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.
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.
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.
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.
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.
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.
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.
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.
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 –
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.
