Torn Elbow Ligament

By  siteadmin  published  October 8, 2020

If you are feeling numbness or tingling in your hand and/or elbow stiffness, you may have suffered atear in the ulnar collateral ligament in your elbow.

Ulnar Collateral Ligament Tears

Ligaments are bands of tissue connecting bones to each other at joints. A tear in the ulnar collateral ligament is an injury to this ligament in the elbow. The ulnar collateral ligament attaches the humerus to the ulna, supporting and stabilizing your arm. Injury to the ligament can be caused due to stretching or getting partially or completely torn.

The UCL tear is usually accompanied by a “pop” sound. You wouldn’t be able to continue activity once the UCL tears. Other signs of a UCL tear include:

  • swelling or bruising at the inner elbow and upper forearm
  • elbow stiffness
  • inability to straighten the elbow
  • a weakened grip in the hand
  • inability to throw a ball at full speed
  • numbness or tingling in the hand

If your job or sport involves repeated throwing motions, it may stretch and cause the fibers in the ligament to fray. With time, small microtears may develop and cause the ligament to tear.

Other common causes of UCL tears include –

  • Overuse of the ligament from a work or sports activity — like throwing a ball
  • A sudden movement that twists or tears a ligament, like falling onto an outstretched hand or if another person lands on your elbow.

UCL Tear Treatments

Treatment for UCL tears depends on the severity of the injury. Treatment options for minor tears include –

  • rest and ice
  • anti-inflammatory medications
  • physical therapy to strengthen the elbow muscles
  • Platelet-Rich Plasma (PRP) injections to help repair damaged ligaments

If conservative treatments don’t relieve the pain, Tommy John surgery may be performed. The procedure involves replacing the ligament with a tendon from another place in the body, like the hamstring or the forearm. Physical therapy is needed after Tommy John surgery for proper rehabilitation to improve range of motion and strengthen your elbow.

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Do I Need Wrist Surgery?

By  aenriquez  published  September 24, 2020

Certainly, patients in our modern times are permitted and even expected to understand the cause of their discomfort or pain and the various options available for treating a condition. They have a well-educated staff of nurses and doctors to attend to them who are fully aware that communicating well with their patients is one of their primary tasks and questions could (and should) come at them from all sides. Patients also have the Internet that has, one would think, information on every topic known to man.

There’s only one problem: It’s called time.

Patients are in a hurry; doctors and nurses are in a hurry, too. Communication takes time. As such, you need to have targeted questions about the diagnosis, prognosis, and treatment options you face. In these modern times, doctors and patients choose treatment options together. Everyone wants to be on the same page. To get there, you need information that will allow you to ask the right questions to understand and participate in your own recovery.

All that said, what about your wrist? It is a complex, constantly functioning part or your anatomy made up of muscles, bones, bone joints, and ligaments. Moreover, sometimes you know why your wrist hurts, especially if it’s from a traumatic event. At other times, the pain sneaks up on you. This type of injury is apt to be a wear and tear condition that evolves when you perform the same task or tasks again and again, sometimes for weeks, months, or years.

A wrist is vulnerable to a variety of common injuries. A traumatic event – an accident, or a fall, for example—results in ligament tears, sprains, and fractures. Wear and tear (overuse) injuries include carpal tunnel syndrome or tendonitis. Also, wrist joints are susceptible to arthritis and arthritis pain.

When to See the Doctor

The first step on the road to recovery is the decision of when to call the doctor. There are a few simple guidelines here. First, judge whether the pain is constant or intermittent. Then judge whether the pain interferes with a standard function at work or at home, such as picking up lightweight or moderately heavy items. If a hurt wrist is not functioning properly, see a doctor to find out what’s the matter.

How do you judge pain? Do this the same way it is done in a doctor’s office. Imagine a scale in which one represents a no pain at all and 10 represents pain that is hard to tolerate. If your pain levels are at five or six or higher, call the doctor, whether the pain is constant or intermittent.

Secondly, evaluate your ability to function. Can you lift the same weights that you lifted before you noticed the pain or is function compromised?

Ask yourself … is it painful to lift or twist objects? Is there numbness you cannot account for? Are you having trouble bending or straightening out your wrist?

