Orthopedic Center

immagine di un trattamento di fisioterapia


Our Orthopedic Department offers world class orthopedic care, including state-of-the-art equipment and techology. Our experts who are some on the nation's most experienced orthopedic specialists, treat a wide range of musculoskeletal conditions. They provide care to relieve pain and improve mobility so patients can return to their highest level of performance and enjoy a healthy, active life.


The team of specialists at Aventino38 has been serving the orthopaedic needs of the community since 1996. During these years we provided comprehensive orthopedic care to our patients from diagnosis to treatment and rehabilitation at the Physiotherapy department at Aventino38. Whether you have an athletic injury, painful arthritis or need a joint replacement, we will help our patients return to their active lifestyle as quickly as possible. In a rapidly advancing world of medicine where no single specialist can claim to have up-to-date expertise and skill in every area, Aventino38 believes in a team approach, so that patients can benefit from the collective expertise within the group if required.

Services provided encompass all major areas of orthopaedics, including:

  • Joint Replacement Surgery for knee, hip, spine, ankle and shoulder
  • Arthroscopy surgery for all major joints
  • ACL reconstruction
  • Orthopedic Trauma, including Fractures and Dislocations
  • Cartilage, Ligament and Meniscus injuries
  • Foot and Ankle injuries
  • Shoulder and Upper Limb Injuries
  • Osteoarthiritis
  • Osteoporosis
  • Spine problems and Scoliosis
  • Sports Surgery
  • Bone Tumours
  • Excision of lumps and bumps
  • General Orthopedics

Conditions &


Bursitis and Tendonitis

Inflammation of the bursa that cushion the joint often occurs together with rotator cuff tendonitis, or inflammation of the tendons that connect muscles to the shoulder bones. Both conditions cause pain and limited movement.

Rotator Cuff Injury

Rotator cuff injury includes partial or complete tearing of tendons and muscles. Rotator cuff tears may be due to injury, degenerative changes, overuse, and daily wear and tear over time.

Shoulder Impingement

Often called “swimmer’s shoulder,” this occurs when you lift your arm and the top of your shoulder blade rubs, or impinges on, your rotator cuff tendons. Impingement leads to bursitis and tendinitis.

Shoulder Dislocation or Instability

A dislocation can be partial or complete, both cause pain and unsteadiness in your shoulder. Your shoulder can dislocate forward, backward, or downward. One of the most common dislocations is when the upper arm bone moves forward and out of the socket, called an anterior instability.

Once you have a torn rotator cuff, dislocations frequently recur. It’s also possible to partially dislocate your shoulder, an injury known as shoulder subluxation


Osteoarthritis is the most common type of shoulder arthritis. It develops slowly over time, causing progressive cartilage degeneration, pain, inflammation, and joint stiffness. Shoulder dislocations and fractures can increase your risk of post-traumatic arthritis.


Shoulder fractures are often caused by a fall or high-energy injuries, such as a car accident or contact sports injury. Clavicle fracture or broken collarbone is a common result of falls and accidents.

Other problems that could be causing your shoulder pain include:

- Frozen shoulder
- Pulled shoulder muscle
- Shoulder strain
- Labral tear
- Shoulder separation
- Pulled arm muscles

How is shoulder pain treated?

Your treatment at Aventino38 is always customized to meet your individual needs. Based on the cause and severity of your shoulder pain, your treatment may include one or more of the following:
  • Change in activities to rest your shoulder
  • Shoulder exercises
  • Using a sling to take the weight off your shoulder
  • Physical therapy to diminish pain and inflammation, restore strength, and regain movement
  • Medications to reduce inflammation and pain
  • Arthroscopy to diagnose and treat pain in the shoulder joint
  • Shoulder surgery to remove scar tissue, repair torn soft tissues, stabilize your shoulder, or replace your shoulder


Some common leg pain causes include:
  • Anterior cruciate ligament (ACL) tear
  • Medial collateral ligament (MCL) tear
  • Meniscus tear
  • Patellofemoral knee pain
  • Patellar tendinitis (runner’s knee)
  • Tendonitis
  • Articular cartilage injuries
  • Patellar (kneecap) instability
  • Patellar dislocation
  • Knee dislocation
  • Iliotibial (IT) band injury

What is a meniscus?

