provide you with effective solutions that empower you to live a fulfilling and active life. At Next Journey Orthopaedics, we are here to reassure, educate, and guide you through any complications that may arise. No matter the challenge, our team is dedicated to delivering compassionate care tailored to your unique needs. If you have any concerns about your recovery, don't hesitate to reach out—we're here to help.

If you've been injured at work, understanding your rights and the workers' compensation system is crucial. At Next Journey Orthopaedics, we guide you through the process, from starting a claim to obtaining medical treatment. Learn how to navigate your workers' compensation benefits and ensure you receive the support you need for recovery. Contact us for assistance today! Injured at Work? We're Here to Help You Recover Expert orthopaedic care and guidance through the workers' compensation process. Schedule Your Appointment Submit Paperwork Understanding Workers' Compensation What is Workers' Compensation? Workers' compensation is a system designed to provide financial assistance and medical benefits to employees who suffer work-related injuries or illnesses. It ensures prompt medical treatment and compensation for lost wages, facilitating a safe and efficient return to work. Your Rights and Responsibilities Report Promptly: Inform your employer about the injury as soon as possible, detailing how and when it occurred. File a Claim: Submit a Claim for Benefits Form with the Virginia Workers' Compensation Commission to initiate the process. Seek Authorized Medical Care: Ensure that the medical treatment is authorized and keep detailed records of all related documentation. Why Choose Next Journey Orthopaedics? Specialized Expertise: Our team is experienced in treating work-related injuries, providing personalized care plans tailored to each patient's needs. Streamlined Process: We assist with the necessary paperwork and guide you through the workers' compensation process, ensuring a hassle-free experience. Comprehensive Services: From diagnosis to rehabilitation, we offer a full spectrum of orthopaedic services under one roof. Navigating the Workers' Compensation Process Step 1: Report the Injury Notify your employer immediately, providing specific details about the incident. Step 2: File a Claim Complete and submit the Claim for Benefits Form to the Virginia Workers' Compensation Commission. Step 3: Seek Medical Treatment Obtain authorization for medical treatment from your employer's insurance provider and schedule an appointment with our specialists. Step 4: Follow Through Attend all medical appointments, follow prescribed treatments, and maintain open communication with your employer and healthcare provider. Required Information for Patient’s Visit: Insurance Information: Name of the insurance company managing the worker’s compensation case. Authorization Letter: A letter from the assigned adjuster authorizing medical treatment for Dr. Scott or Next Journey Orthopaedics, including: Claim Number Payer specific address (including P.O. Box) Employer name Employer address State of injury Date of injury Adjuster’s first and last name Adjuster’s email and phone number Injury location on the body Identification: A valid photo ID. Supporting Documents: Any additional documents that may be helpful to the provider. What to Expect During Your Visit Your Path to Recovery Initial Consultation: Assessment of your injury by our orthopaedic specialists. Diagnostic Testing: Utilization of on-site imaging services, such as X-rays, to accurately diagnose your condition. Treatment Plan: Development of a personalized treatment strategy, which may include physical therapy, medication, or surgical interventions if necessary. Follow-Up Care: Regular appointments to monitor your progress and adjust the treatment plan as needed. Our Commitment to Your Recovery Experienced Professionals: Our board-certified orthopaedic surgeons and medical staff are dedicated to providing the highest standard of care. Patient-Centered Approach: We prioritize your well-being, ensuring that all treatments are tailored to your specific needs and circumstances. Accessible Care: With flexible scheduling and a convenient location, we make it easy for you to receive the care you need when you need it. Important Workers' Compensation Resources At Next Journey Orthopaedics, we are committed to providing not only expert medical care but also guidance through the workers' compensation process. Below, you’ll find essential resources to help you navigate your claim, understand your rights, and take the necessary steps for a smooth recovery. Claim Form To receive workers’ compensation benefits, you must file an official claim with the Virginia Workers’ Compensation Commission. Use the link below to access the required form. Download the Claim for Benefits Form Injured Worker Guide This comprehensive guide provides step-by-step instructions on what to do after a work-related injury, including how to report the incident, seek medical care, and file a claim. Read the Injured Worker Guide Virginia Workers' Compensation Glossary Understanding legal and medical terms related to workers’ compensation can be overwhelming. This glossary explains common terms and definitions used in the process. View the Workers' Compensation Glossary Injured Worker FAQ Got questions? This FAQ section answers the most frequently asked questions about workers’ compensation benefits, medical treatment, and legal rights. Explore the Injured Worker FAQ Virginia Worker’s Compensation Contact Information: Email: questions@workcomp.virginia.gov Phone: (877) 664-2566 Address 333 East Franklin Street Virginia Workers’ Compensation Commission Richmond, VA 23219 By ensuring your patients have all the necessary information and documentation, you can help facilitate their treatment and the worker’s compensation claim process efficiently.

