Knee Re-Alignment (OSTEOTOMY) What you need to know!

Osteotomy literally means “cutting of the bone.” In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint.

Knee osteotomy is commonly used to realign your knee structure if you have arthritic damage on only one side of your knee. The goal is to shift your body weight off the damaged area to the other side of your knee, where the cartilage is still healthy. When surgeons remove a wedge of your shinbone from underneath the healthy side of your knee, the shinbone and thighbone can bend away from the damaged cartilage.

Imagine the hinges on a door. When the door is shut, the hinges are flush against the wall. As the door swings open, one side of the door remains pressed against the wall as space opens up on the other side. Removing just a small wedge of bone can “swing” your knee open, pressing the healthy tissue together as space opens up between the thighbone and shinbone on the damaged side so that the arthritic surfaces do not rub against each other.

Knee osteotomy is most commonly performed on people who may be considered too young for a total knee replacement. Total knee replacements wear out much more quickly in people younger than 55 than in people older than 70. Because prosthetic knees may wear out over time, an osteotomy procedure can enable younger, active osteoarthritis patients to continue using the healthy portion of their knee. The procedure can delay the need for a total knee replacement for up to ten years.

 

Why it’s done

Slick cartilage allows the ends of the bones in a healthy knee to move smoothly against each other. Osteoarthritis damages and wears away the cartilage — creating a rough surface.

When the cartilage wears away unevenly, it narrows the space between the femur and tibia, resulting in a bow inward or outward depending on which side of the knee is affected. Removing or adding a wedge of bone in your upper shinbone or lower thighbone can help straighten this bowing, shift your weight to the undamaged part of your knee joint and prolong the life span of the knee joint.

Osteoarthritis can develop when the bones of your knee and leg do not line up properly. This can put extra stress on on either the inner (medial) or outer (lateral) side of your knee. Over time, this extra pressure can wear away the smooth cartilage that protects the bones, causing pain and stiffness in your knee.

(Left) A normal knee joint with healthy cartilage. (Right) Osteoarthritis that has damaged just one side of the knee joint.

Advantages and Disadvantages

Knee osteotomy has three goals:

  • To transfer weight from the arthritic part of the knee to a healthier area
  • To correct poor knee alignment
  • To prolong the life span of the knee joint

By preserving your own knee anatomy, a successful osteotomy may delay the need for a joint replacement for several years. Another advantage is that there are no restrictions on physical activities after an osteotomy – you will be able to comfortably participate in your favorite activities, even high impact exercise.

Osteotomy does have disadvantages. For example, pain relief is not as predictable after osteotomy compared with a partial or total knee replacement. Because you cannot put your weight on your leg after osteotomy, it takes longer to recover from an osteotomy procedure than a partial knee replacement.

In some cases, having had an osteotomy can make later knee replacement surgery more challenging.

The recovery is typically more difficult than a partial knee replacement because of pain and not being able to put weight on the leg.

Because results from total knee replacement and partial knee replacement have been so successful, knee osteotomy has become less common. Nevertheless, it remains an option for many patients.

Procedure

Most osteotomies for knee arthritis are done on the tibia (shinbone) to correct a bowlegged alignment that is putting too much stress on the inside of the knee.

During this procedure, a wedge of bone is removed from the outside of the tibia, under the healthy side of the knee. When the surgeon closes the wedge, it straightens the leg. This brings the bones on the healthy side of the knee closer together and creates more space between the bones on the damaged, arthritic side. As a result, the knee can carry weight more evenly, easing pressure on the painful side.

In a tibial osteotomy, a wedge of bone is removed to straighten out the leg.

Tibial osteotomy was first performed in Europe in the late 1950s and brought to the United States in the 1960s. This procedure is sometimes called a “high tibial osteotomy.”

Osteotomies of the thighbone (femur) are done using the same technique. They are usually done to correct a knock-kneed alignment.

 

Candidates for Knee Osteotomy

Knee osteotomy is most effective for thin, active patients who are 40 to 60 years old. Good candidates have pain on only one side of the knee, and no pain under the kneecap. Knee pain should be brought on mostly by activity, as well as standing for a long period of time.

Candidates should be able to fully straighten the knee and bend it at least 90 degrees.

Patients with rheumatoid arthritis are not good candidates for osteotomy. Your orthopaedic surgeon will help you determine whether a knee osteotomy is suited for you.

Read More About Eligibility for Knee Osteotomy

Your Surgery

Before Surgery

At most medical centers, you will go to “patient admissions” to check in for your outpatient arthroscopic surgery.

After you have checked in to the hospital or clinic, you will go to a holding area where the final preparations are made. The paperwork is completed and your knee area may be shaved (this is not always necessary). You will wear a hospital gown and remove all of your jewelry.

You will meet the anesthesiologist or anesthetist (a nurse who has done graduate training to provide anesthesia under the supervision of an anesthesiologist). Then, you will walk or ride on a stretcher to the operating room. Most patients are not sedated until they go into the operating room.

Here are some important steps to remember for the day of your surgery:

  • You will probably be told not to eat or drink anything after midnight on the night before your surgery. This will reduce the risk of vomiting while you are under general anesthesia.
  • Wear a loose pair of shorts or sweatpants that will fit comfortably over your knee bandage when you leave the hospital.

Take it easy. Keeping a good frame of mind can help ease any nerves or anxiety about undergoing surgery. Distractions such as reading, watching television, chatting with visitors, or talking on the telephone can also help.

 

Surgical Procedure

A knee osteotomy operation typically lasts between 1 and 2 hours.

Your surgeon will make an incision at the front of your knee, starting below your kneecap. He or she will plan out the correct size of the wedge using guide wires. With an oscillating saw, your surgeon will cut along the guide wires, and then remove the wedge of bone. He or she will “close” or bring together the bones in order to fill the space created by removing the wedge. Your surgeon will insert a plate and screws to hold the bones in place until the osteotomy heals.

This is the most commonly used osteotomy procedure, and is called a closing wedge osteotomy.

After the wedge of bone is removed, the tibia may be held in place with a plate and screws.

In some cases, rather than “closing” the bones, the wedge of bone is “opened” and a bone graft is added to fill the space and help the osteotomy heal. This procedure is called an opening wedge osteotomy.

After the surgery, you will be taken to the recovery room where you will be closely monitored as you recover from the anesthesia. You will then be taken to your hospital room.

After Surgery

Recovery Room

Following a knee osteotomy, you usually stay in the recovery room for at least two hours while the anesthetic wears off.

This procedure typically causes significant pain. You will be given adequate pain medicine, either orally or through an IV (intravenous) line, as well as instructions for what to do over the next couple of days.

Your knee will be bandaged and may have ice on it. You may have significant pain early on and you should take the pain medicine as directed. Remember that it is easier to keep pain suppressed than it is to treat pain once it becomes present, so ask the nurse for medication when you feel pain coming on.

You should try to move your feet and ankles while you are in the recovery room to improve circulation.

Your temperature, blood pressure, and heart rate will be monitored by a nurse, who, with the assistance of the doctor, will determine when you are ready to leave the hospital or, if necessary, be admitted for an overnight stay. Most patients remain in the hospital for two to four days following an osteotomy.

After knee osteotomy, you usually are taken to a hospital room where nurses, anesthesiologists, and physicians can regularly monitor your recovery. Most patients spend two to four days recovering in the hospital.

As soon as possible after surgery is completed, you will begin doing continuous passive motion exercises while in bed. Your leg will be flexed and extended to keep the knee joint from becoming stiff.

This may be done using a continuous passive motion (CPM) machine. The CPM is attached to your bed and then your leg is placed in it. When turned on, it takes your leg through a continuous range of motion.

There will likely be pain, and you can expect to be given pain medication as needed. Ice also helps control pain and swelling.

For two or three days after surgery, you may experience night sweats and a fever of up to 101. Your physician may suggest acetaminophen, coughing, and deep breathing to get over this. This is common and should not alarm you. The incision usually starts to close within six days and the bandage can be removed. Physicians commonly fit you with a knee brace that may allow a limited range of movement and helps push your knee into the correct position. For a high tibial osteotomy, the knee brace pushes your knee inward, making you slightly more knock-kneed. Please note that some surgeons will cast your knee for 4 to 6 weeks to ensure that the osteotemy heals.

You may be able to put some weight on your knee, but physicians usually prescribe crutches for at least six weeks. You will be given a prescription for pain medication and usually schedule a follow-up visit sometime around six weeks after surgery.

You will most likely need to use crutches for several weeks.

About 6 weeks after the operation, you will see your surgeon for a follow-up visit. X-rays will be taken so that your surgeon can check how well the osteotomy has healed. After the follow-up, your surgeon will tell you when it is safe to put weight on your leg, and when you can start rehabilitation.

During rehabilitation, a physical therapist will give you exercises to help maintain your range of motion and restore your strength.

You may be able to resume your full activities after 3 to 6 months.

Read More About: Knee Osteotomy Recovery

Rehabilitation

Most patients can begin physical therapy around six to eight weeks after surgery. Unlike other surgical treatments for arthritis, osteotomy relies on bone healing before more vigorous, weight bearing exercises in the gym can begin. In the best scenario, people respond to strengthening exercises and stop wearing the brace after the first three to six months of therapy.

Light exercise is one of the most effective ways to relieve arthritis pain by stimulating circulation and strengthening the muscles, ligaments, and tendons around your knee. Strong muscles take pressure off the bones so there is less grinding in the knee joint during activities. In conjunction with a healthy diet, exercise can also help you lose weight, which takes stress off your arthritic knee.

Stretching

In the first few weeks of rehabilitation, your physical therapist usually helps you stretch the muscles in the hamstrings, quadriceps, and calves while flexing and extending your knee to restore a full, pain-free range of motion.

Aerobic Exercise

When pain has decreased, physicians generally recommend at least 30 minutes a day of low-impact exercise a day for patients with arthritis. You should try to cut back on activities that put a pounding on your knees, like running and strenuous weight lifting.