The meniscus is a piece of cartilage in your knee that stabilizes the joint and helps cushion it from impact and concussive injuries. The meniscus is one of the most commonly affected tissues in the knee, being susceptible to tearing if the knee joint gets twisted during physical activities. A torn meniscus causes swelling and stiffness in the affected knee, but may not be painful until the cartilage becomes inflamed.

What are some non-surgical knee treatments?

Your orthopedic knee specialist may determine that your injury or disorder can be best treated without surgery.

Most nonsurgical treatments for knee injuries include:
  • Activity modification
  • Braces
  • Cortisone injections
  • Joint fluid replacement
  • Rimozione del versamento articolare
  • Physical therapy

What is knee arthroscopy?

Knee arthroscopy is a form of keyhole surgery that uses a small incision in the knee to pass a miniaturized camera, called an arthroscope, into the joint. Your surgeon uses the arthroscope to diagnose the cause of your knee pain, and can also perform corrective procedures at the same time using instruments contained within the arthroscope.

Arthroscopy is used to diagnose knee problems, including a torn meniscus or misaligned patella as well as to repair joint ligaments.

When is knee replacement surgery recommended?

At Aventino38, our specialists may recommend knee replacement surgery when more conservative approaches, like physical therapy, medication, bracing, and injections, have failed to provide you with adequate relief.Your specialist only turns to surgery to repair joints that have been damaged by degenerative conditions, like osteoarthritis, rheumatoid arthritis, or as a result of a traumatic injury.

Osteoarthritis is one of the most common causes of degenerative changes where surgery may be the best option. Knee replacement surgery replaces the ends of worn bones with artificial components designed to improve range of motion and eliminate pain.

Neck & Back

There are numerous possible causes of neck and back pain. When you experience a sudden onset of pain, especially low back pain, while engaged in physical activity, the likely cause is a ligament or tendon sprain or a strained muscle.

Acute injuries like these are often caused by:
  • Lifting heavy weights
  • Using unsafe lifting and carrying techniques
  • Exceeding current fitness levels
  • Making the same movements repeatedly
  • Moving awkwardly or too quickly
  • Muscle strains
  • Tendon or ligament sprains
  • Muscle tension caused by stress and anxiety
Keeping fit, adopting the correct posture, and observing safe manual handling techniques can prevent many of these types of injuries.

Other common causes of back and neck pain include:
  • Falls and trips
  • Herniated disks (slipped disc)
  • Scoliosis (curved spine)
  • Osteoporosis (brittle bones)
  • Neuropathic pain conditions
  • Joint wear
  • Pinched nerves
  • Sciatica
  • Degenerative disc disease
  • Compressed nerves
  • Bone spurs
  • Spinal stenosis
  • Whiplash injuries
  • Osteoarthritis
  • Rheumatoid arthritis
Acute injuries, such as pinched nerve in the neck or strained muscles, can heal completely with correct treatment, but degenerative conditions like arthritis and osteoporosis can cause chronic back and neck pain.

What are the best treatments for back and neck pain?

You can ease the discomfort of mild, acute attacks of pain by following some simple self-care advice:
  • Don’t take to your bed; rest your back but keep moving
  • Don’t repeat whatever activity you were doing when the injury occurred
  • Perform gentle exercise to keep your body moving and prevent it from stiffening
  • Follow a gentle stretching program
  • Apply heat packs to the affected area
If these home remedies aren’t helping, or your pain is more than mild discomfort, contact Aventino38 to book an assessment.

Treatments available include:
There’s also a range of medications that may help relieve pain and inflammation:
Strong painkillers that belong to a class of drugs known as opioids may be effective, but there are restrictions on their use due to their addictive properties.

Surgery is only advisable when all other treatment methods haven’t resolved the problem; for example, where there is disc herniation, or if there is nerve compression.

