Author Archive: aenriquez

Options for Shoulder Impingement Treatment

Shoulder impingement syndrome is known by many names including painful arc syndrome, swimmer’s shoulder, and subacromial impingement and this condition occur when the tendons of the rotator cuff muscles become inflamed as they move through subacromial space. As a result, there is reduced the flexibility of the shoulder, and weakness and pain will usually be experienced too. Pain usually intensifies if the shoulder is moved to an overhead position or, at night, when the individual lays upon that shoulder. Restricted movement increases the sense of frustration experienced. Pain may manifest as a dull ache, gradually occurring, or, it may suddenly manifest and be acute. There may be a grinding motion or a popping sensation. Elevation of the arm is likely to be painful but will also occur when applying downward force too although this will ease. Seeking medical assistance for shoulder impingement treatment is paramount.

Although other options are likely to be considered first, a subacromial decompression may be required which helps to prevent the bones and tendons rubbing together. Subacromial simply means under the acromion which is a part of the shoulder blade helping to form the shoulder joint. This is usually done through keyhole surgery and a general anesthetic would be required. When there is subacromial impingement, this means that the actual space between the rotator cuff tendons and the shoulder blade is reduced, typically through swelling and irritation or, the development of bony spurs. Where the latter occurs, it’s often as a result of osteoarthritis. Treatment enables this space to be extended and any inflamed bursa or bony spurs can be removed.

Any surgery can be worrying and so, it’s important for good communication to be in place and to speak to specialists in the field such as the Orthopedic Center, Arizona who can explain the process reducing any fears about the procedure. Any surgical operation will be carried out by an orthopedic surgeon who will guide each person through the process as is relative to their case. As a general anesthetic is likely, fasting will be necessary prior to the operation. Any individual who smokes will be asked to stop as smoking increases the risk of infection. The procedure takes approximately one hour although this will vary on an individual basis and a local anesthetic may also be injected into the shoulder nerves to reduce any discomfort experienced following surgery. Pain management is important and there will be options to ease discomfort. The surgeon may also decide to repair any damaged tendons at the same time.

Shoulder impingement treatment does not always require surgery. There are various causes and symptoms which may not mean invasive treatment at all. Certainly, resting the shoulder joint and avoiding extensive movements can help and doctors may suggest non-steroidal anti-inflammatory medicines along with physiotherapy initially. Where necessary, steroid joint injections may be given. Note that subacromial decompression will only be recommended usually if other treatments have not helped. It can take up to four months for full recovery following surgery and most people will make a complete recovery.  Following up with physiotherapy is often beneficial to aid flexibility and to increase movement. It will also be important to build strength up in the shoulder joint too. Find out more by visiting OSPLarizona.com

What Happens in an Ulnar Collateral Ligament Injury?

Ulnar collateral ligament injuryAn ulnar collateral ligament injury is an injury to the elbow ligament. It happens due to overuse of one of the ligaments on the inner side of the elbow and can result in tearing the ligament.
The injury is very common in contact sports where athletes have to repetitively stretch their arms or where elbow dislocation occurs. The injury is caused by a force that exceeds the strength of the ligament with activities like throwing or overhead sports being very likely triggers.

Possible complications and treatment

Injuries of this type hold the potential to damage other structures of the elbow and cause elbow stiffness.
In most cases, where the injury is not too serious, ice and pain medications can be used to treat the swelling and discomfort. Ice helps target swelling while medications stop the pain temporarily. Where pain persists, the individual may also get a brace or cast to seek relief.

What is Tommy John surgery?