Cross-training exercise programs are commonly prescribed when you have arthritis. Depending on your preferences, your workouts may vary each day between cycling, cross-country skiing machines, elliptical training machines, swimming, and other low-impact cardiovascular exercises. Walking is usually better for arthritic knees than running, and many patients prefer swimming in a warm pool, which takes your body weight off your knees and makes movement easier.

Strengthening

Strength training usually focuses on moving light weights through a complete, controlled range of motion. You should generally avoid trying to lift as much as possible with your quadriceps and hamstrings. Your physical therapist typically teaches you to move slowly through the entire movement, like bending and straightening your knee, with enough resistance to work your muscles without stressing the bones in your knee.

Once your physical therapist has taught you a proper exercise program, it is important to find time each day to perform the prescribed exercises.

Recovery at Home

You will likely feel pain or discomfort for the first week at home after an osteotomy, and you will be given a combination of pain medications as needed. A prescription-strength painkiller is usually prescribed and should be taken as directed on the bottle.

Swelling in your leg usually decreases over a span of three to six months after surgery. There may be some minor bleeding for a few days, but by the time you are released from the hospital, most bleeding should have stopped. If you notice an increase in swelling or bleeding, you should call your physician.

Physicians generally recommend that you avoid putting stress on your knee until the bones have healed. Putting weight on your knee too early may damage the bone surface and prolong healing time.

Here is what you can expect and how you can cope after an osteotomy:

  • Icing your knee for 20 or 30 minutes a few times a day during the first week after an osteotomy will help reduce pain. Ice therapy may need to intermittently continue for a few months if pain bothers you.
  • As much as possible, you should keep your knee elevated above heart level to reduce swelling and pain. It often helps to sleep with pillows under your ankle.
  • Immobilize your knee in the prescribed, hinged knee brace for about six weeks. You may remove the brace for brief periods to perform passive motion exercises with the aid of a physical therapist or a CPM machine. Range of motion exercises are important for healing. Regaining full extension is just as important as bending your knee.
  • Your leg may appear slightly bent after the surgery as it heals into its new alignment.
  • Most patients have to keep the incision dry for seven to ten days. Your physician can recommend a surgical supply store that sells plastic shower bags. Wait until you can stand comfortably for 10 or 15 minutes at a time before you take a shower.
  • Crutches or a cane may be needed for between six and ten weeks, depending on the pain. It is difficult to describe the amount of pain any given patient will experience.
  • Six weeks after surgery, your physician usually gives you a check-up. X-rays can determine how your bones are healing and whether you are ready to begin rehabilitation.

You may have to take between six weeks and six months off from work, depending on how much you rely on your knee to perform your job.

Prevention

After rehabilitation, preventing osteoarthritis is a process of slowing the progression and spread of the disease. Because patients remain at risk for continued pain in their knees after treatment, it is important they are proactive about managing their conditions.

A fall or torque to the leg during the first two months after surgery may jeopardize the healing of your bones. You should exercise extreme caution during all activities, including walking, until your physician determines that your bones have healed.

Maintaining aerobic cardiovascular fitness has been an effective method for preventing the progression of osteoarthritis. Light, daily exercise is much better for an arthritic knee than occasional, heavy exercise.

When you have arthritis in your knees, it is especially important to avoid suffering any serious knee injuries, like torn ligaments or fractured bones, because arthritis can complicate knee injury treatment. You should avoid high-impact or repetitive stress sports, like football and distance running, that commonly cause severe knee injuries. Depending on the severity of your arthritis, your physician may also recommend limiting your participation in sports that involve sprinting, twisting, or jumping.

Because osteoarthritis has multiple causes and may be related to genetic factors, no simple prevention tactic will help everyone avoid increased arthritic pain. To prevent the spread of arthritis, physicians generally recommend that you take the following precautions:

  • Avoid anything that makes pain last for over an hour or two.
  • Perform controlled range of motion activities that do not overload the joint.
  • Avoid heavy impact on the knees during everyday and athletic activities.
  • Gently strengthen the muscles in your thigh and lower leg to help protect the bones and cartilage in your knee.

Non-contact activities are a great way to keeping joints and bones healthy and maintain fitness over time. Exercise also helps promote weight loss, which can take stress off your knees.

Osteotomy can relieve pain and delay the progression of arthritis in the knee. It can allow a younger patient to lead a more active lifestyle for many years. Even though many patients will ultimately require a total knee replacement, an osteotomy can be an effective way to buy time until a replacement is required.

If you are experiencing knee pain call one of our experts at TOCA at 602-277-6211!

#Recovery #Results #Relief #kneepain #painfree #DrYaco #TOCA #TOCAMD #DrPadley #DrLederman #DrCarter #MyOrthoDoc

TOCA Performs First Meniscus Replacements in Arizona with NUsurface® Meniscus Implant

The Orthopedic Clinic Association

 

Media Contacts: Merryman Communications for Active Implants
Joni Ramirez joni@merrymancommunications.com
323.532.0746

Lisa Paulson for TOCA (The Orthopedic Clinic Association)
602.512.8525
lpaulson@tocamd.com

TOCA (The Orthopedic Clinic Association) Performs First Meniscus Replacements in Arizona with NUsurface® Meniscus Implant

Phoenix Suns Physician Treats Local Resident with Persistent Knee Pain in SUN Clinical Trial

PHOENIX, Arizona – July 6, 2017 – TOCA (The Orthopedic Clinic Association), a one-stop resource for orthopedics in Arizona, and Active Implants, a company that develops orthopedic implant solutions, today announced that the first meniscus replacement procedures in Arizona were successfully performed by Dr. Tom Carter. TOCA is the only center in the state – and one of just 10 sites nationwide – enrolling patients with persistent knee pain caused by injured or deteriorating meniscus cartilage in the SUN trial, which is designed to assess the safety and effectiveness of the NUsurface® Meniscus Implant (pronounced “new surface”) in restoring function similar to that of a natural, healthy meniscus.

One of the first patients to receive the implant in Arizona was Robert Nowlan, a 55-year-old Anthem resident, who first tore his meniscus 17 years ago while hiking in the Grand Canyon. Although he underwent three surgeries and injection therapy to treat the injury, he experienced constant pain that limited his daily activity. Nowlan’s knee was consistently throbbing with pain whether he was walking, working or even sitting. The pain became so intense, he had to give up hobbies he loved like running, hiking and karate.

The meniscus is a tissue pad between the thigh and shin bones. Once damaged, the meniscus has a very limited ability to heal. Over 1 million partial meniscectomies to remove or repair a torn meniscus are performed in the U.S. every year, about the same as the total number of hip and knee replacement surgeries combined. However, many patients still experience persistent knee pain following meniscus surgery.

“There aren’t many options for patients who experience persistent knee pain following meniscus surgery,” said Dr. Tom Carter, orthopedic surgeon at TOCA. “We hope the NUsurface implant decreases or alleviates pain in these patients, helps them delay knee replacement surgery, and improves their level of activities.”

Nowlan received the NUsurface Meniscus Implant in October 2016 through a small incision in his knee and completed a six-week rehabilitation program. Eight months into his recovery, he is most looking forward to biking and hiking the Grand Canyon again with his family – but this time pain-free.

“My knee pain over the last 17 years had reduced my quality of life, as I was too young for knee replacement and had resigned myself to just living and working with constant pain,” Nowlan said. “A couple weeks after receiving the NUsurface Meniscus Implant, the knee pain I was used to living with was gone. It felt like I drank from the fountain of youth – I can finally walk around and do all the activities I’ve been missing out on.”

The NUsurface Meniscus Implant has been used in Europe under CE Mark since 2008 and Israel since 2011.

About the Clinical Trial
The SUN study (Safety Using NUsurface®) will enroll approximately 120 patients as part of regulatory process to gain approval from FDA to sell the device in the U.S. All patients who meet study requirements and agree to enter the trial are offered the NUsurface Meniscus Implant as treatment. Treatment with NUsurface in the SUN trial is eligible for coverage by Medicare and some private insurance companies. To be eligible for the study, participants must be between the ages of 30 and 75 and have pain after medial meniscus surgery that was performed at least six months ago. To learn more about the SUN study, please visit http://sun-trial.com or call (844) 680-8951.

About the NUsurface® Meniscus Implant
The NUsurface® Meniscus Implant is an investigational treatment for patients with persistent knee pain following medial meniscus surgery. It is made from medical grade plastic and, as a result of its unique materials, composite structure and design, does not require fixation to bone or soft tissues. The NUsurface Meniscus Implant mimics the function of the natural meniscus and redistributes loads transmitted across the knee joint. Clinical trials are underway in the U.S., Europe and Israel to verify the safety and effectiveness of the NUsurface Meniscus Implant.

About TOCA (The Orthopedic Clinic Association)
TOCA (The Orthopedic Clinic Association) has served the Valley with orthopedic care since it was founded in 1949. TOCA is a one-stop resource for orthopedics in Arizona, led by nationally recognized, established orthopedic physicians who are passionate about quality care. TOCA brings expertise in orthopedics and sports medicine, numerous sub-specialties, physical therapy and hand therapy. Each TOCA Physician brings their own passion and integrity to a common purpose, honoring TOCA’s mission statement: “Serving our Patients through Innovative and Comprehensive Orthopedic Care.” Our physicians and staff are dedicated to providing for each person’s needs and ensuring the highest level of care for a wide range of musculoskeletal conditions. For more information, visit https://tocamd.com/.

About Active Implants
Active Implants, LLC develops orthopedic implant solutions that complement the natural biomechanics of the musculoskeletal system, allowing patients to maintain or return to an active lifestyle. Active Implants is privately held with headquarters in Memphis, Tennessee. European offices are in Driebergen, The Netherlands, with R&D facilities in Netanya, Israel. For more information, visit www.activeimplants.com.

CAUTION Investigational device. Limited by United States law to investigational use.

Protect you and your Children from Injury this Fourth of July Holiday!