Array of options

Your doctor could offer an array of options to correct a condition that is causing mild pain, but as pain increases the options tend to get narrower.  For example, you don’t take an aspirin for a broken wrist. 

The most common causes of wrist pain are these:

  • carpal tunnel, an overuse injury of the ligaments that attach the wrist to the forearm
  • arthritis
  • sprain and strains (ligament and muscle injuries)
  • fractures and breaks (bone injuries)
  • tendonitis (inflamed tendon or tendons)

Remember: visit your doctor loaded with questions. Come prepared so you can get direct answers and meet the goals of your visit to the doctor’s office.

And remember: In Tempe, Arizona, dial (486) 449-FXRX for an appointment to treat sports-related injuries and all other orthopedics needs.

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What is PRP therapy for knee pain?

By  siteadmin  published  September 4, 2020

Patients are often looking for options to avoid a knee replacement surgery. While surgery is recommended only when other treatment options have failed, some patients can still benefit from knee injections.

One such knee injection treatment option is Platelet-Rich Plasma (PRP) injections.

Platelet-Rich Plasma Knee Injections

Platelets are one of the first natural repair agents to reach an injury. They begin by sealing the injury with a clot. During the clot formation, they release proteins, including growth factors for repair and “signaling” factors that bring in the patient’s own stem cells to aid in the repair process.

During the PRP therapy, the patient’s own blood is obtained from a peripheral arm vein. It is then centrifuged to separate the various blood components. Red blood cells are removed. That leaves a concentration of platelets in the remaining plasma. This is why the term platelet-rich plasma, or PRP is used for this treatment.

The PRP is then administered, in the same manner as other knee injections, after a local anesthetic has been injected.

While experienced surgeons can accurately administer PRP knee injections, you can ask for ultrasound guided injections. This non-invasive technique allows the surgeon to precisely visualize the injection needle within the knee joint. Sometimes, your surgeon may also recommend hyaluronic acid injections to aid lubrication in the knee joint and allow smoother movement.  Consult your orthopedic surgeon whether you are a good candidate for PRP injections for knee pain.

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Know More About Paget Disease

By  aenriquez  published  September 3, 2020

Paget disease is a chronic condition that affects your bones.  The most striking characteristic is unnecessary bone growth that includes deformities. While the bones can enlarge, they can also grow weaker.

Paget disease most often occurs in adults over 50-years of age. It can also occur concurrently with osteoporosis, which is the natural tendency of bones to become brittle (and more porous) as people age.

The cause of Paget disease is unknown. One theory holds that a virus that affects bones causes Paget disease.

Symptoms and complications

The most pronounced symptom of Paget disease is bone growth leading to bone deformity. It can also cause pain that runs from mild to severe depending on the location and rate of growth. It can lead to arthritis or bone cancer, although cancer is a rare occurrence.

Diagnosis

There are several ways to diagnose Paget disease. Usually, a combination of the following techniques is used:

Family history

A risk factor for Paget includes whether or not other family members have had this condition.

X-rays and other scanning tests can help diagnose Paget disease.

Bone scans are used to evaluate blood flow to bones. The scanner detects a trace amount of radioactive material that is injected into your bloodstream.

Bone biopsies are also a frequently used diagnosing tool. A needle and a syringe can remove samples of bone, although minor surgery may be required.

Treatment

There are several options for treating Paget disease, including non-evasive therapies such as physical therapy. Pain management is also frequently used.

The pharmaceutical option

The most commonly prescribed medications are called bisphosphonates. This class of drug slows the rate of bone growth.

Pain management

Depending on the amount of pain, doctors will advise you to take over-the-counter pain killers that you can find at a pharmacy or prescription medication, keeping in mind that opioid-based medications can be addictive.

Surgery

Typical surgery involves cutting away bone masses or realigning them to reduce pain. It call also a replacement of bone when the original bone structure is too compromised to perform its expected functions.

Some Important Reminders

 Every visit to see your physician should have a goal or, perhaps, two or three goals, that you want to accomplish. Make sure you get your goals for that visit met.

