Dr. Paul Pace on Trigger Finger

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Have you ever woken up in the morning to find that one of your fingers or your thumb is locked?  Or have you noticed that the base of your finger has been very stiff and/or sore recently? 

If so, you may be suffering from a common condition known as a “trigger finger,” or stenosing tenosynovitis. It can affect any finger in the hand, and can range from mild pain to significant discomfort and “triggering” of the affected finger.

What is Trigger Finger? 
Trigger finger/thumb affects the pulleys and tendons in the hand that bend the fingers. “Triggering” occurs when the pulley at the base of finger/thumb becomes thickened and constricts the tendon, making it difficult for the tendon to move through its normal range of motion. Because of this inflammation through the pulley-tendon mechanism, the patient may feel pain, popping, or locking of the finger.

What Causes Trigger Finger?
Sometimes the causes of a trigger finger are not always clear. One may develop trigger finger after an acute injury to the hand such as a fall or trauma to the palm. Some diseases, such as diabetes or carpal tunnel syndrome, may increase the risk of developing trigger finger.  Most of the time the cause is unknown. 

How is Trigger Finger Treated?
The goal of treatment is to eliminate pain and locking of the finger/thumb by decreasing the swelling around the flexor tendon and tendon sheath. Mild trigger fingers may be managed by oral anti-inflammatories, stretching exercises, and splitting techniques. Moderate trigger fingers may require localized steroid injection to reduce inflammation. Persistent severe trigger fingers may require a minor surgical procedure to release the pulley mechanism to allow the tendon to glide through its full range of motion.  

In any situation, the sooner you come in for an evaluation of the finger/thumb, the better your clinical outcome will be.  Please contact our office if you feel you may have a trigger finger/thumb.

Dr. Paul D. Pace is a board certified surgeon with The San Antonio Orthopaedic Group.  He is fellowship trained in hand and microvascular surgery and treats conditions of the hand and wrist for patients of all ages.  His special interests include the prevention and treatment of carpal tunnel syndrome and trigger finger.  To schedule an appointment with Dr. Pace, please call 210.281.9595.




TSAOG Customer Survey Highlights – September 2013

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 When our patients have something nice to say about us, we like to brag about it!
Please enjoy some of the highlights from TSAOG’s September 2013 Customer Survey:

  • Dr. Brown is so personable and I never felt he was in a hurry to move on to the patient. He always makes you feel that you are his only patient.”
  • Dr. Burkhart is spectacular and provided me with incredible care”
  • “This is what a medical practice experience should be like”
  • Dr. Connor, wonderful doctor.”
  • “Helpful, pleasant staff and physician” (Dr. Drukker)
  • “Dr. Gonzalez was prior service and understood what I was going through with the VA.”
  • “The office is very spacious, relaxed and professional. I was taken care of in a very timely manner, even though I was running late. I was very satisfied with my first visit to this Dr. I felt very welcomed.” (Dr. Hibberd)
  • “No need for suggestion. Everyone always professional, and on the move !!”
  • “Always Great!” (Dr. Jacobs)
  • “Everyone is always professional, courteous, and friendly. Don’t change anything!!”
  • Dr. Bryan W. Kaiser always make me feel better. All my pain in my knees is gone when I leave his office.”
  • “The SAOG has the most qualified and experienced doctors and staff. I recommend them to my family and friends.”
  • “Wait time was unbelievably fast. I did not wait over two minutes before I was promptly escorted to see Dr. Pace
  • “I appreciated Dr. Rowland’s attention and care. Everyone on the staff was kind.”
  • Dr. Tolin has always given me wonderful care along with his staff. I believe Dr Tolin considers my treatment options carefully, listens to my concerns and presents me with the pros and cons of all treatment . I am pleased to call him my doctor, because of his compassion as well as his medical knowledge. A wonderful physician.”
  • “Professional and expert” (Dr. Viroslav)
  • “Friendly staff and they appear to enjoy their jobs which really shows.”
  • Brandon DelBosque answered everything i wanted to know and seemed to enjoy teaching about the injury.”
  • “As a person constantly involved in sports I am looking forward to recovering with your practice. I feel confident about getting back to rugby and crossfit.” (Dr. Ochoa)
  • “The physician was very attentive and not once did I feel he had to hurry to another patient. He was informative and very professional and courteous” (Dr. Taber)
  • Dr. Ursone is awesome!”
  • “Everyone is very professional, friendly and polite, making me feel confident that I have received the very best in care.”
  • “Cast care specialist- Anthony Rodriguez went above and beyond when it came to casting time. I was very nervous and in a lot of pain due to a broken wrist. It was my first time having a cast put on, but Mr. Rodriguez made me feel comfortable and at ease. I was impressed!! I really couldn’t believe how much a cast could stabilize pain. Wow. Thumbs up to Anthony!!!”
  • “Overall, I really like Dr. Bell and feel I’m fortunate to have had him repair my shoulder and biceps tendon.”
  • Dr. Brenman promptly diagnosed my long-time problem after x-rays and MRI, then gave me a spinal injection on the return visit, yesterday.Today, I got out of bed feeling better than I have in 4 months. My physical therapy starts next week.Thank you, Dr. Brenman.”
  • “There’s nothing I don’t like about SAOG.”
  • “Everyone I have come in contact with has been friendly and efficient. I am very impressed with my doctor. I spent several months under the care of another physician, who gave me no hope. Dr Marx has given me a solution so I am beginning to see some light at the end of the tunnel. After spending 25 yrs as an RN, I have never seen anyone more skilled in casting [than] Larry. I am so pleased with the care given to me!”
  • Physical therapy was done at the Babcock location by Jessica Ward . . . she was amazing!”
  • “The entire staff is great. Everyone is friendly and always laughing and joking with me. This puts me at ease if I’m nervous or in pain.”
  • “I had such a good experience I have already recommended the doctor (C. Woodbury) to a friend and she has booked an appointment. I really appreciated the time and patience of the entire staff and I was made to feel like a person not a number”
  • “Trust me, I’ve had three surgeries and there is nothing I don’t like about TSAOG”
  • “I would like to thank the staff and Dr. Hennessy for taking me in after I showed up late to my appointment due to road closures. Everyone at san antonio orthopedic group was professional and nice, definitely will recommend to others!”
  • CT staff were great- explained procedure at my level and careful while positioning in scanner.”
  • “Dr Bergfeld was courteous, spoke concisely and examined in gentle manner.”
  • “I have had Dr. Balldin for 2 surgeries and he does an incredible job. Top notch!” 
  • Dr. Seidel’s staff were very considerate and professional.”
  • “My visit should be the benchmark of medical care.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.

TSAOG Customer Survey Highlights – August 2013

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When our patients have something nice to say about us, we like to brag about it!
Please enjoy some of the highlights from TSAOG’s August 2013 Customer Survey:

  • Dr. Balldin is so kind and skillful. I really appreciate how he explains my options and works to help me make the best informed decisions for my injury.”
  • “When I scheduled my original appointment in July, the scheduler was very helpful in getting me an appointment the next day with a doctor who specialized in my problem.”
  • “The PT staff are so very caring and competent. I appreciate how they work with me to make the best progress for my comfort and long term positive outcome.”
  • “I have been to four doctors in your group and all have been excellent. My wife and mother in law have been to see your group also.”
  • Dr. Seidel is awesome! Ditto for Tanyell”
  • “Attentive physician and staff” (Dr. Marx)
  • “Professional staff and doctors” (Dr. Hennessy)
  • “Most services are conveniently located at the same site.”
  • “I really liked Dr. Bergfeld she was thorough and allowed me to have a voice in the prescribed treatment for my pain.”
  • “This is the BEST group of Professional and caring people! Thank you All so much!”
  • “You cannot fix anything that is already Perfect, and a Dr office that has all the best employees. It simply cannot get any better, perfect Doctor, perfect employees!! And I have referred several of my colleagues to your group!” (Dr. Viroslav)
  • “very good service” (Dr. Ochoa)
  • “Keep on doing what you do, I’ve been to so many doctors, can’t count them, and by far your system is the best.”
  • “I have all the respect in the world for your doctors.”
  • “I thank Dr Taber and his staff. This man saved my life, my job, and my sanity.”
  • Dr. Connor and his staff are superior!”
  • “Always a pleasant experience and Dr Drukker is just wonderful!”
  • “From start to finish I was pleased with everyone.”
  • “As a personal injury attorney, I have referred my clients here & as a patient myself now, will continue to do so. Very impressed with my doctor, staff & location.”
  • “Both Dr Galindo & his RN were very friendly, professional and took time with you”
  • “In my opinion, there is a strong team concept in place at the San Antonio Orthopaedic Group which [works] from the top down. I view everyone as committed health professionals. I have complete confidence in Dr. Alan Hibberd and his staff.”
  • “Scheduling went very smoothly.”
  • “This is a great medical practice. One of the best I’ve seen. I truly thank and appreciate the doctors and staff for their care of my father.”
  • “The level of attention from staff and doctor is exemplary.” (Dr. Bell)
  • “Compassionate, efficient, friendly. I especially like this patient portal where I can get my reports as quickly as possible, am able to understand the process, and feel like I Have an integral part in reaching my recovery objectives.”
  • Dr. Brenman is super. I know he sees a lot of patients in a day, but he always takes a little time to know the person, which means a lot to most people. We are people, not just patients with issues to fix.”
  • “My doctor took the time to explain everything to me. He answered all my questions.” (Dr. Valdez)
  • Dr Woodbury has been very informative, helping me to understand treatment options”
  • “Dr Gonzalez was thorough, took time with and was patient to listen to questions”
  • “Doctors and staff are very professional, capable, courteous, and friendly. Office is convenient to where I live.”
  • “I have the highest confidence in Dr. Tolin. I am extremely pleased with his expertise and staff….Linda is awesome”
  • “Therapy staff was EXCELLENT! Hard to believe that physical therapy could be made FUN! But they did it!”
  • Dr. Ursone provided excellent preoperative and postoperative care. My shoulder surgery provided full range of motion and I am pain free.”
  • “Friendly, courteous and knowledgeable provider.” (Dr. Pace)
  • Dr. Burkhart and the STAFF, very knowledgeable and caring”
  • Dr Kaiser is a rare Dr. He has the surgical skills, the bedside manner & is always focused on just you when you are in his office.”
  • “I have had chronic acute RA since 1979 & as a result have been in many Dr offices/groups all across the country. Y’all by far have the smoothest running organization I’ve ever encountered!”
  • “Keep focusing on good medical care. That is what is most important to me. I have utmost confidence in Dr. Brown’s medical knowledge. My feet are soooo important because I am an active person. I trust my feet to Dr. Brown because of his knowledge and experience.”
  • “I am very satisfied [with] the competent and professional care provided by Dr. Garcia and his staff. Dr. Garcia certainly should be named in the Best Orthopedic Physicians of San Antonio.”
  • Dr. Jacobs takes care of my sports injuries and gets me back on the field (in some capacity) as quickly as possible. I like his aggressive approach at therapy and treatment options.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.


TSAOG Wins 2012/2013 APEX Quality Award

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 We are pleased to announce that TSAOG has been selected by Voyance for the third consecutive year to receive an APEX Quality Award for outstanding physician practice!  

According to Voyance’s website:

APEX Quality Award – the Gold Standard in Service. 
Voyance’s annual APEX Quality Award has been adopted as one of the more prestigious awards in the healthcare industry. Simply put, APEX Quality Award winners are determined solely by feedback given by their patients. 

This national distinction recognizes outstanding healthcare organizations that demonstrated the highest level of excellence in patient satisfaction and overall care over a 12-month period. Key Performance Indicators tied closely to Clinical, Operational, and Interpersonal Measures are paramount drivers in the overall evaluation process. Each year Voyance evaluates and revises award criteria making the honor more challenging to receive. Experiential measures tied most closely to actual care are emphasized and weighted appropriately. 

TSAOG is so happy to have earned this prestigious award for the third year in a row!

