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.
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.
Riding a bicycle is one of the most pleasant and appealing global
pastimes. In the minds of many, bicycling ranks right up there with taking a
nap and hiking in the woods among the most pleasant activities.
A pedal bicycle is quiet, gets you where you want to go, and is a
terrific exercise for staying in shape and getting in those cardio minutes that
your doctor recommends.
But bicycling does involve serious risks for mishaps and injuries based
on overuse of a particular muscle group. As far as mishaps go, sadly, the
American Family Physicians organization notes that bicycling is second in a
list of most dangerous activities, following No. 1, which is riding animals as
a sport. Bicycling accounts for approximately 900 deaths per year in the United
States and accounts for 23,000 hospital admissions, 580,00 emergency room
visits, and 1.2 million appointments with family physicians each year.
Yes, this is the activity that brings to mind bucolic scenes of bicycle
riders in the 1800(s) and reminds of us of that playfully romantic song, “A
Bicycle Built for Two.”
There are risks in any sport, but bicycling has numerous risk factors,
some of which are behavioral and some of which are circumstantial. That said,
you can change your behavior by wearing a helmet. But most of us do not change
genders and males are more likely to have a bicycle accident than females. Here
is a list of risk factors. Pay special attention to the risk factors you can
change:
Circumstantial Risk Factors
Men are more likely than females to get into a bicycle accident
Cyclists are between the ages of 9 to 14 have a higher risk
Riding over unsafe ground, such as riding on ice or mountain biking
An automobile is involved
Cyclist has a pre-existing condition
Bicyclist is from an unstable family life
In contrast, here are some behaviors that you can change to reduce your risk of getting into an accident or sustaining a dangerous injury:
Wearing a helmet, which is required by law in some places
Riding while intoxicated
Bicycling in early mornings or late evenings – essentially, this refers to bicycling when sunlight is apt to be glaring or dim
Riding without reflective warning lights on a bicycle
Bicycling when tired
Bicycling when under the influence of medicinal or non-medicinal drugs.
Riding at high speeds downhill or otherwise
Trying to perform trick while riding
Common Injuries
Of course, there are specific injuries involving bicycles, which
include strained muscles and sprained tendons. The most common areas for
inflammation to build up from overuse injuries are in the lower back and the
knee. Neck strains are also common due to holding your head up while leaning
forward for long periods.
Minor injuries include chafing, sore muscles, and sunburn.
Final Words
At the start of the biking season, many people try to bike more miles than they are used to. Remember to start slow and work up your stamina from there. Consult your doctor on what your limitations might be. Then get out there and stay safe and have fun.
It is safe to
say that stretching before you exercise is one of the most under-appreciated
health tips. Yes, it’s popular to establish a cardio-style exercise regime.
Yes, it’s helpful to improve muscle tone by lifting or with other isometric
practices. But stretching? Who has time for that?
The fact is,
that athletic-looking man or woman in the parking lot who is walking on
crutches or that great tennis player you watched at the courts with two knee
braces to keep him going is often someone who did not stretch before going full
force in their chosen sport. In addition, many people who stretch will tell you
they do so because they suffered a ligament tear in high school or the doctor
warned them their knee would “blow out” again if they didn’t take
proper care of themselves.
Of course, you
can stretch properly and still get hurt. You can ignore stretching and get
lucky, working out hard without injury. But you are still raising risks by not
stretching before your workout. Here’s why.
BENEFITS OF STRETCHING
Makes tasks easier
Increased
flexibility simply makes it easier to perform in any sport. Furthermore, going
hard in any sport can make muscles and ligaments tighten, rather than gain
flexibility, according to the Mayo Clinic. So, why risk injury or a compromised
performance?
Improves range of motion
An approved
range of motion is also why some tasks are easier when you stretch first. You
can reach further, run easier, and extend yourself a bit more when you stretch
regularly. Have you ever noticed how you can climb a set of stairs much easier
after you stretch?
Better posture
Having good
posture can be compared to the balance you need to ride a bicycle. When you are
in balance, the bike seems to have no weight. When you are off-balance, then
you realize how much the bicycle weighs.
The same can
be said for better posture. You can run faster and react quickly when you have
the correct posture. Also, the correct posture will translate to less wear and
tear progression on your joints.
Better circulation
Your
cardio-vascular system pumps oxygen to the many parts of your body. Oxygen is
transferred from the atmosphere to your blood supply by your lungs. You also
need to exhale carbon dioxide.
Needless to
say, your cardio-vascular system is critical for all human movement and
survival. When you exercise, of course, you breathe harder, because your body
needs more oxygen when you work out. Stretching helps by getting your heart
pumping at a higher rate before you start running hard.
Some Tips On Stretching
There are two
basic styles of stretching. One is called “dynamic” stretching. This
involves stretching in a more aggressive style – stretching by exercising
lightly or “bouncing” as you stretch.
The other
style of stretching is called “static ” stretching. This style
involves no bouncing, only pulling gently on muscles and ligaments. With static
stretching, you stretch in one direction gently and keep up the pressure for a
moment or two.
Leg stretches
while sitting with your legs stretched out in front of you and bending forward
is a form of static stretching, while running in place would be seen as dynamic
stretching.
