Category: News

Mask Optional Policy

Mask Optional | TOC With the expiration of Governor Ivey’s “Stay Apart” Emergency Order, TOC is now moving to a “Mask Optional” policy at all locations.

Effective June 1, 2021:

  • Patients of Dr. Clark, Dr. Cosgrove, Dr. Licht, and Dr. Maddox will be required to wear a mask at their appointments. (Update 6/11/21: patients of Dr. Cosgrove and Dr. Maddox are no longer required to wear a mask.)
  • No-Lobby Waiting: Patients will continue have the option to wait in their vehicle after checking in for their appointment.
  • If you are not feeling well or have been exposed to someone with COVID-19, please call so that we can reschedule your care.

We look forward to providing you and your family with exceptional orthopaedic care.

Athlete of the Year – Gracie Lynn Butler

CONGRATULATIONS to Gracie Lynn Butler from Hazel Green High School.
She was named the TOC Sports/ Huntsville Hospital Sports Center 2020-2021 Athlete of the Year Scholarship Winner!

Gracie Lynn has been awarded a $1,000 scholarship to use for future schooling.
Please congratulate Gracie Lynn and all our Athlete of the Year candidates on an amazing school year!

Gracie Lynn Butler

Hazel Green High School

Volleyball / Tennis

4.35 GPA


– Volleyball — 1st Team All-State – 3x / Maxx Preps “Best Player in the State” / State Champion / Tennis – #1 Seed & Co. Champ

– AP Scholar / Girls State Candidate / National Honors Society / Trojan Ambassador / Student Council / Numerous Subject Awards

– Church Bible Study Leader / Special Olympics Volunteer / S.P.A.R.K.S. Member (Assist In youth schooling) / Church Volunteer

Updated Mask Policy


Effective 4.12.21:

With the statewide COVID restrictions being lifted by the Governor of Alabama, TOC will implement the following COVID guidelines at all TOC locations.

  • Beginning April 12th, we encourage our patients to wear masks; however, masks are not required. TOC will continue to provide a mask for any patient that requests one.  Please note:  patients of Dr. Clark, Dr. Maddox, Dr. Licht, and Dr. Cosgrove will be required to wear a mask until further notice.
  • All TOC staff are required to wear masks until further notice.
  • Our lobbies will be open, following the guideline of social distancing. TOC will continue to offer our No Lobby wait option. Once you check-in, you can wait in your car until time to see your provider.
  • If you are not feeling well or have been exposed to COVID, please call so that we can reschedule your care.

As always, TOC will continue to provide exceptional orthopaedic care to our current and future patients in the safest environment possible.

4 Tips for Distance Runners

4 Tips for Distance Runners

By Dr. Matthew DeOrio, Foot & Ankle Surgeon with TOC – The Orthopaedic Center

Over the last three years, I’ve learned a lot about running. Much of what I have learned has come through trial and error.

There are plenty of books about running; I probably should have read some of them before I started taking on longer distances.  There are some things that I have done well and other things where I completely missed the boat.

Here are some things to consider if you plan on spending any significant time running. In no particular order:

  1. Prepare your body for running, even before you start running. Consider spending weeks, even months working on core strength training, and remember to include simple running exercises. There are plenty of exercises for running that you can find on the Internet. Doing this will prepare your body for running rather than shocking your body when you first start running and putting yourself at risk for a potential injury.
  1. Don’t underestimate the importance of hydration. Your body can only absorb 300 mL to 800 mL of water per hour during exercise. Drinking small amounts of water more often should lead to more effective hydration. If you are exercising less than an hour, plain water is probably acceptable.  However, if you’re exercising for more than an hour, an electrolyte/carbohydrate-loaded drink will offer additional benefits.

With extreme exercise, not only will fluid be lost, but you will also lose electrolytes.  Early on, despite drinking plenty of fluid, I still had problems with muscular cramping/spasms. This was due to sodium loss, magnesium loss, and overconsumption of water without replenishing electrolytes. This is called exercise-induced hyponatremia.