Protect you and your Children from Injury this Fourth of July Holiday: Celebrating our Independence with a Boom has been a tradition for many families for years over the July 4th Holiday season. Unfortunately every year thousands of children and adults are needlessly injured by not following basic fireworks safety tips. With the proper respect fireworks deserve, everyone can safely enjoy the show.

Children are most frequently injured by fireworks. Most are under the age of 15. You may think firecrackers or other types of explosive or rocket variety fireworks are most responsible for their injuries. In fact, the biggest risk of injury comes from sparklers. Sparklers account for roughly 16% of all firework related injuries. If you consider children alone, sparklers account for about 1/3 of all injuries and over half of the injuries to children under 5.

In order to prevent children from being injured by sparklers, it is important to consider following some very simple safety tips.

1. Never let children handle, light or play with sparklers without adult supervision.
2. Don’t let your child handle or light more than one sparkler at a time.
3. Don’t pass of a lit sparkler to someone else, have them hold the unlit sparkler while you light it.
4. Don’t hold your child in your arms while you or the child is using sparklers.
5. Keep your distance: its recommended children stay at least 6 feet apart from one another while handling sparklers.
6. Instruct your child to hold the sparkler away from their body keeping them at arm’s length.
7. Avoid waving the sparklers wildly through the air as children frequently lose hold of the sparkler causing injury to themselves or others around them.
8. Wear proper clothing and footwear. Many injuries occur when an burnt out sparkler is dropped on the ground causing foot burns or puncture wounds from stepping on them.
9. Once the sparkler flame goes out, the metal rod should be dropped directly into a bucket of water. The extinguished sparkler and metal rod remain hot for a long time.
10. Keep your fireworks out of the reach of children. Lock them up. Kids are creative and can easily find a source of fire to ignite fireworks, i.e. a lit candle.

Above all, use common sense, pay attention to children, and if alcohol is involved in an adult party with children, designate someone to remain sober and responsible while any and all fireworks are in use. Hopefully these simple tips can help you and your family avoid an unwanted trip to the emergency department, or worse yet, a permanent and disfiguring injury.

The Hand Surgeons at TOCA, as well as the rest of the Physicians and Staff with you and your family health and happiness as we celebrate with pride, our Independence Day.

To learn more or to schedule an appointment call our dedicated TOCA Team at: 602-277-6211!

#Recovery #Results #Relief #4thofJuly #IndependanceDay #FireworkSaftey #InjuryPrevention #4thofJulyInjuryPrevention #TOCA #TOCAMD

(TFC/TFCC) Triangular Fibrocartilage Complex Tear

WHAT IS A TFCC TEAR?
The triangular fibrocartilage complex (TFCC) is a cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist. The TFCC keeps the forearm bones (radius and ulna) stable when the hand grasps or the forearm rotates. An injury or tear to the TFCC can cause chronic wrist pain.

There are two types of TFCC tears:
1. Type 1 tears are called traumatic tears. Falling on an outstretched hand and excessive arm rotation are the most common causes.
2. Type 2 TFCC tears are degenerative or chronic. They can occur over time and with age. The degenerative process wears the cartilage down over time. Some inflammatory disorders, such as rheumatoid arthritis or gout, may also contribute to Type 2 TFCC tears.

WHAT ARE THE SYMPTOMS OF A TFCC TEAR?
• Common symptoms of a TFCC tear include:
• Pain, at the base of small finger side of the wrist
• Pain worsens as the wrist is bent from side to side
• Swelling in the wrist
• Painful clicking in the wrist
• Loss of grip strength

WHO IS LIKELY TO GET A TFCC TEAR?
Anyone can get a TCFF tear. It occurs most often in those who fall on an outstretched hand. Athletes are at risk, especially those who use a racquet, bat or club and those who put a lot of pressure on the wrist such as gymnasts. Degenerative tears are more common in people over 50. Medical attention should be sought as soon as possible after an injury to the wrist.
The hand and wrist specialists at TOCA we provide the most advanced treatment options for TFCC tears. Individualized treatment options are developed for each patient to ensure optimal outcomes.

WHAT CA– USES A TFCC TEAR?
TFCC tears are often sustained when a person falls and lands on the hand, bending the wrist backwards. They can also be present in patients with wrist fractures. Degenerative TFCC tears are more common in people over 50. A longer ulna (arm bone on the small finger side of arm) can also contribute to this condition because it puts more pressure on the TFCC.

HOW IS A TFCC TEAR DIAGNOSED?
TFCC tears are diagnosed through careful examination of the wrist. This involves some manipulation to see the extent and location of pain and immobility. An X-ray may be performed to check for fractures and other abnormalities. The most reliable imaging test is an MRI, which allows doctors to inspect the tissue and cartilage to see the extent of the injury. It is important for a patient to see a board certified physician specializing in treating wrist conditions soon after a traumatic injury.

WHAT ARE THE TREATMENTS FOR TFCC TEAR?
Treatment of a TFCC tear depends on stage of severity.
Non-surgical Treatment Options

• Rest
• Ice
• Splint or cast
• Anti-inflammatory medication, such as ibuprofen
• Cortisone injection
• Ultrasound therapy
• Surgical Treatment Options

Surgical Treatment
If no-operative management fails and the TFC tear is still painful, the next step is often a diagnostic arthroscopy. If there’s just a flap of injured tissue causing the problems, but the DRUJ is stable, the flap can be removed arthroscopically. If the TFC is torn, but the DRUJ is stable, the TFC tear can be repaired arthroscopically. If the TFC is torn and the DRUJ is unstable (loose), an open repair is usually the best treatment. The results from these surgeries are usually very good. If a TFC repair is performed, an above-elbow cast will be used for 4 weeks, and then therapy is started.

Often times, the TFC injury is either caused or exacerbated by the ulna being longer than the radius. In these cases, the ulna may have to be shortened to prevent the TFC from re-tearing. The ulnar shortening can be performed at the same time as the TFC repair. Sometimes, if the relative ulnar length is not too bad, a TFC repair is done without ulnar shortening. In these cases, if pain persists the ulnar shortening is then performed as a 2nd surgery.

Ulnar shortenings are traditionally done through a long incision: A small length of bone (usually 2-4 mm) is removed from the middle of the ulna and a plate is put on to stabilize the ulna while it heals. A short-arm cast is worn for 6 weeks and heavy activities are avoided until the bone is healed, which can take 3-4 months. However, a newer technique of ulnar shortening can be performed through a smaller incision, with a quicker healing time. In these cases, after 2 weeks only a removable splint is used. The newer type of ulnar shortening usually heals in 6 weeks. Most, but not all, patients will have this newer option available to them.

In summary, TFC tears are very common. Fortunately, there is effective treatment for them. All of the surgeries discussed here are performed as outpatient procedures (you go home the same day), and newer techniques are available that allow patients to return to activities quicker, with fewer problems.

At TOCA (The Orthopedic Clinic Association) we have some of Arizona’s most experienced physicians who treat triangular fibrocartilage complex injuries, in addition to other hand and wrist injuries, degenerative diseases and many other orthopedic needs.

To schedule an appointment contact our dedicated TOCA Team at 602-277-6211! You can also learn more about our Orthopedic Hand & Wrists Specialists here on our TOCA website.

 

#Recovery #Results #Relief #Handpain #painfree #TFC #handsurgery

Protecting Yourself from Dehydration in the Hot Summer Months

The heat is on “high” in Arizona! Staying hydrated in the Arizona climate is definitely a challenge but most importantly a necessity.

With Valley temperatures in triple digits, it’s important to stay hydrated. How much water do you need to drink during the summer in Phoenix?
According to the Mayo Clinic, men should drink about 13 cups (3 liters) of total beverages per day in a moderate climate and women should drink about 9 cups (2.2 liters) per day. That’s roughly in line with the old adage to drink eight 8-ounce glasses of water or fluid per day, at least if you’re a woman. Eight 8-ounce glasses per day is about 1.9 liters. Men would need to drink more to meet their needs. Keep in mind, though, that the 13 cups for men and 9 cups for women applies to moderate climates. Phoenix is in a desert climate, so your body needs significantly more water to keep hydrated.

2-1-1 Arizona, the state’s community information service, suggests drinking 5 to 7 ounces of fluids every 15 to 20 minutes to replenish the fluids necessary to stay hydrated. That translates to roughly 240 ounces or 30 cups per day if you drank 5 ounces every 20 minutes for the 16 hours (the typical person is awake).

The typical bottler of water holds nearly 17 ounces or 2 cups of water, so to drink 30 cups, you need to drink roughly 15 bottles of water per day in Phoenix. If you’re heading outside for any length of time or exercising, you’ll need to up your fluids even more!Image result for summer hydration

The good news is that you don’t need to rely solely on the water and fluids you drink. You can get some of your water intake from the foods you eat. Fruits and vegetables are particularly good for getting additional water since some, like cucumbers, melons, tomatoes, celery, and lettuce, are at least 90 percent water.

Since it’s hard to track how much water you’re getting from your food, it’s important to know the signs of dehydration. Mild dehydration can leave you feeling lethargic; signs of more severe dehydration include nausea, headaches, and dizziness. If you start experiencing those symptoms, get water as soon as possible.

Dehydration can come on quickly, especially if you are outside. If you plan on playing sports or hiking during the summer, the recommends starting to hydrate a few days before you go out.

Beverages: some hydrate, others dehydrate

Some beverages are better than others at preventing dehydration. Water is all you need if you are planning to be active in a low or moderate intensity activity, such as walking, for only an hour or less. If you plan to be exercising longer than that, or if you anticipate being out in the sun for more than a few hours, you may want to hydrate with some kind of sports drink. These replace not only fluid, but also chemicals like sodium and potassium, which are lost through perspiration. Too much or too little sodium and potassium in the body can cause trouble. Muscle cramping may be due to a deficiency of electrolytes, such as sodium and potassium.