Total knee replacement treatment available. Walk-ins welcome at Next Journey Orthopaedics. Book now! Total Knee Arthroplasty - Get Back to Life! Welcome to your Knee Recovery Journey Understanding Knee Replacement Surgery Knee replacement surgery involves replacing damaged parts of the knee joint with artificial components to alleviate pain and restore function. This procedure is commonly recommended for individuals suffering from severe arthritis or significant knee injuries. Welcome to your recovery journey. We understand that undergoing knee replacement surgery is a significant step, and we're here to support you every step of the way. Our goal is to provide you with the information and resources you need to heal comfortably and confidently. Immediate Post-Surgery Expectations The First Few Weeks at Home As you transition home, it's important to follow your care plan diligently. Use assistive devices as recommended, and gradually increase your activity level. Attending all follow-up appointments ensures your recovery is on track After surgery, it's normal to experience some discomfort and swelling. Our medical team will work closely with you to manage pain effectively. You'll begin gentle movements soon after the procedure to promote healing and prevent stiffness. Physical Therapy and Rehabilitation Long-Term Recovery and Lifestyle Adjustments Recovery is a gradual process, and patience is key. Most patients return to their regular activities within a few months. Maintaining a healthy weight and staying active with low-impact exercises can prolong the benefits of your new knee. Engaging in physical therapy is crucial for regaining strength and mobility. Exercises such as supported knee bends and walking with assistance will be introduced to help you restore function. Your therapist will tailor a program to meet your specific needs. Protocols Phase 1: Immediate Post-operative Phase (Day 0 - Hospital Discharge) Goals: Control pain and swelling Protect healing tissue Begin restoring range of motion (ROM) Establish lower extremity muscle activation Restore independent functional mobility Precautions: Weight-bearing as tolerated (WBAT) with crutches or walker Monitor for signs of deep vein thrombosis (DVT) Recommended Exercises: Passive and active-assisted knee flexion and extension Heel slides Quad sets, glute sets, hamstring sets Straight leg raises (emphasizing no lag) Ankle pumps Functional Mobility: Bed mobility training Transfer training Gait training on level surfaces Stair training (if appropriate) Phase 2: Early Post-operative Phase (Hospital Discharge - 8 Weeks) Goals: Improve ROM (target: 0-110 degrees) Restore muscle strength, especially quadriceps Initiate proprioceptive training Normalize functional mobility Wean from assistive devices Precautions: Progress weight-bearing as tolerated Monitor wound healing and signs of infection Recommended Exercises: Continue Phase 1 exercises Heel slides with towel Prone knee flexion Stationary biking (starting with partial revolutions) Patellofemoral and tibiofemoral joint mobilizations Hamstring, gastrocnemius/soleus, and quadriceps stretching Closed chain exercises (mini-squats, step-ups) by end of phase Functional Mobility: Gait training emphasizing normal gait pattern Progress to cane, then no assistive device as appropriate Phase 3: Intermediate Phase (8-12 Weeks) Goals: Maximize knee ROM Restore normal lower extremity strength Return to baseline functional activities Precautions: Avoid high-impact activities Avoid activities requiring repeated pivoting/twisting Recommended Exercises: Continue previous exercises, increasing resistance Add resistance machines (leg press, hamstring curl, hip exercises) Single-leg stance and balance exercises Gentle agility exercises (tandem walk, side-stepping) Progress biking program, adding mild to moderate resistance Begin walking program Phase 4: Advanced Phase (12 Weeks and Beyond ) Goals: Continue improving strength and endurance Return to recreational activities as appropriate Precautions: Avoid high-impact and contact sports Avoid repetitive heavy lifting Recommended Exercises: Progress strengthening exercises Advance proprioceptive and balance training Increase intensity and duration of cardiovascular exercises Key Milestones: By 8 weeks: ROM should be 0-110 degrees By 12 weeks: Patients should be able to walk on uneven surfaces with minimal assistance Additional Recovery Tips: Apply ice after exercising to manage swelling. Follow your healthcare provider's advice before advancing activities. Individual progress may vary; always listen to your body. This protocol serves as a general guide, and individual progress may vary based on specific patient factors and surgical outcomes. Driving Left knee replacement: As early as 2-4 weeks if driving an automatic transmission and off narcotic pain medication Right knee replacement: Generally 6-8 weeks, depending on regaining reflexes and muscle strength Overall range: Most patients can resume driving between 2-8 weeks after surgery Light Sports (e.g., Golf) Hitting balls off a mat: Around 6 weeks post-surgery Full round of golf: Some patients may be able to play a full round, even without a cart, by the 3-6 months Exercising 0-4 weeks: Focus on gentle exercises to regain movement and prevent blood clots 4-12 weeks: Transition to moderate activities like walking and cycling 3-6 months: Begin low-impact activities such as swimming, cycling, and walking on flat surfaces 6-12 months: Start moderate-impact exercises like elliptical training, golfing, and light jogging 12+ months: High-impact activities are generally discouraged, but consult with your surgeon for personalized recommendations It's important to note that these timelines are general guidelines, and individual recovery can vary. Always consult with your healthcare provider before starting new activities or exercises after knee replacement surgery. Medications Celecoxib Aspirin 81 mg twice a day Steroids Neurontin Tylenol Frequently Asked Questions Contact Information Remember, you're not alone. If you have any questions or need additional support, please don't hesitate to contact our office at (571) 416-8244. We're here to assist you You might have questions about your recovery process. For instance, 'When can I drive again?' or 'How do I manage swelling?' Our FAQ section provides answers to these common concerns.