With more intense exercise, the type of fluid used for hydration becomes more important. Your body will use glycogen stores during the first hour, but after that first hour, the glycogen stores become depleted. Your body will begin to rely more on fat for energy.  During extremes of exercise, consider replenishing your glycogen stores with 30 to 60 g of carbohydrates every hour. This will help prevent your body from “crashing” with a loss of energy.

  1. Selecting the proper shoewear, depending on your foot type, will also lead to more efficient and enjoyable running. There is a lot more to shoes rather than just style and color. Make sure you are fitted with an appropriate shoe based on your running style, foot type, and surface that you are running on, such as road or trail.

If you tend to wear the shoe asymmetrically, it is important to replace your shoes more frequently. This is particularly important for runners who put more pressure along their foot’s lateral (outside) border, who have a cavus foot/high arched foot. Once a shoe begins to wear on the outside of the sole, this will accentuate the pressures on the outside of the foot and lead to tendon issues over time.  The goal of proper shoewear is to provide the right balance for your foot. The three different foot types are feet that pronate, are neutral, or supinate.  Making sure you are fitted with an appropriate shoe type will help to minimize injuries.

  1. Finally, make sure you warm up before you begin running. The older we get, the more time that it takes to get warmed up. Stretching is particularly important after a run or after a warm-up. The warm-up improves the mind-body connection and can help to minimize the potential for injuries.

Some people are born to run and have biomechanics that require less fine-tuning. Unfortunately, this does not apply to everyone; however, we can all become better runners through practice and education. Becoming a better runner can have many different interpretations. Set a goal, such as distance, speed, or fitness. Joining a running group makes training more enjoyable and can exponentially increase your knowledge. Get out and run and have fun!

Dr. Matthew DeOrio

Dr. Deorio running in the Mt. Cheaha 50K Dr. DeOrio running in the Mt. Cheaha 50k

“Getting better! Working towards my goal of an Ironman!”

I completed my fifth ultramarathon on 2/27/21 – “The Race to the Top of Alabama” Mount Cheaha 50k, in Talladega National Forest.  8th place out of 212 finishers, in 5:46:34.

Dr. DeOrio running in the Race to the Cave Cathedral Cavern Half Marathon Dr. DeOrio running in the Race to the Cave Cathedral Cavern Half Marathon

Race to the Cave Cathedral Cavern Half Marathon, Woodville, AL on 3/21/21.  16th place out of 603 finishers, in 1:38:36.

Not only am I healthier, but it has altered my perspective on distance running and associated injuries. These experiences have allowed me to identify with this subgroup of athlete patients and the injuries resulting from training.

Cathy Reas – Patient Story

Cathy used to be a distance cyclist and long-haul downhill snow skier who knew the French, Austrian, German, and Italian Alps very well.  She took a fall from a ladder in October 2012 and knew immediately that it was bad; but she also knew she was in good hands with Dr. David Griffin, who was the trauma surgeon on call at the ER that night. Both legs were injured in the fall and she hoped the right leg was worse because she already knew her right knee needed replacement surgery.  However, the end of her left tibia was crushed – a very serious injury which leaves many unable to walk again.

The day after Cathy’s injury, Dr. Griffin studied images and was satisfied with his planned course of action.  After hours in the OR, Dr. Griffin sternly explained recovery instructions to Cathy and her husband: mostly staying in a wheelchair for 5 months, with NO weight-bearing physical therapy at all, not even standing – for five long months. Dr. Griffin said if she could stay off of her leg, there was a chance she’d be able to walk again.  Cathy resolved to follow Dr. Griffin’s orders and her husband rented a wheelchair.  He also bought her a shower chair, and other friends provided another wheelchair.

At her 2-week post-surgery checkup, Dr. Griffin reviewed x-rays with Cathy and confirmed that she indeed had already needed knee replacements for both knees, even before her fall. Dr. Griffin said they could discuss that again in 2 years; but for now, Cathy had a recovery plan that would require a lot of time, therapy, persistence, and patience.  She and her husband both got on board with Dr. Griffin’s plan.