The surgical treatment for correcting an ulnar collateral ligament injury is called the Tommy John surgery. The procedure derives its name from a surgery performed on the MLB pitcher and LA Dodgers Tommy John for a tendon transplant.
The procedure works by replacing the torn ligament with a graft tendon taken from the hamstring, forearm, knee or foot of the individual. However, the surgery is only recommended for those patients who do not find relief from non-surgical methods.
Athletes who need to engage in grueling overhead throwing activities and whose careers depend on performance are ideal candidates for this procedure.
The surgery involves implanting the graft to the injury site by drilling tunnels in both the forearm and upper arm bones once the elbow is opened up.
Flexor muscles in the area are also opened up where the graft is woven and the reconstruction is performed. Any remaining portion of the original ligament is then attached to the reconstructed ligament.
While it might seem like a lot of work, the surgical procedure takes between an hour and an hour and a half to perform. Most patients are required to stay overnight in the hospital and are discharged the next day.

Post-operative care

Post-operative care after this procedure involves keeping the incision dry and clean and not showering for 3 days. The patient also needs to give the elbow a rest for a week with no driving for a minimum of six weeks. Other remedial steps include resting the elbow on a pillow when seated and keep it elevated to minimize swelling.
Most patients will recover from surgery in 6 to 8 weeks with motion achieved in this time without pain.

Rehabilitation

Rehabilitation consists of gentle exercises such as squeezing a softball while avoiding moving the elbow. With improvement, the patient can advance to an active motion from passive motion.
Once comfortable, the patient can move to engaging the elbow more by working with a fuller range of motion. Care needs to be taken not to cause direct stress to the elbow during recovery.
It usually takes 12 months for returning to normal sports.

What is Osgood Schlatter Treatment?

Osgood Schlatter is a common cause of knee pain resulting from an inflammation just below the knee. The condition occurs primarily through periods of growth spurts when structures like bones, muscle, and tendons change rapidly. Depending on the severity of the condition, Osgood Schlatter treatment involves taking a few different measures.

Good osgood schlatter treatmentOsgood Schlatter symptoms

The symptoms of Osgood Schlatter typically involve pain at the tibial tuberosity or bony pit at the top of the shin.  When this part becomes inflamed or swollen, the affected area becomes more prominent than usual.

Other symptoms include experiencing tenderness and pain which is worsened during and after exercise. Some children may even experience limping after physical activity.

The severity of the symptoms can easily vary from one person to the next. Some children may only experience mild pain during specific activates while others may suffer from a constant throbbing pain. The duration of the discomfort can also vary, lasting from a few weeks to a couple of years.

Adequate rest, however, can improve these symptoms and symptoms typically disappear once the growth spurt is over.

Osgood Schlatter disease causes

While the condition does occur through an overuse of the tibial tuberosity, there are specific factors that may increase the susceptibility of sustaining this disease. These can include the following causes:

  • Age can be a notable factor in the diagnosis of Osgood Schlatter disease. In many instances, the pain experienced by boys between 13 to 15 years of age and girls between 10 -12 years old is put down as growing pains. However, it may actually be Osgood Schlatter especially if young adolescents are engaged in high impact sports or other such activities.
  • Gender seems to play a part in the occurrence of the disease. That is to say that the condition is diagnosed more in boys than girls. But with more girls getting involved in sporting activities, the gap is becoming narrower between the two.
  • Activity levels can also be a contributing factor. As the bones of young athletes grow, it may take some time for their muscles and tendons to catch up. Regular sports activity can pull on localized tendons which in turn pull on the tibial tubercle. The result of this repetitive traction can lead to inflammation in the area and cause distressing discomfort.

Osgood Schlatter treatment options

Treatment for this disease aims at reducing the associated pain and swelling. Such treatment may also demand to limit exercise and activity until the person starts to feel better.

  • Medications are usually the first line of treatment for this condition. Over the counter pain relievers like acetaminophen, ibuprofen and naproxen are all helpful. They reduce swelling and help subside the associated pain.
  • Physical therapy can be used to stretch the quadriceps which assist in reducing tension in the inflamed area.
  • Surgery may be considered as a last resort in very rare cases. Typically the condition resolves without formal treatment as symptoms usually disappear after the growth spurt is over.

However, in cases where the pain persists and does not subside even after the growth spurt, the doctor may decide to administer surgery. The surgical procedure will likely be done to remove the bony overgrowth in the area.