This quick guide for providers outlines essential steps for handling worker’s compensation injuries. Ensure your patients receive the right care by helping them start a claim and gather required information, including insurance details, authorization letters, and identification. For more support, contact us at 571-416-8244 or email questions about their care. Streamline the process for a successful recovery! Worker’s Compensation Injury: Quick Guide for Providers If the patient was injured at work, it's important to get the right care to help them to recover fully. Is Your Patient's Injury a Worker’s Compensation Injury? If your patient's injury is work-related, they may be eligible for worker’s compensation benefits. Here’s what you need to know: To Setup a Work-Related Injury Emergency Room Follow Up: Start a Claim: Instruct the patient to go our website g2n.info or www.nextjourneyortho.com as soon as possible and follow the instruction For Patients for Worker's Compensation. Also We highly recommend they fill out the Virginia Claim Form as soon as possible to avoid delays in being seen. Contact Us: Please text 571-425-5393 or email the patient's name, hospital that they were seen at, and the patient's best contact number. Required Information for Patient’s Visit: Insurance Information: Name of the insurance company managing the worker’s compensation case. Authorization Letter: A letter from the assigned adjuster authorizing medical treatment for Dr. Scott or Next Journey Orthopaedics, including: Claim Number Payer specific address (including P.O. Box) Employer name Employer address State of injury Date of injury Adjuster’s first and last name Adjuster’s email and phone number Injury location on the body Identification: A valid photo ID. Supporting Documents: Any additional documents that may be helpful to the provider. Required Information for Patient’s Visit: Claim Form Injured Guide Virginia Worker's Compensation Glossary Injured Worker FAQ Virginia Worker’s Compensation Contact Information: Email: questions@workcomp.virginia.gov Phone: (877) 664-2566 Mailing Address: Virginia Workers’ Compensation Commission 333 East Franklin Street Richmond, VA 23219 By ensuring your patients have all the necessary information and documentation, you can help facilitate their treatment and the worker’s compensation claim process efficiently.

Durable Medical Equipment (DME) Policy Our Commitment to Transparency & Quality Care At Next Journey Orthopaedics, we strive to provide our patients with high-quality Durable Medical Equipment (DME), including braces, supports, mobility aids, and post-surgical devices. To ensure a smooth process and clear understanding, we have outlined our DME policies regarding financial responsibility, insurance claims, and returns. No Refunds or Exchanges on Durable Medical Equipment Due to the nature of medical equipment and healthcare regulations, we do not offer refunds, returns, or exchanges on any DME items once they have been dispensed, fitted, or used. This policy ensures: Patient Safety & Hygiene – Once issued, DME cannot be resold or re-used due to health standards. Manufacturer Guidelines – All DME is new and dispensed directly to each patient. Proper Functionality & Fit – Our trained team ensures each item is fitted correctly before it is dispensed. Please ensure you discuss fit, function, and comfort with our staff before taking possession of your equipment. Patient Financial Responsibility – Deductibles & Co-Insurance If your DME is billed through insurance, you are financially responsible for any deductible, co-pay, or co-insurance as determined by your insurance provider. Key Points to Understand: ✔ Coverage Varies by Insurance Plan – DME benefits depend on your specific insurance policy. ✔ Out-of-Pocket Costs May Apply – If your insurance does not cover the full cost of the equipment, you are responsible for the remaining balance. ✔ Verification & Payment Requirements – We will verify your benefits, but it is ultimately your responsibility to confirm your coverage. 🛍️ HealthMe DME Purchases – Not Submitted to Insurance For patients who prefer to purchase DME items directly at a fixed price without having to go through insurance, we offer an easy-to-use link through HealthMe: Important Notice: HealthMe purchases are direct-pay only. These purchases will NOT be billed to insurance. No reimbursement will be available through your insurance provider. This option is ideal for patients who prefer to purchase DME independently or do not wish to involve their insurance provider. HealthMe Questions? We’re Here to Help! We encourage all patients to discuss insurance coverage, out-of-pocket costs, and fitment concerns before purchasing DME. Next Journey Orthopaedics Call us at: 571-416-8244 Schedule an Appointment to Discuss Your DME Needs Schedule an Appointment HealthMe

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