Bring a pad of paper and a pen, not just to write down the answers your doctor gives you, but also to write questions in advance so you don’t forget them.

 It is often helpful to bring someone else with you to sit in on the exam or the interview or both. Bringing a spouse, significant other or adult offspring can not only give you a broader perspective on the visit, but they can also calm you down if the visit is anxiety-provoking.

Make sure you are clear on any new medicine or procedure. You should be aware of the reasons for a decision and the procedures involved. When it comes to a new medicine, ask about side effects and possible adverse reactions of combinations of medicine you may be taking.

And remember: In Tempe, Arizona, dial (486) 449-FXRX for an appointment to treat sports-related injuries and all other orthopedics needs.

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What is Kyphosis?

By  aenriquez  published  August 27, 2020

Kyphosis is a seldom-occurring genetic disorder of the spine marked by a forward curvature in the upper back. Technically kyphosis is diagnosed for a spine with an upper back curvature of 50 degrees or greater. In comparison, a normal spine can bend between 20 and 45 degrees.

The spinal curve can develop simply from poor posture. If that is the case, it can often be treated with physical therapy. The outlook for improvement (the prognosis) for postural kyphosis is usually favorable.

A more serious version of kyphosis is called  Scheuermann’s Kyphosis. This occurs if the vertebrae that make up the bony infrastructure of your back develops in a wedge shape. While rare, the wedge shape of the vertebrae forces the patient to bend forward. The bony structure can worsen until you reach your adult size and have stopped growing.

Congenital kyphosis is often diagnosed at birth. While noticeable at birth, the curvature can increase until the child stops growing.

Causes of Kyphosis

There is more than one cause for Syphosis to develop. Metabolic issues could be the cause. Neuromuscular disorders can also cause the upper back to develop a forward curve. Osteogenesis imperfecta, a disease marked by brittle bones, can cause kyphosis. Spina bifida, poor posture, and Scheuermann’s kyphosis can cause kyphosis. The cause of Scheuermann’s kyphosis is unknown.

The condition of spinal osteoporosis can also cause a humpbacked condition. Osteoporosis is a natural condition that develops as we age. Our bones become brittle as we age. When this occurs in the spine, the vertebrae can crack from age or injury. If the front of the vertebrae weakens first, the vertebrae will lean forward and develop a wedged shape.

Symptoms

The symptoms of kyphosis can be subtle or pronounced. The common symptoms are:

  • back pain
  • hamstring pain in the back of your thigh
  • a noticeable hump, especially when bending forward
  • comparing left and right, shoulders or shoulder blades form at different heights
  • a head tilted forward

Diagnosis

           The most common test used to diagnose kyphosis is an X-ray. This allows doctors to get a look at your bony structures. Doctors can then check to see how severe the curve of your spine might be.

Treatment

For severe cases of youth who have kyphosis, surgery may be recommended. This likely will involve vertebrae fusion, which binds neighboring vertebrae with the help of surgical screws. The operation can take several hours and will include the help of a neurophysiologist, who will observe closely to ensure the screws do not interfere with the spinal cord.

Alternative options for less severe cases could involve a combination of pain medication and physical therapy or exercises to strengthen muscles in the back or abdomen.

Braces are also prescribed. While this is a non-evasive technique, the improvements for growing children can be pronounced. Surgery is always considered a last resort measure taken if other options fail.

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Hip Dislocation

By  aenriquez  published  August 18, 2020

A dislocated hip can be a very painful experience that requires medical intervention as soon as possible. The hip joint is located where the femoral end of the thighbone is joined to the hipbone socket. When the bone is dislocated it is pushed or forced out of the socket, most often the result of a collision between the knee and something hard – the ground, a wall, the helmet of another football player, and any number of other situations. A dislocation is also common after a car crash, as the knee is pushed fast at the dashboard, pushing the thighbone out of place.

Except for a bone fracture of some kind, however, any joint dislocation, from a medical point of view, is focused on ligaments, tendons, and other soft tissue that is damaged when the bone is dislocated. Flexible soft tissue, such as a ligament, can be overstretched and tear when a joint is pushed out of place.

