Patient Story of: Jay Adlersberg, M.D.

I have known Dr. Rock Positano for over thirty years, during which time I have seen him as a patient, and in my rheumatology practice, I have referred a number of patients to him. The art of my subspecialty is to use nonpharmaceutical modalities as much as possible. Rock’s nonsurgical approach to foot and ankle arthritis is one of the mainstays of care for my patients. I trust him implicitly, as his knowledge of the mechanical structure and function of the foot and ankle are stellar. His books on the subject are a library of knowledge for both professionals and laypeople who deal with and suffer from lower extremity pain.

In my own case, Rock takes care of my crooked toenails monthly and I’ve worn his orthotics for years. They were custom made to my feet (I think that makes them bespoke orthotics), and if they needed adjustment after first use, his office and lab corrected the pressure hot spots with alacrity. It is not just the commonplace orthotics that make him special. It’s his knowledge in and experience of the biomechanics of the leg, foot and ankle that make him a standout practitioner.

I once badly twisted my ankle, and after a normal x-ray, I thought it was a sprain and did physical therapy. But I still felt pain weeks later. Rock examined my ankle at that point and thought it was more than a sprain. He thought I had an occult fracture. He immediately sent me for an ultrasound. This procedure is not commonly used by orthopedists. But Rock uses it, as an adjunct to x-rays. He shuttled me over to a radiologist who uses sonography for puzzling foot issues. The sonogram showed an avulsion fracture not reported on the x-ray. Eight weeks of splinting and I was jogging again, thanks to Rock. There is one of Rock’s books written about how various diseases affect the foot, and how medical illnesses can be diagnosed by a thorough foot exam. As an internist for decades, I never knew this.

Here’s a personal story. On one routine visit, Rock did his usual complete lower extremity exam. He felt sponginess at the attachment of a tendon to the navicular bone of my left foot. He asked me if I had osteoporosis, which happens to about 10% of men over sixty. He expressed concern, as he said he had seen this physical finding in patients with the disease. At his suggestion, I had a DEXA scan. I was shocked when the results showed bad bone loss, osteopenia. The condition put me just three tenths of a point above absolute osteoporosis. My endocrinologist put me on bone-stabilizing meds. My bone density has improved as a result, in no small part due to Rock’s expertise.