How to Treat Sharp Pain In Front Right Shoulder?

Having sharp pain in front right shoulderPain experienced at the front of the shoulder may be acute or chronic. Also known as bicep tendonitis, this condition can occur from injury, strain, tear or an inflammatory response. Here is what to do when experiencing sharp pain in front right shoulder:

Reduce inflammation

The first line of treatment is to address the inflammation in the affected area. This can be done by taking adequate rest along with anti-inflammatory medication to start the healing process.

Improve range of motion

When pain starts to subside, individuals can start working on getting their range of motion back. In most cases, the overreach is affected and suffering individuals need to reclaim their overhead full flexion.

One consideration while doing so is that any tightness felt in the back of the shoulder may cause increased stress at the front of the shoulder and trigger more pain.

Build strength

As part of early recovery, individuals can try to strengthen affected muscles in the shoulder along with others in the back which support the shoulders.

When doing so, try strengthening the rotator cuff muscles as this muscle group and their tendons provide strength and stability during movement of the shoulder.

Go for functional training

Once the healing process starts and inflammation subsides, the individual can then start functional training. This step focuses on enhancing movement in a coordinated manner.

Functional training promotes proper mobility of shoulder, trunk, and scapula to allow synchronized movement.

There are a number of flexibility exercises that can help with bicep tendonitis treatment and may even help prevent the condition in the first place.

These can include the following:

  • Pec stretch
  • Rhomboid stretch
  • Inverted Rows
  • Side lying external rotation
  • External arm rotation
  • Push up to side plank

Other Bicep Tendonitis Treatment Options

Where exercise alone does not suffice, it may be paired up with other treatment options like the following:

  • Medications such as NSAIDs are typically the first option to treat the discomfort associated with the condition. The drugs can be helpful in alleviating the pain in the initial stages.
  • Icing is an elementary injury management technique and a drug-free method of relieving pain. An application of an icepack to the skin can soothe symptoms from strains, sprains, bruises as well as tendonitis.
  • Stretching on a regular basis may also help prevent tendonitis from occurring in the first place. Gentle stretches before and after workouts are highly recommended.
  • Massage is another effective way to loosen tissue and keep it from clogging muscle fibers. This therapy not only sustains the range of motion but also keeps muscles more supple to minimize the chance of further injury.

Among the different type of massages, deep tissue massage helps reduce inflammation and relieve muscle tightness. Sports massages, on the other hand, target muscle-tendon junctions to improve endurance and flexibility.

  • Surgical intervention is typically considered a last resort for people who do not benefit from other types of treatments.
  • Non-operative management involves the administration of injections to the inflamed area to manage inflammation and pain.

The Continuing Relationship Between Physical Therapy and Regenerative Medicine

In regenerative medicine, stem cells are used to treat damaged or destroyed tissues and organs. These stem cells come from the patient themselves and are a “blank state” which can be turned into several different variations of cells including bone, ligament, tendon or muscle.

Given that the main goal of both regenerative medicine and physical therapy is to restore the normal functioning of a diseased or injured tissue it is only appropriate that the two therapies – physical therapy and regenerative medicine – combine forces.Regenerative medicine aims to help the body heal itself more effectively. The study of using a tissue, cellular, organ and medicine substitutes to restore biological function lost as a result of injury, disease, congenital abnormalities or age has brought together a variety of scientists – many with overlapping backgrounds – in the field of regenerative medicine.

Once the regenerative medicine is administered via injection or other procedure, patients are often encouraged to continue physical therapy – as the strength gained from the stem cell therapy enhances their ability to complete physical therapy.

Furthermore, in cases such as artificial organs and medical devices, the relationship between the two fields is also important. A major problem with organ transplant is that there is no way to know if the body will reject the organ or not, and unfortunately, there is no way to prevent it either. However, the great benefit to regenerative medicine, and specifically stem cell therapy and the like, is that the materials used to aid in the healing process are taken directly from the patient – via their blood, bone marrow, or other appropriate sample collected for the needed materials.