The treatment approach used is decided after careful consideration of a patient’s history and symptoms, to find the most effective solution for your back and neck pain.

Foot & Ankle

What are the most common causes of ankle and foot pain?

Feet are composed of an array of structures and tissues, including bones, joints, muscles, tendons, ligaments, and nerves, and foot pain can be caused by an issue with any of these components. Some people are more prone to developing ankle and foot pain, including athletes and people whose jobs require long periods of standing, people who are older or overweight, and those with chronic diseases, like diabetes and arthritis.

Some of the most common causes of ankle and foot pain are:
  • Sprained ankle
  • Tendonitis
  • Bursitis
  • Torn ligaments
  • Metatarsal fracture
  • Arthritis
  • Bunions
  • Plantar fasciitis
  • Flat feet (“fallen” arches)
  • Plantar warts
  • Hammertoes
  • Shoes that don’t fit properly
  • Achilles sprain
  • Calf strain
  • Ankle fracture
  • Peroneal tendonitis
  • Shin splints
  • Stress fracture
  • Metatarsalgia
  • Achilles tear
Ankle pain is often accompanied by swelling and loss of mobility. Some injuries can also cause numbness in the toes.

What techniques are used to diagnose ankle and foot pain?

Diagnosis begins with a patient history and a review of symptoms, followed by a careful examination of the foot to pinpoint the source of pain as well as its underlying cause. In some cases, diagnostic imaging tests like X-rays or MRIs may be required to look “inside” the foot or ankle to determine the cause of pain and other symptoms, X-rays can be done here at Aventino38 center.

Passive and active movements may be used to pinpoint the cause of pain and the foot will be gently palpated to look for areas of tenderness. Some issues, like corns and calluses, can be easily diagnosed with a visual examination while more complex problems may require diagnostic imaging like X-rays.

What causes ankle sprains?

Ankle sprains occur when the ligaments that hold the joint together become stretched beyond their normal limits, resulting in inflammation and tissue damage that can take some time to heal. Sometimes, the ligaments tear apart.

Sprains cause pain in and around the ankle, especially when trying to bend the joint or place weight on it as well as local tenderness, swelling, and instability in the joint.Sometimes, a sprain can be accompanied by a snapping or popping noise as the ligament is stretched. Sports injuries from playing games, such as football and rugby, are common causes of sprains and strains.

How are ankle and foot pain treated?

Treatment will depend on the underlying cause of pain. For instance, foot pain related to diabetes will focus on treating the specific symptoms in addition to managing blood sugar levels. Sprains, strains, and fractures may require splinting, casting, or even surgery to repair broken bones, or torn ligaments or tendons.

Often, treatment will involve oral or injected medication to relieve pain and inflammation combined with physical therapy to relieve pain and restore mobility and strength. Issues like corns, calluses, and toenail fungus can be treated with simple in-office procedures.

Custom orthotics and ankle braces play a major role in treating many types of ankle and foot pain, and in preventing pain from recurring following surgery or other treatment.

Hand & Wrist

Wrist and hand pain and disability can be due to acute injuries, such as fractures and sprains, or ongoing conditions, such as arthritis, De Quervain’s Tendinitis, and Carpal Tunnel Syndrome.

Fractured hand or wrist

Fractures are breaks in the hand bones or wrist and vary from hairline fractures and stress fractures to compound fractures where the broken bone protrudes through the skin. They’re typically a result of accidents, such as falls, sports injuries, crushing, and climbing injuries.

A broken bone in the hand or a wrist fracture is usually painful and limits movement.Our team at Aventino38 can diagnose fractures using their digital X-ray equipment.

Tendon damage

Tendons in the wrist may be damaged through overuse injuries, resulting in wrist tendonitis, or you may suffer an acute tendon injury or sprained wrist. Mallet finger is a condition in which the tendon on the back of the finger gets separated from the muscles to which it’s normally connected. It’s a common sporting injury, as are many tendon problems.