Symptoms

  • Groin pain
  • Leg pain or numbness
  • Overheated skin (from swelling underneath)
  • Numbness in the feet

What to do …

Your physician at FXRX will first order X-rays or use another imaging machine to get a look at your hip socket. After that, you may be mildly sedated while the physician manipulates the thighbone back into place. One that is done – that step is called a reduction – the main concern will be healing the soft tissue that held the joint together in the first place.

The aim, of course, is to have the healing take place without long-term damage. This may take some time, as ligaments can be slow to heal. Part of the reason for the slow healing is the point that you will likely be moving your hip as soon as possible.

Talk to a physician at FXRX to find the right hip brace mean to immobilize a hip joint while it heals. It is unlikely you will re-injure the hip in the same manner, but in the early stages of healing your soft tissue will not be as strong as before, leaving you vulnerable to a repeated incident, although certainly, your doctor is trying to reduce the odds on that as much as possible.

If X-rays reveal considerable damage to ligaments in the area, your physician might suggest an arthroscopy procedure. This is considered a minimally invasive operation that requires a very small incision and insertion of very small equipment that can allow the physician to see your soft tissue structure and how much damage has been done.

 During an arthroscopy procedure, the physician can also insert medical devices that manipulate ligaments directly to repair the damage done.

Healing from a hip dislocation can take several months with movement range growing slowly but surely. You can work with a physical therapist to learn how to get around despite this injury. A brace may be recommended and a physical therapist can help you learn how to put one on and make use of it.

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Shoulder Arthritis Treatments

By  siteadmin  published  August 4, 2020

Experiencing shoulder pain when performing daily tasks, such as while brushing your hair or putting on your coat, can be a sign that you need to see an orthopedic specialist. Arthritis in the shoulder is a common cause if shoulder pain and it can lead to stiffness, pain, swelling, and poor quality of life.

Shoulder Arthritis

Arthritis refers to the degeneration of joint cartilage. As the cartilage wears out, it can cause pain, limit your range of motion, and prevent you from carrying out your daily activities, such as household chores. The damaged cartilage makes the bones grind against each other, leading to pain and other symptoms.

Treatment Options for Shoulder Arthritis

Should arthritis treatment include both conservative and invasive options.

Conservative treatments include –

  • activity modification to reduce stress on the shoulder by reducing movements that cause pain
  • heat and ice to relieve pain and inflammation

In severe cases, invasive or surgical treatment may be necessary to relieve pain and improve functional movement. These may include –

  • Arthroscopy – Arthroscopic surgery involves inserting a small camera inside the shoulder joint to look at and repair the shoulder tissue. Only two small incisions are needed. Removal of loose cartilage and bone can help in reducing shoulder pain and irritation.
  • Cartilage Transplant – The cartilage around the joint can be replaced with healthy cartilage from a healthy joint or a non-articulating joint, or a donor. This is done to stimulate growth of new cartilage.
  • Microfracture – Microfracture treatment involves removing the damaged cartilage and drilling holes into the bone marrow. This can activate stem cells to stimulate growth of new cartilage.
  • Joint Replacement – Joint replacement surgery is done to replace the head of the humerus and the shoulder socket with an implant to reduce pain and inflammation.
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Blood Clots – No Concern Or Scary?

By  aenriquez  published  July 23, 2020

Blood clots, which are diagnosed as Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE) are a very dangerous condition that can lead to heart attack, stroke, and damage to the lungs. If large enough, the PE type of blood clot can block blood from getting to your lunges, which causes your lungs to fail, which is quickly fatal.

The more optimistic news from a medical point of view is that DVT blood clots can be treated if caught in time, as doctors can prescribe medication that lowers blood viscosity, which can help dissolve the blood clot. Secondly, there are a variety of steps you can take to reduce the chances of developing a blood clot. And, more good news, you can discuss with your physician the option of having surgery to remove the blood clot.

DVT types of blood clots usually occur in deep veins in the legs, the pelvis, and sometimes in the arm. The danger of clots is that they can starve tissues of blood flow, which provide oxygen, nutrients, and other necessities to various parts of the body. A large clot that reaches blocks off blood flow to your lungs can result in long-term damage to your lungs or it can be quickly fatal if blood flow comes to a halt.

