Final Kick Ankle and Foot Clinic supports direct primary care, or “pay by cash” options, for all patients. This model puts more control back in the hands of the patients. Under the direct primary care model, there are no surprise bills when an insurance company refuses to cover a visit. Many patients will never reach the high deductibles now common under the their insurance price structure. Regardless of whether you have in-network, out-of-network, or no insurance coverage, we will offer you affordable and transparent pricing for all office visits and procedures.
Patients are allowed to pay by cash, check or charge according to the transparent price structure. The benefit of a “pay by cash” structure is that we can offer prices closer to the actual cost of doing business because we are not restricted to your insurance company’s contract. The time saved by the practice by avoiding third party insurance companies, can be passed onto our patients. As a result we can spend more time individualizing care, and answering all questions, while still providing true patient privacy. Direct primary care is an important piece of any replacement for the Affordable Care Act (ACA), largely because of its free market approach and focus on price transparency.
We are also more than happy to submit claims through your insurance company. Nevertheless, we believe it is important that you are aware of all your payment options, and we will work with you to insure that you are getting the best value for your treatment.
Note: If you do have out-of-network coverage, you many seek reimbursement from your insurer for out-of-network care as allowed under the contract you have with your insurer. If you have a Health Savings Account (HAS), you may use it to cover your costs or get reimbursed for care.
Absolutely, we believe everyone should have access to our exceptional services, regardless of your insurance situation. We are in the process of getting on every insurance plan in Utah. Nevertheless, if you are out of network, we will offer you affordable self pay pricing. Our self pay prices are often cheaper than what you would pay through your insurance company. We can also work out a payment plan tailored to your needs.
When you schedule your initial appointment, we will ask for your insurance information. We have an expert on our team who will call your insurance company to prior authorize any procedures or medical device (i.e orthotics, custom bracing, medical grade bracing, fracture walkers ect.) that may be rendered during your appointment. This information will provide cost transparency, so that you have no unexpected costs at the time of your appointment.
The Level 1 research studies funded for SUPARTZ FX have all been for knee joints. Although research has not been performed for ankle joints, physicians are getting the same outstanding patient outcomes as they are with knees. Eventually studies will be funded to evaluate SUPARTZ FX efficacy in ankle joints. But until then, SUPARTZ FX will continue to be used off label for ankle degenerative arthritis.
If comparing the physiology of knees and ankles, both are composed of the same type of hyaline cartilage, and undergo the same degenerative process at the cellular level. Additionally, both joints have the same synovial fluid components.
Supartz was developed to augment the synovial fluid that is severely diminished with degenerate arthritis. Supartz is a viscous substance that lubricates the joint, and stops further degeneration of cartilage. After each injection, the joint will become progressively more mobile, which will inherently allow for some natural production of synovial fluid as well.
Supartz therapy involves one injection per week in the effected joint for three to five weeks. Most patients only require three injections.
Independent of whether or not your child is complaining about foot pain, you should schedule a consult if they have flat feet. Most children with flat feet don’t complain about pain. However, parents typically notice a problem with their child’s ability to walk or run. These children may tire out faster while playing sports, or simply avoid activities all together. Flexible flat feet are caused by poor joint alignment and mobility, which stems from soft tissue weakness surrounding the foot and leg. Often, weakness surrounding the hips will result in the ankle and foot collapsing inwards.
Your child’s initial consult will consist of a comprehensive biomechanical exam. Their ankles and feet will be evaluated on the exam table, and then while walking and running in the clinic’s hallway. The position and mobility of your child’s feet, ankles, knees, and hips will all be considered when prescribing a treatment protocol. X-rays are also recommended.
Treatment consists of strengthening feet, ankles, and hips. A referral to physical therapy can be provided; however, most exercises can be performed at home under parental guidance.
Medical grade orthotics are suggested for flat feet. Orthotics will re-establish proper alignment of the foot and ankle. This will inherently lead to optimal foot and ankle function. Additionally, orthotics will prevent the flat feet from getting progressively worse. If flat feet are treated with orthotics early enough in childhood, an arch can be established once osseous maturity has been reached.
We offer Quadrasteps and LittleSTEPS. On occasion, a custom orthotic is necessary. However, since children’s feet grow so quickly, we prefer to hold of on casting for custom orthotics until osseous maturity has been reached.
Given that every foot is unique, it’s difficult to find an over-the-counter orthotic that will benefit everyone. For this reason, we steer away from over-the-counter orthotics, and offer Medical Grade and Custom Orthotics.
The Medical Grade orthotics that we offer are Quadrasteps and LittleSTEPS. Foot structure can be grouped into six major categories (see chart). During your clinic appointment, a comprehensive biomechanical exam will be performed. Your foot structure and the corresponding Quadrastep will be determined. Once determined, you will stand on the appropriate Quadrastep and your ankle and foot alignment will be re-evaluated. Most patients have immediate positive feedback from the Quadrasteps.