Alcoholic and caffeinated beverages, such as coffee, teas, and colas, are not recommended for optimal hydration. These fluids tend to pull water from the body and promote dehydration. Fruit juice and fruit drinks may have too many carbohydrates, too little sodium, and may upset the stomach. If you’re going to drink fruit juices while exercising, you may try diluting them with 50% fruit juice and 50% water first.Image result for summer hydration

Adequate hydration will keep your summer activities safer and much more enjoyable. If you need to increase your fluid intake, keep an extra pitcher of water with fresh lemons, limes, or cucumber in the refrigerator.

Hydration tips

As summer temperatures hit, here are a number of important tips.

  • Drink enough water to prevent thirst.
  • Monitor fluid loss by checking the color of your urine. It should be pale yellow and not dark yellow or cloudy.
  • For short-duration (less than 60 minutes), low-to-moderate-intensity activity, water is a good choice to drink before, during and after exercise.
  • Any time you exercise in extreme heat or for more than one hour, supplement water with a sports drink that contains electrolytes and 6 percent to 8 percent carbohydrates. This prevents “hyponatremia” (low blood sodium), which dilutes your blood and could also lead to serious impairment and death.
  • Begin exercise well-hydrated. Drink plenty of fluids the day before and within the hour before, during and after your exercise session.
  • Avoid alcohol the day before or the day of a long exercise bout, and avoid exercising with a hangover.
  • Consider all fluids, including tea, coffee, juices, milk and soups (though excluding alcohol, which is extremely dehydrating). The amount of caffeine in tea and coffee does not discount the fluid in them, even if they have a slight diuretic effect, according to the most recent report by the National Research Council’s Food and Nutrition Board.
  • Eat at least five cups of fruits and vegetables per day for optimum health, as they all contain various levels of water and the all-important nutrient potassium.
  • During exercise, for those who experience high sodium losses, eat salty foods in a pre-exercise meal or add an appropriate amount of salt to sports drinks consumed during exercise. Orange juice is high in potassium. Dilute juices, such as V-8 or orange juice, 50/50 with water so that the drinks are 6 percent carbohydrate solutions (the same as sports drinks), which will empty from your stomach quicker than 100 percent juice (juices are naturally 12 percent solutions), allowing the electrolytes and water to quickly reach your heart and organs.
  • Following strenuous exercise, you need more protein to build muscle, carbohydrates to refuel muscle, electrolytes to replenish what’s lost in sweat, and fluids to help re-hydrate the body. Low-fat chocolate milk is a perfect, natural replacement that fills those requirements.
  • You can also replace fluid and sodium losses with watery foods that contain salt and potassium, such as soup and vegetable juices.
  • For long hikes, when you’ll need food, dried fruit and nut mixtures contain high amounts of potassium, sodium, protein, carbs and calories — though continue to drink plenty of water.
  • To determine your individualized need for fluid replacement: During heavy exercise, weigh yourself immediately before and after exercise. If you see an immediate loss of weight, you’ve lost valuable water. Drink 3 cups of fluid for every pound lost; use this figure to determine the amount of water (or sports drink) you’ll need to drink before and during your next exercise session to prevent weight/water loss in the future.

Signs and Symptoms of Dehydration

If you want to avoid health problems from dehydration it’s vital to listen to your body and drink water throughout the day. Water is the best way to prevent and beat dehydration, especially during the warm summer months when we are all prone to perspire even more so than usual.

Symptoms of Dehydration

  • Dry mouth
  • Sleepiness
  • Thirst
  • Decreases urination
  • Muscle weakness
  • Fatigue
  • Headache
  • Dizziness

Symptoms of Severe Dehydration

  • Extreme thirst
  • Irritability
  • Confusion
  • Extremely dry mouth and mucus membranes
  • Sunken eyes
  • Lack of sweating
  • Lack of tears
  • Very little or no urination
  • Skin that won’t ‘bounce back’
  • Low blood pressure
  • Rapid heartbeat
  • Fever
  • Delirium

People at Risk for Dehydration and Hypernatremia

  • Children and infants
  • Elderly
  • Chronically ill
  • Endurance athletes
  • High altitude dwellers

Simple Steps to Avoid Dehydration

The best way to avoid dehydration, particularly during hot summer months, is to be sure you and your loved ones are drinking plenty of pure water on a daily basis, at least eight to ten, eight ounce glasses full. If you are exerting yourself or out in the heat, drink even more water.

Avoiding dehydration is as simple as drinking enough pure water on a daily basis but so many just don’t do this. When you realize the high price your body will pay from a serious case of dehydration or hypernatremia, you’ll be asking for more water to drink everyday.

Top Hydrating Foods

  1. Coconut Water
  2. CeleryImage result for hydrating foods
  3. Watermelon
  4. Cucumber
  5. Kiwi
  6. Bell Peppers
  7. Citrus Fruit
  8. Carrots
  9. Cultured Dairy (amasai/kefir/yogurt)
  10. Pineapple
  11. Tomatoes
  12. Strawberries
  13. Star fruit
  14. Cantaloupe

 

If you suspect that someone is dehydrated, seek immediate medical attention.

The Maricopa Association of Governments coordinates the Heat Relief Network, a listing of places where people, especially vulnerable individuals such as those experiencing homelessness, can receive water and, in some cases, a place to cool off. Get more information www.azmag.gov/heatrelief.

 

#heat #Dehydration #InjuryPrevention #IllnessPrevention #HeatStrokePrevention #HeatStroke #KeepHydrated #Results #Recovery #Relief #Summer

Read about Summer Time Injuries

What you need to know: #NationalFlipFlopDay

What you need to know: #NationalFlipFlopDay

Flip-flops might make you feel like you’re on vacation, but they’re actually making your feet work overtime.

Fun and fashionable, flip-flops have their place in your shoe closet, experts say. But they’re not meant to be worn with abandon — or else you may be courting foot pain.

When you wear the thonged sandals, you have to slightly “clench” your toes to keep them on and that’s not a natural position for your feet.
See for yourself: Take your shoes off. Take a step, paying attention to how your midfoot and toes bend at the end as your heel leaves the floor.

Now slightly “clench” your toes, curling them down toward the pads of your feet. Take another step. It doesn’t feel the same, does it? Your foot will be stiffer, and the step won’t “flow” like the first step.

But let’s face it, Flip-flops are a summertime staple. So wear them—but put a cap on the distance you travel in the sandals. Like anything else, moderation is key: Slipping flip flops on by the pool or for a short jaunt likely won’t cause any harm — the problems arise when your thongs become your go-to summer shoes.

This constant tension alters your gait, eventually causing muscular issues in your feet and calves. That can lead to the painful condition plantar fasciitis—also called “jogger’s heel”—when you run. You’ll feel a sharp shooting pain in the bottom of your heels with each step. In extreme cases, flip-flops may even be the cause of other lower-body issues like knee pain.

What’s their best purpose?

“Flip-flops give you some basic protection to the bottom of your foot to walk around poolside or on a surface that may be warm during the summer,” says Jim Christina, DPM, director of scientific affairs for the American Podiatric Medical Association.Image result for flip flops and your foot health

They can also help prevent you from catching athlete’s foot or plantar warts in public showers, according to foot specialists.

Experts give flip-flops thumbs up for the poolside, thumbs down for foot pain

Why? “They let your foot be as flat as they can be,” Christina says. “For some people, that’s OK, depending on the structure of their foot. But if you have a foot that tends to over-flatten, then you’re not getting any support.

If you are walking in flip-flops for days on end with no support, it’s very common to see arch and heel pain.

Don’t overdo the flip-flops at home: everything in moderation. As long as you’re not doing a lot of walking, it’s probably OK. For example, To have flip-flops on for short periods of time to do errands, that’s usually not going to be a problem.

If you have foot pain and need an alternative to flip-flops and their flimsy support.

 

Flip-flop concerns and Safety.

Bacteria and Fungal Infections
Truth: Any open-toed shoe in a dirty environment (think: campgrounds, the beach, pool, or locker room) can lead to infections if your feet are exposed to fungus. Remember, fungus loves moist, warm environments. So to curb your risk of skin or toenail infections, keep your feet clean and dry.

Blisters
Flip flops tend to slip around on your foot more than a sneaker or flats, blisters are an inevitable part of wearing flip flops. Blame movement, moisture, and rubbing, says Ward. Of course, any shoe that doesn’t fit right can cause blistering, but flip flops are among the worst culprits because of their instability.

Heel and Toe Pain
Floppy sandals might not completely destroy your heels, but they could come close. Flip flops could cause serious pain or even conditions like plantar fasciitis, which occurs when the tissue that connects your heel bone to your toes becomes inflamed. See, the ligament that attaches your toes to your heel can stretch or even tear when it’s not appropriately supported. If you notice any redness, irritation or blisters developing between your toes, discontinue use of the flip-flops and find sandals that don’t separate your toes.

Posture Issues
Your feet are the building blocks for how your ankles, knees, hips, back, and shoulders are aligned. Take away the building blocks (which is what you do when you wear shoes with little support) and you’re left with a weak foundation. This can cause everything else in your body to collapse or be poorly aligned, leading to pain and issues with your posture.

Falling Objects

When you wear flip-flops, your toes and feet are exposed, making them susceptible to falling objects or people stepping on your toes.

Thin Soles

Unlike sturdy shoes, flip-flops aren’t good for extensive walking because they offer no arch support, heel cushioning, or shock absorption, according to the American Podiatric Medical Association (APMA). Wearers can suffer foot pain due to lack of arch support, tendinitis, and even sprained ankles if they trip.

When shopping for flip-flops, test their flexibility before buying them. Grab one end of the flip-flop in each hand and gently bend it. If the flip-flop bends in half, this means that it won’t offer any support for your foot. But if it gives a little in the ball of the foot, this means it will properly support your foot and will move with your foot while you’re walking.

Thong Effect

The Auburn study indicates that the thongs in the middle mean you have to grip the shoe to keep it on. The thong can actually rub against the skin and causes ulcerations and sores. Also, when you have a toe thong, you tend to grip the shoe with your toes to try and keep it on. That alters your gait and puts strain on muscles you don’t normally use when you walk in regular shoes.