That said, while chances of survival have improved with modern medicines and techniques, between 33 percent and 50 percent of persons who develop a DVT are expected to develop complications from the DVT event. These complications include damage to the veins – most critically to valves in the vein – that creates a condition called post-thrombotic syndrome. This condition can include painful swelling, water retention, pain, and discoloration.  It can also create changes in your skin, most often with dry scaly skin, and with internal ulcers.

Risk factors

Besides the other complications that come with a DVT event, there is the bad news that a DVT event also puts you at higher risk for future DVT incidents. Other risk factors include”

A physical injury to a vein precipitated by a bone fracture, a muscle injury, surgery and other events that cause internal scarring

Slow blood flow precipitated by long episodes of staying in bed (while healing from various ailments or other reasons) limited movement caused by having to wear a cast, for example, and paralysis. Also, sitting for long periods with your legs crossed can increase your risks.

Various chemotherapy treatments for cancer

  • High levels of estrogen over long periods (often by taking birth control pills)
  • Heart disease
  • Lung diseases, such as emphysema
  • Lower bowel diseases (such as Crohn’s disease)
  • Family with a history of DVT
  • Obesity
  • A sedentary lifestyle
  • Age (the older you become, the higher your risk
  • Use of prostheses, such as a stent for your heart or a catheter place close to a deep vein

Lowering Your Risk of A DVT

Let’s see if we can balance out the risk factors with a list of risk reducers. Some lifestyle changes help lower your risk of DVT. Here are a few. Ask your doctor for other recommendations.

After confinement either sitting or lying for long periods, while recovering from surgery, for example, get up and move around as soon as you can. Get that blood flowing as they say – only now it’s for real. Get that blood flowing!

Wear what is called a graduated compression stocking that promotes better blood flow

Exercise, especially after an extended period sitting (in your car, for example). It is recommended that you take a break every two hours and stimulate blood flow with a vigorous walk for ten minutes or so. If that’s too stringent, walk for five minutes … or walk every three hours. You get the idea.

  • Loose weight
  • Stop smoking
  • Cut back to safe levels of alcohol intake

Find exercises you can do while sitting at a computer or watching television. For example, do 20 toe lifts followed by 20 heel lifts. Repeat that often. Sitting still promotes DVT events, while movement reduces your risk.

Symptoms

A PE event (pulmonary embolism) can hit quick and creates a very critical medical emergency. Like having a stroke or a heart attack (both of which can be brought on by a blood clot) a PE event is one of the top causes of sudden death.

While the symptoms are also critical, being aware of the symptoms might help you remember to get medical attention as quickly as possible. The symptoms to look for include:

  • Shortness of breath
  • Chest pain
  • Swelling
  • Redness of the skin

A fast or irregular heartbeat (as your heart struggles to get enough oxygen for itself and other tissues.

For top injury care in the Tempe, Arizona, area, call the FXRX clinic for an appointment. Dial 480-449-FXRX.

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Treating Shoulder Injuries with Arthroscopic Surgery

By  siteadmin  published  July 13, 2020

The shoulder is the most mobile joint in the body and that leaves it vulnerable to injuries. While conservative, non-surgical treatment options, such as rest, anti-inflammatory medications, and physical therapy are able to treat a number of shoulder injuries, serious shoulder injuries may require surgery, especially if they do not respond to nonsurgical treatment options.

Arthroscopic shoulder surgery is an advanced and effective surgical procedure that causes less post-operative pain and allows a quicker recovery. This is different from earlier surgeries that were performed using a large open incision.

Shoulder arthroscopic procedures can treat a large number of shoulder conditions and injuries. Here are 2 common injuries that can benefit from shoulder arthroscopic surgery.

Rotator Cuff Repair

The rotator cuff is a group of four muscles and tendons that attach to the top of the shoulder. The rotator cuff is an important structure because it allows you to raise, rotate and keep your shoulder stable.

A partial or complete rotator cuff tear is a severe injury that requires urgent medical attention. Your orthopedic surgeon can diagnose a rotator cuff tear and prescribe a treatment plan.