Thirty Seconds
Stretching a
muscle group gently but firmly is recommended for static stretching, widely
viewed as the correct style for most of us. It is also recommended that you
hold each stretch for 30 seconds, then relax and repeat the stretch several
times.
Pain-free
If the stretching
causes you pain, you have gone too far. Ease back and aim for pain-free stretching.
If the pain persists or reduces your functioning significantly, discuss the
matter with your physician.
It has been postulated, casually and
clinically, that there will be a sudden rise in childbirths nine months after
the initial COVID-19 lockdown date in each country. If this is true,
congratulations are in order. However, one study has shown that 37.1 percent of
pregnant women experience some degree of discomfort from symphysis pubis
dysfunction, an ailment that also affects men and non-pregnant women.
Symphysis pubis discomfort is the name
given to a condition marked by pain in the symphysis pubis joint, which is
where the two pelvis bones meet in the front of the pelvis. This joint is held
together by a dense pattern of ligaments, which can become stretched and
strained. When this occurs, the discomfort can be anywhere from mild to severe.
Symptoms of Symphysis Pubis Dysfunction
Pain in the pelvic region, which can be mild to severe. Clicking noise in the pelvis while in motion occasionally appears
Difficulty walking or maintaining proper posture when walking
Incontinence can develop.
Difficulty urinating can also occur.
Diagnosing Symphysis Pubis Dysfunction
Doctors begin diagnosing symphysis pubis
dysfunction or SPD by reviewing the patient’s medical history and through a
one-on-one discussion. Frequently,
ultrasounds are given to assess the problem. In addition, X-ray images can be
used to diagnose SPD, but this is not recommended for pregnant women.
Symphysis Pubis Dysfunction and Pregnancy
Pregnancy can cause SPD and occurs in
higher rates among pregnant women who were obese before they became pregnant.
It is also prevalent in men or women who experienced lower back pain in the
past.
The
health of the fetus is not affected by PSD, although it could be a factor in
the decision of how to deliver the child. Women with PSD should discuss this
with their obstetrician and/or their primary physician.
One option for pregnant women with PSD is
to wear a supportive belt that takes some of the pressure off the woman’s
pelvic bones. This can reduce discomfort if worn for the prescribed duration.
Another study reported that 20 percent of those with PSD experience bouts of
severe pain.
What Can You Do? Treatment Options
There are several steps you should review
with your physician. These include several options you can try at home to
reduce distress from PSD.
Chiropractic sessions help in some cases
Massage therapy can help in some cases
Stretching. Doctors often recommended an
exercise that involves lying on your back with knees bent and feet flat on the
floor. The patient then tightens the stomach muscles and the gluteal muscles in
20-second intervals. The process is repeated 10-20 times.
Putting a pillow between legs while asleep
Avoid long periods of sitting
Rest
Supportive shoes help in some cases
Kegel exercises
Keep knees together when standing from a sitting position to reduce discomfort
The COVID-19 lockdown has reminded many of
us that you don’t need New Year’s Eve to establish new priorities in your life.
Many people have re-established their connections to nature, taking long walks
that may have faded from memory before the crisis began. Others have dusted off
their neglected home exercise equipment dedicated an hour a day to get in
shape.
However, with and without lockdown
measures, modern lives are busy. We fill
up the day with work, chores, projects, cooking, and time-erasing entertainment.
So, how do you maintain a healthy workout routine when your life seems too busy
to do so?
Here are some tips for starting an exercise
routine or sneaking one in when your life seems to busy to do so.
One strategy involves becoming more
efficient in your exercise style. Often recommended are styles called interval
training or a similar strategy called Tabata training. There is also a popular
option known as the Seven-Minute Workout.
Interval training
This style of training combines various exercises.
A very common form of this is a jogging path that also includes chin-up bars,
rope climbs, and other options.
Tabata training
This is similar to interval training. With
this style, you combine two times of exercises, say pushups combined with jumping
jacks. You do jumping jacks for 20 seconds, then take a 10-second rest and then
do the pushups for 20 seconds. After a few cycles of this, you switch to two
other exercises, still keeping with the 20 second/10 second routine.
Seven-Minute Workouts
This routine involves doing twelve
different activities for 30 seconds then taking a 10-second break between each
one. The specific exercises can vary, but one standard seven-minute routine
includes jumping jacks, wall sits, push-ups, abdominal crunches, step-ups using
a chair, squats, triceps dips using a chair, plank, running in place with high
steps, lunges, push-ups with rotations and side planks.
Other tips:
Do what you love
If you find it difficult to even think of
exercising, try getting a workout through something you love. Maybe you enjoy a
game of tennis. As long as you exercise at least three times a week, you should
be all right.
Take any Motivation you can find
Don’t worry about motivation. Anything that
works is perfectly acceptable. Maybe you just enjoy the company you can find at
the gym. If that helps get you there, don’t argue with it. Say thanks and get
to the gym.
Make a Schedule
Some people need a routine they can stick
to. If so, put exercise down as a priority and don’t let other distractions
derail your routine.
Stairs Instead of Elevators
This idea involves more than just avoiding
elevators when possible. There are many ways to include exercise in your daily
life. Try parking at the farthest reaches of the parking lot rather than
parking as close to the store as possible.
If you are just beginning an exercise regime and need advice, call the FXRX clinic in Tempe, Arizona, for an appointment. Dial 480-449-FXRX.