Osteoarthritis is a degenerative condition in which the cartilage that allows bones to move freely next to one another in a joint starts to disappear. The loss of cartilage causes pain and swelling where the ends of the bones rub together and can affect any joints in the body.

Hands are very commonly affected by osteoarthritis, and finger joints with arthritis and thumb arthritis are common problems for many older people.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is a common cause of hand and wrist pain, and can also cause weakness, tingling, and numbness in the affected arm. The pain can travel right up to the shoulder, and you may feel like your arm or hand has fallen asleep. These symptoms can make it hard to grip objects, and people with CTS often find they’re prone to dropping whatever they’re holding.The symptoms are due to constriction of the median nerve that serves the thumb side of the hand where it runs through the carpal tunnel in the wrist.

What treatments are available for hand and wrist pain?

The cause of your pain will determine the most effective course of treatment, and Dr. Dickinson and his team take a detailed look at your medical history and current state of health before recommending the most appropriate treatment.

Options include:
Complicated fractures may also need surgery to set or repair the bones. The team at Aventino38 specializes in treating orthopedic conditions both acute and chronic.

Repetitive Stress Injuries

Overuse injuries are caused by repeating the same movement so often that the tissues in that part of your body become irritated and inflamed. The repetitive movements cause pain or aching in the affected area, and if the tissues don’t have time to heal, can lead to chronic pain conditions.

Overuse injuries are common in people who play sports regularly or who have to carry out the same actions repeatedly during their working day.

Typical overuse injuries include:
  • Bursitis
  • Shin splints
  • Stress fractures
  • Tennis elbow
  • Tendonitis
  • Tenosynovitis

What causes repetitive stress injuries?

There are several factors that contribute to the development of an overuse injury. It could be that you’ve been trying to do too much too soon, before you’re physically strong enough. You should always start slow and build up fitness gradually to avoid sprains and strains as well as overuse injuries.

If you’re a devoted sports or exercise enthusiast, you might not be giving yourself time for rest and recuperation between sessions. Some people find it hard to take a break from exercising, training, or participating in their chosen sport, but rest is an essential component of building up fitness safely and effectively.

Sometimes people lack the knowledge to manage their training, using poor techniques that overstress their bodies and failing to pace themselves correctly. Using a coach or personal trainer helps prevent these issues from causing injuries.

As the name suggests, overuse injuries are typically a result of putting repeated strain on the same muscles, tendons, or ligaments, so if you don’t vary your exercise or training regime, you could end up with an overuse injury.The equipment you use also has a bearing on the likelihood you’ll develop an overuse injury.

Wearing the incorrect footwear when you’re running, for example, could lead to shin splints; and using equipment that isn’t a good fit for your body, such as golf clubs that are too long or short puts increased strain on your muscles and soft tissues.

What treatments are available for repetitive stress injuries?

Rest is essential, so that you give the inflamed tissues time to heal. Cold applied to the affected area reduces inflammation and pain, and over-the-counter painkillers and anti-inflammatory medications can also help.

More serious injuries could require physical therapy, or in the case of a stress fracture, you might need a splint or cast to immobilize the bone.

Arthritis & Joint pain

A bone disorder, arthritis describes multiple conditions associated with chronic joint inflammation.

Osteoarthritis, the most common form of the disease, results from the degradation of the cartilage in your joints. This soft, cushiony material wears away, leaving your bones to rub together. In most cases, osteoarthritis results from aging, injury, or overuse of the joint, often from repetitive movements required in work or hobbies.

A malfunction in your immune system causes rheumatoid arthritis, a chronic autoimmune disorder. For an unknown reason, the immune system turns on the cells in your joint lining, attacking them. That causes severe inflammation.

What are the symptoms of arthritis?

The most common symptom of arthritis is pain in and around your joint. Arthritis can impact any joint in your body, but it most often attacks your:
  • Knees
  • Hips
  • Back
  • Shoulders
  • Hands
Beyond this pain, arthritis leads to other symptoms, most caused by inflammation. Your joints may swell, stiffen, or ache. You may have decreased range of motion, and with some forms of arthritis, your joints may become deformed.