However, following the introduction of a new organ or a medical device – even if the organ is one grown from the own patient – physical therapy is still a vital part of the rehabilitation process. Physical therapy has the strong power to enhance the healing potential. As a result of physical therapy, the body can maximize the functional interaction between the host and the donor object – rather it is an organ or a medical device. Following a form of regenerative medicine treatment, physical therapy should be appropriately positioned so that it can optimize the patient’s post-transplant recovery.

Oftentimes, regenerative medicine treatment options are also used for problems such as back pain, knee pain, and other debilitating chronic pain. Typically, the patient was probably receiving physical therapy prior to regenerative medicine treatment options – or had at least tried it as an option. However, to continue to increase the mobility and give the stem cells the best chance at being successful, physical therapy should continue to be an important part of the patient’s regimen.

As the two fields continue to work in close contact with one another, it is also imperative that scientists and rehabilitation specialists continue to work to develop clinically relevant protocols.

When combined, physical therapy and regenerative medicine can continue to optimize the quality of life for those patients suffering from chronic pain or other ailments which have previously inhibited them from doing things.

Total Hip Replacement Rehabilitation

Total hip replacement surgery involves removing damaged cartilage and bone from a painful hip and replacing this with prosthetic components. The hip is a ball-and-socket joint, with the ball being the head of the femur (thigh bone) and the socket being a portion of the pelvic bone. Also called total hip arthroplasty (THA), hip replacement is typically done because of damage from arthritis. The main part of the hip replacement process is rehabilitation.

Before Surgery

Rehabilitation begins before your total hip arthroplasty. A physical therapist teaches you about what to expect from the surgery and gives you exercises to precondition your body. Flexibility and strengthening maneuvers are used to make your recovery easier. The therapist may do a home visit to advise you on how to make your environment safe for your recovery.

Immediately after Surgery

Right after a total hip replacement, you will have some weakness, numbness, itching, soreness, pain, and stiffness of the hip and leg. Postoperative pain can continue for up to 6 weeks. However, this is managed using a variety of techniques and medications. Right after surgery, you are monitored in the recovery area for 1-2 hours before being moved to a hospital room.

Rehabilitation continues after surgery. A physical therapist will teach you how to put weight on the affected leg, how to use an assistive device (crutches, walker, cane), and how to move from bed to chair, and up from a chair. The therapist will not allow you to turn the leg inward, cross your legs, or bend forward more than 90 degrees.

Hospital Care

While in the hospital, your physical therapist will visit you 2 times each day and help restore function and prevent injury to your new hip. The therapist continues to work with you to learn how to turn in bed, how to walk with the assistive device, and how to perform a range of motion and strengthening exercises.

Subacute Recovery

Whether you are moved to a skilled nursing facility or return home, physical therapy continues. You progress to walking, climbing stairs, transferring from a car, increasing balance, and full movement of the new hip. Specific muscle strengthening exercises are used to improve standing and walking ability.

Once your new hip is strong, you are encouraged to fully bear weight on the hip and walk more. The physical therapy sessions continue to focus on stretching, mobility, and strength. The therapist aims to return you to your pre-surgery functional status and improve your quality of life. After 6 weeks, you may be allowed to climb ladders, lightly job, pull carts, and lift objects.

Normal Activities

As soon as the orthopedic surgeon gives you the go-ahead, you can return to usual and normal activities. This means you can walk as much as you wish, swim after sutures are removed, and participate in golf, cycling, and household chores. Return to driving, sexual activity, and air travel will depend on your rehabilitation success.

You are permitted from doing some things after a total hip replacement. To ensure proper healing and prevent hip dislocation, don’t:

  • Try to pick something from the floor while sitting.
  • Cross legs at the knees for at least 8 weeks.
  • Lean forward while sitting.
  • Bend at the waist beyond 90 degrees.
  • Reach down and pull up blankets when lying in bed.
  • Turn feet inward when you bend down.

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