Also, a recent study found that men and women who wear flip-flops actually strike the ground with less force than when they wear sneakers, again altering the way you walk and causing you to take shorter steps, which may account for why people who wear them for extended periods experience lower leg pain and have more heel problems, such as heel spurs (little bony growths on the heel) and plantar strain (inflammation of the sheet of tissue covering the bottoms of the feet).

Skin Cancer

If you flip-flop your way through lazy summer days, don’t forget: your exposed feet need sunscreen, too. Because your feet are exposed to the sun, it’s important to cover them with sunscreen when your wear flip-flops. It’s easy to forget your feet when applying sunscreen, but it’s a crucial area to protect. Those little brown spots of sun damage that can eventually turn into skin cancer can be difficult to detect on the feet, especially if they’re on or between the toes. So next time, you plan to have some fun in the sun, protect your feet first.

Skip The Flip-Flops If You Have Or Are Prone To Foot Injuries

If you have any foot injuries, it’s best to stay away from flip-flops until those injuries have healed. If you have diabetes, you should skip the flip-flops altogether as you may acquire an injury without feeling it. If you’re overweight, it’s best to wear a closed-in shoe that will provide more support for the feet, ankles and back.

[Related – Diabetic Foot Pain And Complications]

Driving Hazard (avoid driving in flip-flops)

Flip-flops can impair a driver’s control if they come off the foot and lodge under the brake or gas pedal, according to Bill Van Tassel, PhD, the American Automobile Association’s manager of driver training operations. “Whatever you wear on your feet, make sure it’s not so loose that it pops off and interferes with the pedals,” he says.

Decreasing the Dangers

  • Use sun block and check your feet for any suspicious moles.
  • Don’t walk long distances or play sports in your flip-flops – they’re really made for walking along the beach or by the pool or if you get into a public shower, not for long strolls.
  • Do not Spruce up the yard in flip flops – You may accidentally drop something on your foot, stub your toe, cut it on a piece of glass or get bitten by something you’re allergic to
  • Choose flip-flops with thick soles, which will provide more cushion for your feet and protect you from sharp objects you might encounter on the street.

 

How to Pick a Better Pair!

Don’t fret: There is hope for cute summer shoes. For one, look for a sandal with more than one strap, which will help with stability, suggests Ward. An ankle strap or latch behind your heel may also help cut down how much the shoe moves on your foot.

So, enjoy your flip-flops, but just not all the time and without giving them any thought!

Your foot health should always be a priority. If you suffer from a foot/ankle condition the dedicated team of physicians and staff here at TOCA are here to help! For more information, questions or to schedule an appointment call 602-277-6211!

 

 

Sources:

 

What Is Scoliosis, Causes and Treatment Options

What Is Scoliosis, Causes and Treatment Options: Scoliosis (pronounced sko-lee-o-sis) is a three-dimensional abnormality that occurs when the spine becomes rotated and curved sideways.

If you look at someone’s back, you’ll see that the spine runs straight down the middle. When a person has scoliosis, their backbone curves to the side.

Image result for scoliosisThe angle of the curve may be small, large or somewhere in between. But anything that measures more than 10 degrees is considered scoliosis. Doctors may use the letters “C” and “S” to describe the curve of the backbone.

You probably don’t look directly at too many spines, but what you might notice about someone with scoliosis is the way they stand. They may lean a little or have shoulders or hips that look uneven.

What Causes Scoliosis?

In most cases, doctors don’t find the exact reason for a curved spine. Scoliosis without a known cause is what doctors call “idiopathic.”

Some kinds of scoliosis do have clear causes. Doctors divide those curves into three types:

  • Infantile idiopathic scoliosis: develops from birth to 3 years old
  • Juvenile idiopathic scoliosis: develops from 4 to 9 years old
  • Adolescent idiopathic scoliosis: develops from 10 to 18 years old

Adolescent scoliosis comprises approximately 80% of all idiopathic scoliosis cases. Adolescence is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Common Types of Curves

Image result for Common Types of scoliosis CurvesA scoliosis curve usually looks a bit like a backward C shape and involves the spine bending sideways to the right, which is also called dextroscoliosis. Sideways spinal curvature on the left side of the back is more like a regular C shape and called levoscoliosis. Here are four common types of scoliosis curves:

  • Right thoracic curve. If a straight line were drawn down the center of the back, this curve bends to the right side of the upper back (thoracic region).

See Thoracic Spine Anatomy and Upper Back Pain

  • Right thoracolumbar curve. This curve bends to the right side—starting in the upper back (thoracic) and ending in the lower back (lumbar).

See Lumbar Spine Anatomy and Pain

  • Right lumbar curve. This curve bends to the right side—starting and ending in the lower back.
  • Double major curve. Typically, a double curve involves right thoracic curve on top and left lumbar curve on bottom. People who have a double major curve may initially have a less obvious deformity because the two curves balance each other out more.

When Idiopathic Scoliosis Needs Treatment

Treatment options for idiopathic scoliosis could include:

  • Observation. Typically, a doctor will advise observation for a scoliosis curve that has not yet reached 25 degrees. Every 4 to 6 months, the doctor will take another X-ray of the spine to see if the scoliosis is progressing or not.
  • Bracing. If the scoliosis has progressed past 20 or 25 degrees, a back brace could be prescribed to be worn until the adolescent has reached full skeletal maturity. The goal of bracing is to prevent the curve from getting worse and to avoid surgery.

See Bracing Treatment for Idiopathic Scoliosis

  • Surgery. If the curve continues to progress despite bracing, surgery could be considered. The most common surgical option for scoliosis today is a posterior spinal fusion, which can offer better corrections with fewer fusion levels (preserving more back mobility) than what was done in years past.

In nonstructural scoliosis, the spine works normally, but looks curved. Why does this happen? There are a number of reasons, such as one leg’s being longer than the other, muscle spasms, and inflammations like appendicitis. When these problems are treated, this type of scoliosis often goes away.

In structural scoliosis, the curve of the spine is rigid and can’t be reversed.

Causes include:

Congenital scoliosis begins as a baby’s back develops before birth. Problems with the tiny bones in the back, called vertebrae can cause the spine to curve. The vertebrae may be incomplete or fail to divide properly. Doctors may detect this condition when the child is born. Or, they may not find it until the teen years.

Family history and genetics can also be risk factors for idiopathic scoliosis. If you or one of your children has this condition, make sure your other kids are screened regularly.

Scoliosis shows up most often during growth spurts, usually when kids are between 10 and 15 years old. About the same number of boys and girls are diagnosed with minor idiopathic scoliosis. But curves in girls are 10 times more likely to get worse and may need to be treated.

Scoliosis diagnosed during the teen years can continue into adulthood. The greater the angle of the spine curve, the more likely it is to increase over time. If you had scoliosis in the past, have your doctor check your back regularly.

Degenerative scoliosis affects adults. It usually develops in the lower back as the disks and joints of the spine begin to wear out as you age.

A mild scoliosis curve can go unnoticed to the untrained eye. However, if the curve progresses, various signs and symptoms can become obvious.

Common Early Signs of Scoliosis

Oftentimes scoliosis is first suspected when someone notices something slightly off and comments. Some examples could include:

  • Clothes fit awkwardly or hang unevenly. A parent, friend, or even the person with scoliosis might notice that a shirt or blouse appears uneven, which could be cause for further investigation.
  • Sideways curvature observed while in bathing suit or changing. For instance, a parent could first notice the sideways curvature in an adolescent’s back while at the pool or beach.

Even if a newly discovered asymmetry appears minor, it should be checked by a doctor because scoliosis is easier to treat when caught early.

Symptoms of Moderate or Severe Scoliosis

Only about 10% of people with idiopathic scoliosis have a curve that progresses beyond mild and needs treatment.3 If that progression happens, the deformity becomes more obvious to other people and more likely to cause noticeable symptoms.

Some of the more common symptoms present in moderate or severe scoliosis could include:

  • Changes with walking. When the spine abnormally twists and bends sideways enough, it can cause the hips to be out of alignment, which changes a person’s gait or how they walk. The extra compensating that a person does to maintain balance for the uneven hips and legs can cause the muscles to tire sooner. A person might also notice that one hand brushes against a hip while walking but the other does not.
  • Reduced range of motion. The deformity from spinal twisting can increase rigidity, which reduces the spine’s flexibility for bending.
  • Trouble breathing. If the spine rotates enough, the rib cage can twist and tighten the space available for the lungs. Bone might push against the lungs and make breathing more difficult.
  • Cardiovascular problems. Similarly, if the rib cage twists enough, reduced spacing for the heart can hamper its ability to pump blood.
  • Pain. If curvature becomes severe enough, back muscles could become more prone to painful spasms. Local inflammation may develop around the strained muscles, which can also lead to pain. It is possible for the intervertebral discs and facet joints to start to degenerate due to higher loads.
  • Lower self-esteem. This symptom is commonly overlooked or minimized by outside observers, but it can be a significant factor for people who have a noticeable spinal deformity. Especially for adolescents who want to fit in with their friends, it can be stressful and depressing to look different, have clothes fit unevenly, or wear a noticeable back brace that may be uncomfortable or limit activity.

Can It Be Prevented?

No. So forget the rumors you may have heard, such as, “Childhood sports injuries can cause scoliosis.” Not true.

Likewise, if your kids are in school, you may be concerned about the weight of the textbooks they carry. While heavy backpacks may cause back, shoulder, and neck pain, they don’t lead to scoliosis.

And what about poor posture? The way a person stands or sits doesn’t affect their chances for scoliosis. But a curved spine may cause a noticeable lean. If your child isn’t able to stand upright, ask your doctor to look at her spine.