How is arthritis treated?

Arthritis is a chronic condition and, therefore, has no cure. At Aventino38 we can decrease the severity and frequency of your arthritis symptoms, reducing pain and restoring joint mobility.

Depending on the severity of your arthritis and what joints it impacts, we may use a variety of treatments, such as:
  • Physiotherapy
  • Gentle realignment
  • Chiropractic massage
  • Trigger point therapy
  • Deep heat treatment
  • Magnet Therapy
Along with chiropractic and osteopathic treatments by our dr. Livio Antinucci, the team at Aventino38 also recommends lifestyle changes you can make to improve arthritis, like 30 minutes of daily physical activity. That should include stretching and strengthening exercises, making things like yoga an excellent choice.

Eating a diet rich in whole foods and avoiding inflammation-causing foods and drinks can also improve your pain level. If your work requires you to remain in the same position for an extended period, we advise you to get up and move at least once an hour.

When your arthritis flares up, your chiropractor may recommend using heat and ice treatments to reduce inflammation.

If arthritis pain and mobility issues are stopping you from doing the things you love, find a solution.


Osteopathy is a system of diagnosis and treatment focusing on the whole body. Osteopathic treatment involves gentle manipulation of muscles and joints with the aim of restoring the body’s functional and structural balance.

Osteopaths use palpation, physical manipulation, stretching and massage to enhance the blood and nerve supply to tissues and therefore help your body’s own healing mechanisms.

Aventino38 Osteopathic Clinic was set up in 2009 and has been providing high quality care to its patients since then. Our patients are referred by local doctors, insurance companies, HR departments and friends and colleagues of former patients.

What should I expect from my visit to an osteopath?

Osteopaths consider each person as an individual : On arrival for your first visit you will be asked to fill out a form with your relevant details, then your osteopath will spend time taking a detailed medical history including important information about your lifestyle and diet. You will normally be asked to undress to your underwear or similar and perform a series of simple movements to assess which joints are restricted and what to what extent.

With their hands osteopaths identify abnormalities within the human structure and function.
This will help your osteopath reaching a full diagnosis and treatment plan tailored to your needs.

They then facilitate the body’s ability to heal itself through a variety of stretching, mobilizing and manipulative techniques.

With added exercises and health advice, osteopaths help reducing the symptoms and improve your health and quality of life. Osteopathy is also a preventative therapy. A regular service session two to four times a year helps keep your body stress free and in good working order.

A list of pains and comditions that osteopaths are asked to help with:
Although osteopaths are best known for treating neck & back problems – osteopaths really see many of these – many other conditions present in our osteopathy clinics.

below is a brief list of some of the more common conditions our osteopaths are asked to help with:
  • Tinnitus
  • Cervical or neck pain including whiplash injuries
  • Headaches and migraines
  • Thoracic or back pain including rib pain and sternum pain
  • Lower back pain, pelvic pain, hip pain and gluteal or buttock pain
  • Sciatica and referred pain
  • Curvature of the spine, scoliosis and spinal dysfunction
  • Subluxations, back strain, back injury, correct alignment and musculoskeletal balance
  • Frozen shoulder, shoulder girdle, stereo-clavicular and acromioclavicular pain
  • Elbow pain, wrist pain, hand and finger pain
  • Tennis elbow, golfers elbow and other sports injuries
  • Knee pain, cruciate ligament, acl post-operative rehabilitation
  • Ankle pain, foot pain including plantar fasciitis and metatarsal Gia, toe pain
  • Sprained ankles including Achilles tendon pain
  • Muscle spasm and cramps
  • Muscle and ligament strains and tears of arms and legs eg calf tears, hamstring tears
  • Jaw pain and dysfunction, clenching and grinding of your teeth
  • Lymphatic drainage, bloating, abdominal cramps and pain, constipation, sluggish bowel
  • Work cover assessment / treatment including RSI (repetitive strain injuries) from overuse
  • Ergonomic assessment and advice
  • Pregnancy, neonatal and childcare treatment and advice
  • Arthritis pain and stiffness relief

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