Most rotator cuff repairs can be performed arthroscopically. The procedure involves –

  • A few, tiny incisions are made
  • The damage is visualized with the help of a tiny, arthroscopic camera inserted through an incision
  • Tiny instruments and sutures anchors are used to repair the tear and attach the tendon to the bone
  • The incisions are closed and dressed
  • The shoulder is placed in a sling

Total procedure time usually takes an hour. Physical therapy after surgery is a critical part of recovery because it helps the patient regain shoulder strength and flexibility.

Labrum Repair

The labrum is a ring of soft tissue on the outer edge of the glenoid cavity. It holds the head of the humerus (upper arm bone) in the glenoid cavity and stabilizes the shoulder. A torn labrum is a serious injury because it may cause shoulder instability and even shoulder subluxations or dislocations.

A torn labrum may have to be arthroscopically surgically repaired, which involves –

  • 2-3 tiny shoulder incisions
  • An arthroscopic camera is inserted into the joint to visualizethe torn labrum
  • Through the other incisions, tiny instruments and sutures are inserted to repair the damage and attach the labrum to the glenoid cavity
  • Incisions are closed and dressed and the shoulder is placed in a sling

The total surgery time is aboutan hour, depending on the severity of the tear. Physical therapy after surgery is critical because it helps to stretch the shoulder muscles, ligaments and tendons.

The signs of rotator cuff tears and labrum tears include –

  • Difficulty lifting or raising the arm
  • Instability
  • Pain
  • Subluxation/Dislocation
  • Stiffness
  • Swelling
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Concussions Hit Hard – Take Precautions

By  aenriquez  published  July 2, 2020

Concussions sustained while participating in sports, especially in contact sports, has been a frequent topic for news media outlets in recent years. This occurred after it was discovered that many former professional football players were suffering from devastating effects of chronic traumatic encephalopathy, which occurs after repeated concussions inflicted. 

 

Thankfully, many coaches and medical assistants associated with sports teams have been trained to recognize symptoms of a mild concussion. New rules are also in place in sports leagues open to younger players to prevent repeated head injuries. Many sports organizations that have oversight over various sports have issued rules that say no athlete who suffers a concussion can be allowed back onto the field of play unless first cleared by a qualified neurologist or physician.

 

Chronic traumatic encephalopathy is a degenerative disorder that develops from repeated concussions. It is caused by Tau protein clumps that form in the brain and spread over time, killing brain cells as it spreads. As such, parents or guardians, coaches, and medical staff should be on the lookout for symptoms of concussions, mild, modest, or severe.

 

Primary symptoms

 

The primary symptoms of a concussion include headache, dizziness, changes in vision, sensitivity to light, slow reaction times with any mental activity (including counting, holding a conversation, and anything that involves memory).

In addition, concussions can show up as confusion or disorientation, slurred speech and nausea or vomiting. Ringing in the ears is common and, among children, uncharacteristic crying and mood swings can occur. Fatigue is also a potential symptom. 

 

Public Awareness

 

Public awareness concerning chronic traumatic encephalopathy has risen in recent years starting, tragically with numerous suicides and cognitive disorders among retired professional football players. However important such awareness is, the public is often fed erroneous information about concussions through popular entertainment. Adventure movies are filled with fights that end with someone (or many people) “knocked out.” Yet there is no follow-through that warns the public that being “knocked out,” in a movie fistfight has zero accountability. Knocking someone out in the movies is considered normal, common, and unimportant. This should not be the case in real life. 

 

Treatment

 

Severe or repeated concussions can cause permanent brain damage, which is why even mild concussions must be taken very seriously. Multiple concussions can result in a chronic problem.

For mild to moderate concussions, the symptoms will likely fade away in seven to 10 days. In the meantime, the counter anti-inflammatory, such as ibuprofen and naproxen can help. Anyone recovering from a concussion should also reduce the time spent watching television, video games, or computer screens and get plenty of rest.

The most important tip involving concussions, however, is to avoid strenuous activities, especially one that could result in another blow to the head. Never participate in sports until the concussion has fully healed and the return to sports is cleared by your doctor.

 

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