Adam’s Forward Bend Test

Image result for Adam’s Forward Bend Test

involves a healthcare professional observing the patient bending forward at the waist 90 degrees with arms stretched toward the floor and knees straight. From this position, most scoliosis signs that present as asymmetry are clearly visible in the spine and/or trunk of the body, such as:

The first step toward getting an idiopathic scoliosis diagnosis is typically the Adam’s forward bend test, which primarily looks for abnormal spine rotation.

 

 

This test

 

  • One shoulder or shoulder blade is higher than the other
  • Rib cage appears higher on one side (also called a rib hump)
  • One hip appears higher or more prominent than the other
  • The waist appears uneven
  • The body tilts to one side
  • One leg may appear shorter than the other

The Adam’s forward bend test can be useful in detecting scoliosis located in the upper or mid back, which is where idiopathic scoliosis usually occurs. However, the forward bend test is not as effective at detecting scoliosis in the low back because it does not involve rib rotation.

Scoliometer to Measure Spine Rotation

As part of the forward bend test, the clinician might use a scoliometer, also called an inclinometer, to estimate the angle of trunk rotation (ATR). While the patient is still bending forward, the clinician can put the scoliometer flat on the back in the area or areas where the asymmetry looks the greatest.

As a general rule, if an ATR of at least 5 degrees is recorded, the patient will either be scheduled for a follow-up exam or referred to a doctor who can image the back for more accurate scoliosis testing.7,8 X-ray imaging is needed to measure the degree of the curve and confirm scoliosis.

Cobb Angle Measurement

The lateral curve of scoliosis is described by the Cobb angle. Using an X-ray of the full spine, the Cobb angle is found by drawing a perpendicular line from the spine’s most-tilted vertebra above the sideways curve’s apex and a second perpendicular line from the most-tilted vertebra beneath the apex. The angle formed where those two lines meet is the Cobb angle.

A Cobb angle of at least 10 degrees is typically considered the borderline for a scoliosis diagnosis.

Key Components of a Scoliosis Diagnosis

When diagnosing idiopathic scoliosis, there are 3 key components to take into consideration:

  • Lateral curvature. The lateral (sideways) curvature of the spine is measured by the Cobb angle. The bigger the Cobb angle, the greater the spinal deformity.
  • Axial rotation. In addition to the sideways curvature, the spine abnormally rotates along the vertical axis. Spinal rotation can affect rib rotation, as well as curve rigidity.
  • Skeletal maturity. Often estimated by the Risser sign (amount of calcification at the hip bone’s ridged top as seen on the same X-ray as the Cobb angle), the amount of skeletal maturity remaining is critical to making scoliosis treatment decisions in children and teens.

Understanding these components of a scoliosis diagnosis can help the medical team evaluate the severity of the curve, likelihood for progression, and which treatment options could be best.

Idiopathic Scoliosis Is a Diagnosis of Exclusion

Idiopathic means a condition is of unknown cause. As such, idiopathic scoliosis technically cannot be diagnosed until other types of scoliosis are ruled out. Other types of scoliosis could include:

  • Congenital scoliosis. This type of scoliosis is present from birth and is the result of the spine not forming properly.
  • Neuromuscular scoliosis. Many types of neuromuscular conditions can lead to muscle problems in the back that result in scoliosis. A few examples include cerebral palsy and myelodysplasia.
  • Degenerative scoliosis. Also called adult onset scoliosis, this type of scoliosis results from the deterioration of the facet joints in the spine.
  • Nonstructural scoliosis. This type of scoliosis, also known as functional scoliosis, occurs due to a temporary cause that only affects lateral curvature without spinal rotation. For example, a difference in leg heights could potentially cause a sideways curve in the spine that is corrected with a shoe insert.

If scoliosis starts to cause a noticeable deformity or is at high risk of doing so, a doctor might prescribe a brace to prevent the curve from getting any worse. Typically, a brace is worn until the adolescent has reached full skeletal maturity.

Knowing if a person’s scoliosis curve is likely to worsen is crucial to developing a treatment plan. Bracing is a major time commitment and uncomfortable for adolescents—both physically and emotionally—and is usually not prescribed unless the curve is at significant risk for progressing.

Brace Options

There are two general treatment options for scoliosis bracing:

  • Full-time bracing. These braces are designed to be worn 16 to 23 hours a day. The goal is to wear them all the time with exceptions for bathing, skin care, and exercising.
  • Nighttime bracing. These braces use hyper-corrective forces (which put the body out of normal balance and cannot realistically be applied while a person is standing and/or performing daily activities) and are to be worn at least 8 hours a night.

Choosing between full-time bracing and nighttime bracing can depend on size and location of curves, as well as what the patient is willing to do. Some studies have found that nighttime bracing tends to be more effective because patients are more likely to wear a brace at night as prescribed, but other studies have found that full-time bracing—when adhered to as directed—could work even better.

Other Nonsurgical Treatments Unproven

While some people claim that treatments such as physical therapy and manual manipulation can help stop the progression of scoliosis, there is little scientific evidence to support these claims. Bracing is currently the only nonsurgical treatment that has been proven to reduce the natural progression of idiopathic scoliosis curves.

However, if given the okay by a doctor, exercise is healthy for people with scoliosis and helps keep the back strong and flexible.

When Bracing Fails

Sometimes an idiopathic scoliosis curve continues to progress despite bracing. If this happens and the curve progresses past 40 or 50 degrees, surgery may be considered.

3 Goals of Scoliosis Surgery

Scoliosis surgery typically has the following goals:

  1. Stop the curve’s progression. When scoliosis requires surgery, it is usually because the deformity is continuing to worsen. Therefore, scoliosis surgery should at the very least prevent the curve from getting any worse.
  2. Reduce the deformity. Depending on how much flexibility is still in the spine, scoliosis surgery can often de-rotate the abnormal spinal twisting in addition to correcting the lateral curve by about 50% to 70%. These changes can help the person stand up straighter and reduce the rib hump in the back.
  3. Maintain trunk balance. For any changes made to the spine’s positioning, the surgeon will also take into account overall trunk balance by trying to maintain as much of the spine’s natural front/back (lordosis/kyphosis) curvature while also keeping the hips and legs as even as possible.

In addition, any adjustment of the spine must also consider the possible effect on the spinal cord. The health of the spinal cord must be monitored throughout the surgery.

Surgical Options for Idiopathic Scoliosis

There are 3 general categories of scoliosis surgery:

  • Fusion. This spinal surgery permanently fuses two or more adjacent vertebrae so that they grow together at the spinal joint and form a solid bone that no longer moves. Modern surgical approaches and instrumentation—rods, screws, hooks, and/or wires placed in the spine—have enabled spinal fusion surgeries to achieve better curvature correction and faster recovery times than in the past.

An advantage to spinal fusion surgery is that it has a long-term record of safety and efficacy for treating scoliosis. While a drawback to the procedure is that any fused vertebrae will lose mobility, which can limit some of the back’s bending and twisting, today’s spinal fusions tend to fuse fewer vertebrae and maintain more mobility than in the past.

  • Growing systems (to delay fusion). Rods are anchored to the spine to help correct/maintain the spine’s curvature while the child grows. Every 6 to 12 months, the child has another surgery to lengthen the rods to keep up with the spine’s growth. Once the patient is close enough to skeletal maturity, the patient will usually get a spinal fusion.

If a spinal fusion is done at too young of an age (typically younger than age 10 in girls or less than 12 in boys), that could leave less room for the lungs to develop in addition to the child having an unusually short trunk compared to the limbs. To avoid these complications, the growing systems method helps guide the spine as it grows, preventing the curve from worsening as the spine matures and eventually becomes ready for a fusion if needed.

  • Fusionless. Current fusionless surgery methods employ growth modulation on the spine similar to what has been done in the past to treat unequal leg heights in growing children. The theory is that by putting constant pressure on a bone, it will grow slower and denser. By applying such pressure on the outer side of a spinal curve, the surgeon aims to slow or stop the growth of the curve’s outer side while the curve’s inner side continues to grow normally. As the spine continues to grow in this manner, the lateral curvature should reduce as the spine becomes straighter.

One fusionless method uses a vertebral tethering system, which involves placing screws on the outer side of the curve and then pulling them taut with a cord so the spine straightens. Compared to spinal fusion, fusionless surgery has the potential benefit of retaining more spinal mobility. However, this is a newer approach and long-term data about the risks and benefits are not yet available.

For an adolescent or young adult opting for scoliosis surgery today, by far the most commonly performed surgery is a spinal fusion.

 

If you or a family member are experiencing symptoms or discomfort from Scoliosis or suspect scoliosis, the experts in Spine Care,  Interventional Spine and Back, Orthopedics and Physical Therapy here at TOCA are here to help! For questions or to schedule an appointment call us today at: 602-277-6211!

 

#Results #Recovery #Relief #painfree #scoliosis

Cast Away: Fishing Safety & Boating in Arizona

Cast Away: Fishing Safety & Boating in Arizona! Arizona is blessed with diverse fishing opportunities, from the large reservoirs to the trout lakes in the mountains, and plenty of low-elevation fishing holes in between. Go out and catch a memory!

Recreational fishing (especially angling) is one of the most popular activities in the world, but as with other sports, it’s not without its risks. Most anglers are careful to avoid the obvious and most dramatic of fishing dangers (dehydration, hooking a finger, boat motor fires, accidental drowning, etc.). However, if you want to keep yourself in top fishing shape, you also have to protect yourself from more mundane fishing hazards – overuse injuries.

As the name states, overuse injuries are caused by too many uninterrupted repetitions of an action. The body parts involved become fatigued to the point of injury; this effect is intensified if the repeated action requires awkward or unnatural movements, such as is sometimes seen in bowling or pitching a baseball. Overuse injuries are notoriously stubborn to cure – but then again, it’s often those with the injuries that are stubborn. Because you must treat an overuse injury with rest (which means taking a sometimes lengthy break from the beloved activity that cause the injury in the first place), many people make the mistake of returning to activity before their injury is fully healed, creating a vicious cycle that can be difficult to break.