Striving for excellence in patient service and satisfaction is one more way TSAOG makes your health our mission.

TSAOG Welcomes Dr. Paul Pace Back to Full Time Practice

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As you may or may not be aware, approximately one year ago Dr. Paul D. Pace took on a part-time teaching position in the Department of Orthopaedics at his alma mater, Tulane University School of Medicine in New Orleans, LA.  He has spent the past year splitting his time between San Antonio and New Orleans.  

According to Dr. Pace, “Teaching hand surgery was a great experience that allowed me the chance to work with some truly exceptional medical students and orthopedic residents.   I am so grateful to have had that opportunity.  While I enjoyed my teaching experience at Tulane, I have recently completed my commitment there and I am glad to say that I have returned to The San Antonio Orthopaedic Group on a full time basis.  It’s good to be home.

Dr. Pace has resumed his full time schedule at TSAOG, where he treats patients Monday-Friday at our Orthopaedic Institute location.  Welcome back, Dr. Pace!

Encouraging our physicians to educate and train future generations is one more way TSAOG makes your health our mission.


Dr. Paul D. Pace is a board certified surgeon with additional fellowship training in hand and microvascular surgery.  He treats patients of all ages for conditions of the hand and wrist and has a special interest in the prevention and repair of carpal tunnel syndrome.  To schedule an appointment with Dr. Pace, please call 210.281.9595.


TSAOG Customer Survey Highlights – July 2013

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When our patients have something nice to say about us, we like to brag about it!
Please enjoy some of the highlights from TSAOG’s July 2013 Customer Survey:

  • Dr Jacobs and all his staff are great including the front office staff!”
  • “For my surgery I used North Central Baptist and that turned out to be a most pleasant experience. What a marvelous hospital!!!”
  • Dr. Seidel was great; I am confident he will do everything he can to help me.”
  • Dr. Frank Garcia is a very meticulous physician and answered all my questions. Furthermore in answering my question he showed me the MRI.”
  • “This is an outstanding group of physicians and staff. Thank you for participating in my recovery.”
  • Dr. Marx has taken excellent care of me. He is one of the kindest doctors I have ever met.”
  • “You have the best office in town! It is run very well, the staff and doctors are wonderful.”
  • Dr. Rowland was very informative and made me feel relaxed and confident in the procedure to be performed.”
  • “Everyone was personable. I went to Spurs Lane when I first had knee issues and felt like I was just passed around and lost in a sea of clients. I was rushed through the whole process and was just shipped off to have an MRI done without really speaking with anyone. That’s not at all how I felt when I was at your practice today. Even from the initial call I felt better about the experience. The lady walked me through the process, asked which doctor I would like and explained the online form process. I was welcomed when I arrived and the gentleman that took us back to the room was kind. Dr. Kaiser walked me through everything and I had a clear understanding of what I need to do to get better.”
  • “The PT team is outstanding”
  • Dr. Ursone really listens and I never feel rushed.”
  • “Dr. Bergfeld was very personable and explained my procedure (and results) thoroughly. She’s the bomb.”
  • “Dr. Hennessy is a wonderful doctor and he suggested I go to physical therapy prior to surgery on my neck. That solved the pinched nerve problem without surgery.”
  • Dr. Balldin knows his stuff. Very impressive.”
  • Dr. Drukker was excellent!  Happy that I made appointment. Hopefully wrist problems will be resolved!”
  • Dr. Tolin & his staff are consistently excellent. Linda is a wonderful nurse!”
  • “I loved the comfortable atmosphere and the fact that everyone always had a smile on their face. It was comforting to know that they are happy with where they work thus making the patient feel comfortable”
  • “The most courteous staff at a medical facility that I have encountered in a long time as well as proficient in what they do. Especially Kathy Yates who helped me coordinate my surgery and my return visits.”
  • “My Dr. took care of me in a very professional manner as always. He explains all my results and concerns in the manner I always clearly understand. He went beyond my expectations on this visit. I thank him!” (Dr. Viroslav)
  • “Scheduling staff was amazing. My insurance was being difficult and your staff still fit me into a full schedule to address my fracture to relieve my pain”
  • Dr. Brown is very caring & understanding.”
  • “I saw NP Allison Rice. She was amazing”
  • “My husband had surgery and we were both very impressed with your practice. Everything was very efficient and ran so smoothly. The surgery itself has been better than we ever thought possible. I guess what we like most about your practice is the quality of your physicians.” (Dr. Woodbury)
  • “I would highly recommend Dr. Taber and Derek Harper to anyone that has had hip injuries or hip disease.”
  • “Today is my last physical therapy session, and I have finally taken time to provide feedback. Dr. Connor is great; makes feel I am not just another patient; a very focused man with a sense of humor, and obviously knows what he is doing; I have complete confidence in him. Chris, who runs the physical therapy group, is a great manager and it looks like his crew is happy with their work. Special note on Cindy, who runs the intake desk: she is extra good and I really connected with her. She deserves the highest recognition. Also, Andrea who also runs an intake desk, is really good and has always been really good to me. Michele, who assists me in the physical therapy regime should be recognized for being very high energy and is perhaps the most attentive person in the group. She is tireless in keep everything geared up by paying constant attention. Really great person. My thanks to John, who has filled in as my therapist on occasion, and I felt I was in the hands of someone who was very advanced in both the theory and application of the therapy. Thank you John. Last but not least, Monica has been my regular therapist for more than a year. I am extremely grateful to her for her dedication and inspiration. I hope SA Ortho will recognize they have this prized person with great healing powers. This is my only feedback, so rather than providing comments on every session, this commentary should be multiplied by more than 60 times representing all of my visits. Thank you all for making a significant improvement in my life. Be encouraged and inspired because you are making the world a better place, not just for me, but many, many others.”
  • Dr Burkhart is AWESOME”
  • “Dr. Gonzalez is very patient and answered questions completely for me.”
  • “Great doctors; good treatment staff” (Dr. Pace)
  • “Always great service from Dr Brenman
  • “Excellent doctors and service” (Dr. Hibberd)
  • “I got an appointment right away! I was in so much pain, I could barely walk. So It was great to be able to get an appointment so quickly!”
  • “The San Antonio Orthopaedic Group is extremely efficient and courteous. Along with N.C. Baptist Hospital caused the procedure to run smoothly from the start of the initial paperwork and consultation to release from out-patient surgery.”
  • “I love Dr Galindo! So kind, smart…and puts up with me! But I will NEVER wear SAS shoes!!”
  • “Convenient, helpful staff, really like Dr. Ochoa.”
  • “I have always been impressed with the level of professionalism, courtesy and respect I have always received here. The staff is genuine in their concern and really care about what they do.”
  • “I can never thank Dr. Bell, April, and Dr.Bell’s staff enough. I can’t ever say enough great things about Ken, Christina, Dina, Mark and Megan. They have been genuine in their care and concern for my welfare and rehabilitation. I am in their debt.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.


TSAOG Customer Survey Highlights – June 2013

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When our patients have something nice to say about us, we like to brag about it!
Please enjoy some of the highlights from TSAOG’s June 2013 Customer Survey:

  • Dr. B. Kaiser is great. I have complete confidence in him and TSAOG.”
  • Dr. Rowland is a wonderful hand doctor, after surgery on both hands I wouldn’t consider going anywhere else.”
  • “Very pleasant staff both in the office and at the front desk. It’s nice to have people actually look at you and make small talk.”
  • “Very pleased with the care and attention I get from Dr. Galindo
  • “Your staff is very professional and understand my time is valuable.”
  • “I have been impressed with all the treatment I have received from the San Antonio Orthopedic Group. I have had physical therapy for my knees and my low back. I would highly recommend the San Antonio Orthopedic Group to family and friends.”
  • “Excellent attention and treatment by Dr. Bergfeld and her staff.”
  • “Just a big thank you for your care and especially for Christine’s courtesy and help.” (Dr. Gonzalez)
  • “Staff and doctor is very knowledgeable and well spoken. Also very thorough in his care” (Dr. Hennessy)
  • Dr. Connor was awesome… Very caring and knowledgeable .. Very informative I liked him very much!!”
  • “The practice as a whole is great. Everyone on the Dr and Therapy sides are professional and caring toward the patients.”
  • Dr Marx is a great doctor. Very patient and caring. Takes the time to make sure I understand everything”
  • “Customer service is AWESOME”
  • Dr. Christian Woodbury’s bedside manners were very professional but at the same time very caring.”
  • “Scheduling the appointments have been a breeze. Also appointment times have been very accurate and on time. no waits etc. I Thank you so much for this.”
  • “This was the best doctor visit i have ever had. I made the comment to the staff that they should give a clinic on how to run a doctors office.”
  • “I really like Dr Tolin. I always see the caution and concern in his face. I feel he is a very compassionate doctor. Which lets me know he doesn’t rush into any decision to operate.”
  • Dr. Viroslav is an excellent Dr. and feel very confident in my care”
  • “All of the Schertz staff are exceptional along with Dr. Bell’s staff!!! Thank you for fixing me and getting me back on my feet.” (Dr. Bell)
  • “Don’t change anything, you have a very well run organization.”
  • Dr. Burkhart was the best!”
  • “I am very pleased with my physician, Dr. Ursone and recommend him to friends that are considering knee or hip surgery. His manner is so caring and understanding. He works with his patients and when possible tries to include their suggestions in the plan of care.”
  • “Every aspect of the San Antonio Othopaedic Group made me feel confident. Dr Drukker gave me the attention I needed, even outside of the patient care room when I had a extended question.”
  • “I have seen Dr. Ochoa for several years and am completely confident in him. He is caring and gentle and I trust him.”
  • “Everyone makes you feel like you are the only patient”
  • Dr. Taber and Derek are just wonderful. I was very nervous about knee replacement and they made sure I understood everything and they were very reassuring. Most clinics herd you in and out, but these guys make sure you are comfortable about the whole procedure before and after. Couldn’t ask for better care!!”
  • “Thank you Dr. Garcia for directing my recovery relying on all the help from your group (Doctor, PA and Therapist). I should know I have spent 7 months under medical care that did not have this coordination, physician care and medical group support.”
  • Dr. Pace and his staff are very qualified and always pleasant.”
  • Dr. Brown and his staff are wonderful. They are friendly and go above and beyond for patients.”
  • “After suffering from lower back pain for so long, Dr Brenman has been able to give me the relief that I have been seeking. I have a co-worker that has had surgery on her lower back and still suffers from severe pain. I have told her about the treatment that Dr Brenman has performed on me and have strongly encouraged her to go see Dr Brenman. He takes the time to talk to you as a person, not just another patient.”
  • “i know I can call and they will work me in in a timely manner and Dr. Jacobs has been a great doctor for me with all of my sports injuries.”
  • “Everything was done on time and the entire process completed very efficiently.” (Dr. Hibberd)
  • “The people are awesome! Everyone seems to really care about helping you feel better.”
  • “I was able to get an appointment the day that I called to schedule an appointment.”
  • “Very professional and efficient. Dr. Balldin spent ample time listening and answering questions.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our customer survey and you may see one of your comments online the next month!

Please note: Spelling and punctuation errors may have been corrected for readability.

TSAOG Congratulates Dr. Casey Taber and Dr. Christian Woodbury – Rising Stars in Texas

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Dr. Casey D. Taber and Dr. Christian A. Woodbury were recently featured in Texas Super Doctors® Rising StarsSM Edition2013, which appeared in the July 2013 issue of TexasMonthly magazine.

This list showcases standouts in the Texas medical community, as nominated by their peers, who have been in practice for 10 years or less.  To read more about how physicians are selected for the list, click Texas Super Doctors Rising Stars 2013 – How It’s Done.

We are so proud of Dr. Taber and Dr. Woodbury for making the list and for being 2 of only 3 orthopaedic specialists in San Antonio who did so!

Dr. Casey D. Taber is a board certified orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group.  He treats patients aged 14 years and up for any sports related injury, with a focus on shoulder, hip and knee.  To schedule an appointment with Dr. Taber, please call 210.281.9595.