Cathy learned to prepare meals from her wheelchair.  After 5 months, she could stand up to go to the bathroom (without “hopping” herself out of the wheelchair).  She started limited walking inside the house.  By summer, she used a cane to walk the 100+ feet to their mailbox and started going to the grocery alone.  Cathy’s family medical professionals in other states felt hers was a wildly successful recovery and were amazed to see her walking at the family reunion in July.

After waiting 3 years, Cathy’s knee pain became challenging; but Cathy learned that Dr. Griffin had moved his practice to Florida.  She started researching knee surgeons all over again and actually considered going to Florida to see Dr. Griffin. After another year, Cathy’s knee pain was increasing and she decided to go to TOC and request an appointment with another knee surgeon.  Cathy was still on record as Dr. Griffin’s patient and the scheduler informed her that Dr. Griffin was back from Florida!  He was working in trauma, however – not as a knee specialist.  Nevertheless, she got an appointment and asked him if he would replace her knees.  Dr. Griffin remembered Cathy’s tricky crushed tibia surgery and all the metal braces he had put in place in 2012, and he agreed.

In January 2017, Cathy followed instructions for preparations for her right knee replacement – it was done without a hitch.  She studied the PT instructions during her 3 days in the hospital and soon realized after returning home, that she could manage the PT.  Having been a Candy Striper, and also having managed 2 nursing schools professionally, Cathy could take her own vitals and managed her Lovenox injections easily.  Dr. Griffin had done such a fine job that almost no pain medications were needed.  After 10 days (with Dr. Griffin’s permission to drive), Cathy again drove to her PT sessions.  Weeks later when she was about to be released from PT, she took pictures of the equipment her therapist had regularly used, and found similar machines at her gym on Redstone Arsenal in order to continue exercising after PT ended.

That PT prep and continued exercising proved most helpful when Cathy’s left knee was replaced in September that same year.  This time Dr. Griffin carefully made 2 incisions: first to remove the metal he had meticulously put in place to repair the crushed tibia in 2012; and the second incision to replace the left knee. Dr. Griffin asked Cathy to arrange for her husband to take photos of her red and swollen left leg every day.  She then sent Dr. Griffin the pictures and circumference measurements as instructed every day for 2+ months.  These were the moments when Cathy and her husband again realized Dr. Griffin was superior among surgeons.

Cathy is happy to be walking, if usually with a cane, but she’s mostly free of pain.  Amid the craziness of 2020, Cathy’s husband took her to Nashville to buy a professional Precor recumbent bicycle to keep muscles toned when gyms closed. At her annual checkup with Dr. Griffin, he thought this would be wise.

If Cathy ever needs surgery again, she hopes she can return to Dr. David Griffin; she knows him to be the best! Dr. Griffin provides clear instructions and makes sure they are being followed at every follow-up appointment.  He stays on top of his patients’ progress indefinitely – her next annual follow-up will be March 2021.  Cathy hopes Griffin stays in Huntsville and never retires within her lifetime.

Back in 2012 Cathy knew Dr. Griffin was special as she sat in his waiting room and she met two of Dr. Griffin’s other patients. One had flown in from California for his follow-up appointment, and the other lived in Florida.  “I’ve never known any doctor with such a grand following – like me, these patients didn’t want any other surgeon either.  He is that good,” says Cathy.

Dr. David B. Griffin

Dr. David Griffin is a member of The Orthopaedic Center Trauma Team and Joint Replacement Team. He is board-certified in orthopaedic surgery and has completed fellowship training in orthopaedic hip and pelvis replacement and reconstruction. His goal is to provide comprehensive care for severe injuries. Dr. Griffin offers trauma care in a timely and appropriate fashion to increase the potential for significant recovery. His patients always receive a detailed explanation of procedures in order to ease their concerns.

Request an appointment today!