Angling provides the perfect conditions for an overuse injury thanks to the repetitive movements of casting coupled with the bad body mechanics that are common to so many people. As is often said, prevention is the best medicine. With a few simple tweaks, you can help stop overuse injuries from ruining your fishing trips.

Although it might sound silly, you should prepare in advance of a fishing trip the way you would for other athletic events. Keeping yourself in good physical condition will give you the endurance you need for long fishing sessions, and you will be less plagued by the aches and pains that can make your trip less enjoyable. Besides eating a balanced diet and exercising regularly, you should include stretching and strengthening exercises specifically geared for the muscles you will use during angling – your abdominals, back, and upper body.
Because fishing trips are often all-day affairs, it’s important to change up your activity. Alternate sitting and standing – but do both with good posture – to avoid unnecessary stress on your back and feet. Switch your grip and casting style throughout the day so no one motion or position is repeated excessively (and as an added bonus, this will help you master a diversity of fishing styles). And perhaps most important of all, take breaks to rest, even if you don’t feel tired. Remember that most people don’t realize they are developing an overuse injury until it’s too late.

Lastly, be realistic about your abilities. Seek coaching to fix any bad body mechanics you may have during casting. Shooting heads and sinking weights put extra strain on the wrists, elbows, and shoulders of anglers who aren’t adept at their use, so avoid them for all but short periods of time if you fall into this category. In addition, using heavy or long rods, longer lines, and fishing for heavy fish should all be engaged in sparingly unless you are expert enough to do so correctly.

Fishing memories can last a lifetime, so don’t let an overuse injury keep you from enjoying the water with your friends and family.
You throw a hook into the water, you sit and wait for a bite or you reel back in. Fishing is a great pastime, but in order for it to be truly enjoyable, you must be safe. Keep these important guidelines and tips in mind for a safe fishing experience.Image result for arizona fishing

1. Get physically prepared.
You don’t necessarily need to be in top physical shape to catch a fish, but you do need to be able to navigate in and out of a boat or possibly across rocks to your favorite fishing spot. Since regular physical activity is essential for your family’s health, make sure you stick to a daily fitness routine leading up to fishing season. Consider visiting the local pool to brush up on your swimming strokes in the case you fall out of the boat or into the water from the shore.

2. Check your fishing gear.
Fishing lines get old and tangled, fishing poles get worn, and lures can break. Open up your tackle box and discard broken fishing tackle. Restring your pole if the line looks ragged and replace your reel or pole if showing signs of damage. The last thing you want to do is cast out and hook someone or yourself due to faulty fishing gear. If you are going out on a boat, do a boat safety check and make sure your life vests are in good condition.

3. Dress up for the occasion.
Sturdy, protective footwear is especially important when fishing. It can keep you from cutting your foot on obstacles in the water or on shore, keep your feet warm, and prevent slipping. Wear clothing according to the weather conditions, choosing attire that will keep you cool in the heat and warm in the cold. Wear sunscreen regardless of temperature and consider a hat that shades your ears and face. Be sure you and the kids don those life vests if you are on the water. Life jackets are also important if you are wading in deep waters that have strong currents. Even if you are an excellent swimmer, a life jacket can help keep you safe in the event that you fall and hit your head.

4. Pack a first aid kit.
Image result for first aid kitWhile you are hoping for the big catch, you may fall and sustain a cut, get bit by insects, or get a hook in the hand. A first aid kit can come to the rescue for many injuries.
For scrapes and cuts, rinse the wound with clean water (this doesn’t mean pond water) and stop the bleeding by compressing with a clean cloth. Apply an antibiotic cream and cover with a bandage. Try to keep the area dry, changing bandage as needed.

For insect bites and stings, clean area with water, apply a cold compress if available, apply antibiotic cream, and take acetominophen or ibuprofen for pain. Be sure to remove ticks and stingers, if present, before treating. To avoid bites and stings, apply an insect repellent before you start fishing.

When it comes to fishing hooks, if the hook is embedded in the head or face, in a joint, or near an artery, seek medical help immediately. If the hook is embedded in the finger or elsewhere in the skin, clean area with soapy water. Tie a long piece of fishing line to the rounded part of the hook. Push the hook shank parallel with the skin and give the fishing line a firm, sharp yank. The hook should come right out of the entry point. Wash the area again and apply an antiobiotic ointment and bandage to keep it clean and dry.
Note: Be sure your family is current on your tetanus vaccinations.

5. Stay aware of your fellow fishers.
Keep distance between you and your fellow fishers to avoid hook or pole injuries when casting. Safety glasses are a good idea for kids to protect their eyes, especially as they hone their fishing skills. In addition, always know where your family members are and don’t let your kids fish alone. Employ the buddy system.
New anglers. Should always learn how to cast overhead first. This cast teaches the proper technique and is safer than side casts.

6. Never go fishing alone. Always fish with someone else and, ideally, with two other people. If one person is injured or in danger, a second person can stay with them while the third person seeks help. This is especially important when rock fishing. Let somebody know the location of your fishing trip, who you are going with and an approximate time you will be back.

7. Weather and fishing
Staying aware of weather conditions is an important part of fishing safety. Make sure you have the most up-to-date local weather information available and be prepared for sudden changes. For coastal locations, take particular note of unexpected tide and swell conditions.

Additional Fishing and Boating Safety Tips: 
• No drinking or using drugs while driving a boat.
• Abide by boat speeds and wake zone laws.
• Stay alert of debris, stumps, boulders when boating.
• Stay off of the water if there are lightning storms.
• Use your boat lights at night.
• Keep an extra fully-charged battery on board.
• Use caution with hooks, like baiting, knot tying, rigging.
• Don’t fish in unrestricted zones.
• Be sure you keep your area organized and clean.
• Carry maps of the areas you will be at.
• Bring a cell phone.
• Stay hydrated.

Arizona fishing and boating trips can range from a day of casting for trophy largemouth bass to fly-fishing for brown trout on Woods Canyon Lake. In order to experience the best fishing in Arizona, check for updates to fishing regulations, read local fishing reports, and find the best spot.

These 11 Amazing Spots In Arizona Are Perfect To Go Fishing
Image result for arizona fishing• Big Lake
• Cluff Ranch Ponds
• Dead Horse Lake
• Dogtown Lake
• Lake Pleasant
• Lake Powell
• Oak Creek
• Peña Blanca Lake
• Riggs Flat Lake
• Saguaro Lake
• Tonto Creek

 

 

If you experience an injury during your summer activities the Team at TOCA is here to help! Learn more about our Orthopedic Surgeons, Sports Medicine Physicians and Physical Therapy Team. To schedule an appointment call 602-277-6211!

Read more about summer time outdoors in Arizona: Arizona Hiking Tips: Take a Hike. Do it Right.     10 Common Summer Injuries  Men’s Summer Health & Common Sports Injuries

#Results #Recovery #Relief #family #summer #fishingfun #fishingsafety #TOCA #TOCAMD #AZFishing

Celebrate Global Running Day 2017

Celebrate Global Running Day 2017

The world will be running on June 7. This is your invitation to join.

If you forgot to put it on the calendar, June 7 is Global Running Day. Over two million runners from across the globe, in 164 countries, have pledged to get up, get out, and go for a run. This is a great day to invite a non runner to take up the sport.

You’ve probably heard it said that exercise is medicine. Well, it’s not just a saying; it’s the truth. There’s a raft of scientific evidence that proves that regular exercise (150 minutes per week, which is about 30 minutes five times per week)—and running in particular—has health benefits that extend well beyond any pill a doctor could prescribe. Studies have shown that running can help prevent obesity, type 2 diabetes, heart disease, high blood pressure, stroke, some cancers, and a host of other unpleasant conditions. What’s more, scientists have shown that running also vastly improves the quality of your emotional and mental life, and even helps you live longer.

A study out in the Journal of the American College of Cardiology finds that even five to 10 minutes a day of low-intensity running is enough to extend life by several years, compared with not running at all. It shows that the minimal healthy “dose” of exercise is smaller than many people might assume.

Benefits of Running That Make You Healthier (and Happier)

Everyone knows that running is a great way to get into shape, but did you know that it can benefit almost every part of your body, as well as lift your mood? Running is incredibly effective at making you healthier in a number of ways. While it may not be everybody’s favorite form of exercise, knowing what it can do for your life just may make you look at running in an entirely new light.

Improve Your Health

Believe it or not, running is actually a great way to increase your overall level of health. Research shows that running can raise your levels of good cholesterol while also helping you increase lung function and use. In addition, running can also boost your immune system and lower your risk of developing blood clots.

Running Is Good for Your Heart

Running is the king of cardio. Running even five to 10 minutes a day, at slow speeds (how does a nice 12-minute mile sound to you?) is associated with a drastically reduced risk of dying from cardiovascular disease, according to a landmark study in the Journal of the American College of Cardiology. Compared with never-runners, regular runners have half the chance of dying from heart disease. Every time you run, you decrease your resting heart rate, so your heart doesn’t need to work as hard, says exercise physiologist Greg Justice, founder of AYC Health & Fitness in Kansas City.

Running Strengthens Your Joints and Increases bone density

A Medicine & Science in Sports & Exercise study of nearly 100,000 runners and walkers found that, nope, running doesn’t up the risk of osteoarthritis—even people who cover 26.2 miles on the regular. In fact, the study showed runners were half as likely to suffer from knee osteoarthritis compared with walkers. Surprised? Every time you pound the pavement, you stress your bones and cartilage, just like your muscles, causing them to spring back stronger, explains Janet Hamilton, CSCS, an exercise physiologist with Running Strong in Atlanta. Low-impact exercises like walking, or even spinning or swimming, don’t have that same bone-building benefit. Running stresses your bones. Essential minerals are sent to the bones when under stress, which makes them stronger. However, running does not make you unbreakable, and jumping, say, a 10-foot high fence is still a bad idea.