Dr. Christian A. Woodbury is a board certified surgeon, fellowship trained in hand, upper extremity and microsurgery with The San Antonio Orthopaedic Group.  He treats patients of all ages for conditions for the hand, wrist, and elbow.  To schedule an appointment with Dr. Woodbury, please call 210.281.9595.


Dr. Alexander Rowland on the FAST Technique for Tennis Elbow

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Tennis elbow (lateral epicondylitis) is the most common elbow ailment for which patients seek medical attention.  It is more commonly seen in patients with repetitive overuse injuries but can also be seen after a single traumatic event.  Although tennis elbow was initially thought to be an inflammatory condition, it is now known to be a degenerative process with incomplete tendon healing.

Patients suffering from tennis elbow generally complain of pain on the lateral (or outer) aspect of the elbow. Symptoms are aggravated with gripping and lifting and alleviated with rest. The good news is that the majority of patients are symptom free at 1 year regardless of the type of treatment they receive. 

Nonsurgical management of tennis elbow generally involves a combination of rest, anti-inflammatory drugs, physical therapy, braces, and steroid injections. Comparative studies have shown no single nonsurgical treatment to be superior.  

Operative management has generally been reserved for patients whose symptoms have not improved with conservative treatment. The two most commonly performed surgeries involve tendon debridement (cleaning up and removing scar tissue) either with an open incision or arthroscopically. The advantage of arthroscopic treatment over open surgery is that patients are able to return to normal activities sooner and have no scars. The disadvantage of either of these surgical techniques is that they require general anesthetic and often have a lengthy recovery time which can take up to 6 months.

Another treatment option for tennis elbow is the FAST technique, a relatively new technique developed in collaboration with Dr. Bernard Morrey at the Mayo Clinic for the treatment of chronic tendon injuries. It involves percutaneous removal of abnormal tissue under local anesthetic and ultrasound guidance. The procedure is performed after ultrasound evaluation to localize the abnormal tendon.  A local anesthetic is then given to numb the skin and tissue. Through a small (3mm) incision a probe is placed to cut and remove abnormal tissue and help restore normal tendon function. A small dressing is placed over the incision to allow immediate motion without immobilization.

The entire treatment takes about 15 minutes. Patients are allowed early use of the arm for daily activities the following day, but should avoid heavy lifting for 6 to 8 weeks.  Complete recovery is expected in 8 to 12 weeks. I have decided to incorporate this treatment into my practice mainly because there is little down time, minimal pain, and the recovery time is half or less of standard operative techniques.  The goal is to get patients back to work and a more normal lifestyle in the quickest way possible.

UPDATE 4/2/2015: The FAST technique has been re-branded as Tenex Health TX.



Dr. Alexander S. Rowland is a board certified orthopaedic surgeon, fellowship trained in conditions of the hand, wrist, and upper extremity.  He treats patients aged 6 years and up for conditions of the hand, wrist, elbow, and shoulder, with a special interest in tennis elbow and tendon repair.  To schedule an appointment with Dr. Rowland, please call 210.281.9595.

Online Appointment Scheduling Now Available at TSAOG

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You asked for it and you got it!  You can now schedule yourselves with TSAOG physicians online!

Here’s how it works:

  • New patients to TSAOG can request an appointment with any of our physicians.  Go to the Patient Portal, select “Create an Account” and respond “No” when asked if you are currently a patient at our practice.  You will then be taken to a screen where you can select one of our providers and a clinic location (make sure that the location you select is one at which your provider holds clinic).  That provider’s available time slots at that office will populate and you can choose the one you want.  Then, simply enter your personal contact and insurance information and you will receive a confirmation of your appointment

  • Current patients have the option to request an appointment with their current TSAOG physician(s) through their account on our Patient Portal.  Simply log in to your account and select “Request an Appointment” on the home screen.  This will allow you to request an appointment with any TSAOG physician whom you have seen before.  Please note: if you wish to see a different TSAOG physician than you have seen before, you can message our Scheduling department to request this.

Simplifying the scheduling process is one more way TSAOG makes your health our mission.


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