For those patients who need, or wish, to have a more specialized orthotic, we do cast for custom orthotics. Plaster casting takes place in clinic. Our custom orthotic molds are then sent to one of the best labs in the country to be fabricated. We tailor the orthotic to meet your functional needs. Patients will be given various options, as well as recommendations, when choosing the best custom orthotic. You can expect custom orthotics to last over a decade. We have been very pleased with our patient satisfaction.
I believe that to minimize risk of injury and to optimize performance, various types of shoe gear should be incorporated into your training plan. This includes barefoot and/or minimalist running.
Without question, minimalist running has significant benefits. The foot is the only orthopedic structure in the body, which is protected at all times. Just think, your hands and knees are not casted daily. As a result of shoe protection, the muscles in the feet become weak. Likewise, proprioception diminishes and suboptimal joint alignment, and poor tissue adaptability ensues.
In today’s society, shoes are required to be worn in the majority of our daily situations. Despite this requirement, we have the option to choose shoes that best mimic our natural form. Minimalist running shoes have thin soles, and a zero drop heel to toe ratio. Both these factors promote a forefoot strike and improved proprioception. A forefoot strike is biomechanically more efficient and takes advantage of your dense fat pad for shock absorption. (link to study).
Minimalist shoes should be gradually incorporated into your training. Most patients can’t safely make an immediate transition to wearing minimalist shoes during all their walking and running endeavors. During the transition period, I recommend strengthening exercises (see video links).
Although I don’t recommend a specific brand of running shoe, I prefer that my patients choose shoes with a relatively wide toe box. Additionally, the shoe should feel comfortable when it is initially tried on, rather than expecting a break in period. When choosing a shoe, make sure that the heel counter does not feel painful on your Achilles. Also make sure that the shoe upper does not rub in such a way to cause potential blisters.
Wider toe boxes allow for natural forefoot splay, which is optimal for foot function. Imagine wearing tight mittens throughout the day, you would struggle to handle most basic tasks. Like your fingers, your toes need to splay in order to stabilize your foot and maximize power at push off.
Most forefoot pain that patients experience is due to narrow shoes. This can lead to nerve impingements, capsulitis, and boney deformities.
I also recommend shoe variability. For example, a supportive trail shoe and a more minimalist racing flat should be rotated throughout the week. If tolerated, spikes for speed work is also highly recommended.
We offer free consultations for stem cell therapy to insure that you are an ideal candidate. During the consultation, we will discuss all conservative and surgical treatment options, and then we will both determine if stem cell therapy is best for you.
Stem cell therapy is quickly becoming a preferred method of treatment in the sports medicine and orthopedic communities. Continuous research is supporting the benefits of stem cell therapy for tissue regeneration in any joint, ligament, or tendon.
Dr. Sekulic offers stem cell therapy for any degenerative joint or tissue, in the ankle or foot. Research has shown promising results on how stem cells are regenerating cartilage in joints. As a result, patients are delaying, or even avoiding joint replacements. Unlike surgery, a large benefit to stem cell therapy is that it requires no downtime. Stem cell therapy will be performed in clinic, and patients are able to get back to full activities the same day.
Radial Pulse Therapy (RPT) is not covered by insurance. However, we do offer a free consultation for shockwave therapy, which also covers the cost of x-rays.
RPT therapy involves one treatment per week, for five weeks. It is a non-invasive procedure lasting approximately ten minutes per treatment. High frequency ultrasonic waves are transmitted into injured tissue to stimulate blood flow and promote healing. RPT is a great alternative to surgery, and has comparable efficacy. The service costs $500, which is more affordable than most surgical procedures.
For more information, please see (link).
Outpatient and inpatient surgeries are performed at the following hospitals and surgery centers:
- St. Mark’s 45th Surgery Center
- St. Mark’s Main Hospital
- Cottonwood Surgery Center
- Intermountain Medical Center
- Intermountain LDS Hospital
The majority of ankle and foot procedures Dr. Sekulic performs are outpatient procedures. This means that you will go home the same day of surgery. Please make sure you have a ride to drop you off and pick you up the day of surgery.
If for any reason your surgery requires a hospital stay, Dr. Sekulic will admit you to St. Marks Hospital or Intermountain Medical Center. Dr. Sekulic will also round on you while you are in the hospital and discharge you as soon as you are medically stable.
We offer free consultations for PRP therapy to insure that you are an ideal candidate. During the consultation, we will discuss all conservative and surgical treatment options, and then we will both determine if PRP therapy is best for you.
PRP is performed in clinic and involves a blood draw. The blood obtained will be spun down twice in a centrifuge to isolate the platelets. These platelets will then be injected into your injured tissue. Platelets are rich in growth factors, which will accelerate healing.