Prevent Disease

For women, running can actually help to lower your risk of breast cancer. It can also help reduce the risk of having a stroke. Many doctors today recommend running for people who are in the early stages of diabetes, high blood pressure, and osteoporosis, and it is proven to help reduce the risk of having a heart attack. By helping the arteries retain their elasticity and strengthening the heart, your chances of suffering a heart attack can be significantly reduced.

Lose Weight

Running is one of the best forms of exercise for losing or maintaining a consistent weight. You will find that it is a leading way to burn off extra calories and that it is the second most effective exercise in terms of calories burned per minute, following only after cross country skiing.

Boost Your Confidence

Not all of the benefits of running are physical. Running can provide an noticeable boost to your confidence and self-esteem. By setting and achieving goals, you can help give yourself a greater sense of empowerment that will leave you feeling much happier.

Relieve Stress

Stress can actually cause a number of health and mood problems. It can also diminish appetite and sleep quality. When you run, you force your body to exert excess energy and hormones. Running also helps to reduce your chances of developing tension headaches.

It may seem surprising to learn all of the different ways that running can improve your health, but the truth of the matter is that these are only a few of the many benefits that it can offer to your body.  Running really is incredibly beneficial to the body, mind, and spirit, and you will find that even short runs can leave you feeling more energized, more focused, and better able to enjoy all that life has to offer.

If you have a sports injury/ injury prevention, physical therapy, sports medicine question or concern the team at TOCA is here to help! To learn more or schedule an appointment call us at: 602-277-6211!

#GlobalRunningDay #run #InjuryPrevention #SportsMedicine #RunnersLife #RunforHealth #KeepRunning #TOCA #TOCAMD

Men’s Summer Health & Common Sports Injuries

The summer is a great time to build up your fitness program, enjoy fresh fruits and vegetables, take a vacation, and have fun. It’s also a time to pay attention to your health and safety. Below are tips to help you stay safe and healthy this summer and all year long.

Sprains, strains, tendonitis, and even broken bones are all consequences of living an active and athletic lifestyle. Luckily, with the right knowledge and preparation, many injuries can be diminished or entirely prevented.

There are two classes of injuries: traumatic and cumulative. Traumatic injuries are those accidents that happen in sport or daily life, such as rolling your ankle on a trail run or crashing your bike on the morning commute. Cumulative injuries relate to tissue damage that occurs over time as a result of repetitive strain. These types of injuries creep up and may be a function of poor posture, faulty movement patterns, or improper training.

 

The Seven Most Common Sports Injuries

What weekend warriors need to know about preventing and treating the seven most common sports injuries!

After a sedentary work week, end-zone catches and 36-hole weekends can take their toll in common sports injuries. The seven most common sports injuries are:

  1. Ankle sprain
  2. Groin pull
  3. Hamstring strain
  4. Shin splints
  5. Knee injury: ACL tear
  6. Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone
  7. Tennis elbow (epicondylitis)

To see how to prevent and treat these common sports injuries — and to learn when it’s time to look further than your medicine cabinet to treat sports injuries— read on.

The most common sports injuries are strains and sprains

Sprains are injuries to ligaments, the tough bands connecting bones in a joint. Suddenly stretching ligaments past their limits deforms or tears them. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones. Strains are called “pulled muscles” for a reason: Over-stretching or overusing a muscle causes tears in the muscle fibers or tendons.

“Think of ligaments and muscle-tendon units like springs,” says William Roberts, MD, sports medicine physician at the University of Minnesota and spokesman for the American College of Sports Medicine. “The tissue lengthens with stress and returns to its normal length — unless it is pulled too far out of its normal range.”

Preventing the most common sports injuries

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. “Some injuries,” Roberts says, “we bring on ourselves because we’re not conditioned for the activity.” His advice: “Work out daily and get double benefit — enjoy your weekend activities and garner the health benefits.”

Every workout should start with a gentle warm-up to prevent common sports injuries, says Margot Putukian, MD, director of athletic medicine at Princeton University. “Getting warmed up increases blood flow to the muscles, gets you more flexible, and could decrease injuries,” she adds.

Overuse injuries are common and preventable, according to Putukian. “Don’t come out and hit the ball for an hour after not playing for a while,” she says. Whether it’s hiking, running, or team sports, do some “pre-participation training” first by lightly working the relevant muscle groups in the weeks before the activity.

And learn to recognize when you’ve already left it all on the field. Stop when you are fatigued. Muscle fatigue takes away all your protective mechanisms and really increases your risk of all injuries. You can always come out to play again next weekend — if you don’t get injured today.

Treating the most common sports injuries

Usually, common sports injuries are mild or moderate — there’s some damage, but everything is still in place. You can treat them at home using the PRICE therapy method described later in this article. But you should expect that some common sports injuries may take months to heal, even with good treatment. If a sprain or strain is severe, however, the entire muscle, tendon, or ligament is torn away, and surgery may be needed.

Here are some specific tips for treating each of the most common sports injuries:

1. Ankle sprain

What it is: Most athletes have experienced a sprained ankle, which typically occurs when the foot turns inward. This turning stretches or tears the ligaments on the outside of the ankle, which are relatively weak.

What you can do: With an ankle sprain, it’s important to exercise to prevent loss of flexibility and strength — and re-injury. You can ask your doctor or physical therapist to help you know what kinds of exercise you should do.

When to see a doctor: It’s important to note where the sprain has occurred. A ‘high ankle sprain’ is slower to heal and should probably be seen by a doctor to make sure the bones in the lower leg did not separate. One way to recognize a high ankle sprain is that this sprain usually causes tenderness above the ankle.

2. Groin pull

What it is: Pushing off in a side-to-side motion causes strain of the inner thigh muscles, or groin. Hockey, soccer, football, and baseball are common sports with groin injuries.

What you can do: Compression, ice, and rest will heal most groin injuries. Returning to full activity too quickly can aggravate a groin pull or turn it into a long-term problem.

When to see a doctor: Any groin pull that has significant swelling should be seen early by a physician.

3. Hamstring strain

What it is: Three muscles in the back of the thigh form the hamstring. The hamstring can be over-stretched by movements such as hurdling — kicking the leg out sharply when running. Falling forward while waterskiing is another common cause of hamstring strains.

What you can do: Hamstring injuries are slow to heal because of the constant stress applied to the injured tissue from walking. Complete healing can take six to 12 months. Re-injuries are common because it’s hard for many guys to stay inactive for that long.

4. Shin splints

What they are: Pains down the front of the lower legs are commonly called “shin splints.” They are most often brought on by running — especially when starting a more strenuous training program like long runs on paved roads.

What you can do: Rest, ice, and over-the-counter pain medicine are the mainstays of treatment.

When to see a doctor: The pain of shin splints is rarely an actual stress fracture — a small break in the shin bone. But you should see your doctor if the pain persists, even with rest. Stress fractures require prolonged rest, commonly a month or more to heal.

5. Knee injury: ACL tear

What it is: The anterior cruciate ligament (ACL) holds the leg bone to the knee. Sudden “cuts” or stops or getting hit from the side can strain or tear the ACL. A complete tear can make the dreaded “pop” sound.

When to see a doctor: Always, if you suspect an ACL injury. ACL tears are potentially the most severe of the common sports injuries. “A completely torn ACL will usually require surgery in individuals who wish to remain physically active.

6: Knee injury: Patellofemoral syndrome

What it is: Patellofemoral syndrome can result from the repetitive movement of your kneecap (patella) against your thigh bone (femur), which can damage the tissue under the kneecap. Running, volleyball, and basketball commonly set it off. One knee or both can be affected.

What you can do: Patience is key. Patellofemoral pain can take up to six weeks to clear up. It’s important to continue low-impact exercise during this time. Working out the quadriceps can also relieve pain.

7. Tennis elbow (epicondylitis)

What it is: Repetitive use of the elbow — for example, during golf or tennis swings — can irritate or make tiny tears in the elbow’s tendons. Epicondylitis is most common in 30- to 60-year-olds and usually involves the outside of the elbow.

What you can do: Epicondylitis can usually be cleared up by staying off the tennis court or golf course until the pain improves.

The PRICE principle for treating common sports injuries

The U.S. Marines say that “pain is weakness leaving your body.” Most of the rest of us would add, “OK, but can’t we hurry it up a little?” The answer is yes. Using the PRICE method to treat any common sports injury will help get you back in the game sooner.

First, it’s important to know that swelling is a normal response to these injuries. Excessive swelling, though, can reduce range of motion and interfere with healing. You can limit swelling and start healing faster after common sports injuries by using the PRICE principle:

  • P — protect from further injury
    For more severe injuries, protect the injured area with a splint, pad, or crutch.
  • R — restrict activity
    Restricting activity will prevent worsening of the injury.
  • I — apply ice
    Apply ice immediately after a common sports injury. “Ice is the miracle drug” for sports injuries, says Putukian. “It’s an anti-inflammatory, without many side effects.” Use ice for 20 minutes every one to two hours for the first 48 hours after the injury. Don’t use heat during this time — it encourages swelling and inflammation.
  • C — apply compression
    Compression with an elastic bandage will help reduce swelling.
  • E — elevate the injured area
    Elevating the injured area above the heart will also reduce swelling.

Over-the-counter pain relievers usually relieve the pain of common sports injuries to a tolerable level. If they don’t, it’s probably time to see a doctor.

When to get medical attention for common sports injuries

We know you’re tough — but you also need to be smart. If you suspect a serious injury or if you have any of these signs, see a doctor:

  • Deformities in the joint or bone — it looks “crooked,” or moves abnormally
  • You cannot bear weight or can’t use the limb without it “giving way”
  • Excessive swelling
  • Changes in skin color beyond mild bruising
  • It’s not getting any better after a few days of PRICE therapy

 

If you are injured the Team of Orthopedic Physicians here at TOCA are here to help! To learn more or schedule an appointment call: 602-277-6211.

 

#Results #Recovery #Relief #Injuryprevention #Menshealth #ShowUsYourBlue #SportsMedicine #SportsInjury #TOCA #TOCAMD