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Shoulder Surgery

Shoulder Surgery

The shoulders are among the most important joints in the human body. Unfortunately, as we age our shoulders can wear out plus they may be subject to debilitating conditions such as arthritis, disease, or other injuries.

Your shoulder is the most flexible joint in your body. It allows you to place and rotate your arm in many positions in front, above, to the side, and behind your body. This flexibility also makes your shoulder susceptible to instability and injury.

Depending on the nature of the problem, nonsurgical methods of treatment often are recommended before surgery. However, in some instances, delaying the surgical repair of a shoulder can increase the likelihood that the problem will be more difficult to treat later. Early, correct diagnosis and treatment of shoulder problems can make a significant difference in the long run.

How the Normal Shoulder Works

(Anatomy of the shoulder joint)

The shoulder is a ball-and-socket joint. It is made up of three bones: the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle).

The ball at the top end of the arm bone fits into the small socket (glenoid) of the shoulder blade to form the shoulder joint (glenohumeral joint).

The socket of the glenoid is surrounded by a soft-tissue rim (labrum).

A smooth, durable surface (articular cartilage) on the head of the arm bone, and a thin inner lining (synovium) of the joint allows the smooth motion of the shoulder joint.

The upper part of the shoulder blade (acromion) projects over the shoulder joint. One end of the collarbone is joined with the shoulder blade by the acromioclavicular (AC) joint. The other end of the collarbone is joined with the breastbone (sternum) by the sternoclavicular joint.

The joint capsule is a thin sheet of fibers that surrounds the shoulder joint. The capsule allows a wide range of motion, yet provides stability.

The rotator cuff is a group of muscles and tendons that attach your upper arm to your shoulder blade. The rotator cuff covers the shoulder joint and joint capsule.

The muscles attached to the rotator cuff enable you to lift your arm, reach overhead, and take part in activities such as throwing or swimming.

A sac-like membrane (bursa) between the rotator cuff and the shoulder blade cushions and helps lubricate the motion between these two structures.

 

Shoulder Problems and Treatments

Bursitis or Tendinitis

Bursitis or tendinitis can occur with overuse from repetitive activities, such as swimming, painting, or weight lifting. These activities cause rubbing or squeezing (impingement) of the rotator cuff under the acromion and in the acromioclavicular joint. Initially, these problems are treated by modifying the activity which causes the symptoms of pain and with a rehabilitation program for the shoulder.

Impingement and Partial Rotator Cuff Tears

Partial thickness rotator cuff tears can be associated with chronic inflammation and the development of spurs on the underside of the acromion or the acromioclavicular joint.

The conservative nonsurgical treatment is modification of activity, light exercise, and, occasionally, a cortisone injection. Nonsurgical treatment is successful in a majority of cases. If it is not successful, surgery often is needed to remove the spurs on the underside of the acromion and to repair the rotator cuff.

 

Full-Thickness Rotator Cuff Tears

Full-thickness rotator cuff tears are most often the result of impingement, partial thickness rotator cuff tears, heavy lifting, or falls. Nonsurgical treatment with modification of activity is successful in a majority of cases.

If pain continues, surgery may be needed to repair full- thickness rotator cuff tears. Arthroscopic techniques allow shaving of spurs, evaluation of the rotator cuff, and repair of some tears.

Both techniques require extensive rehabilitation to restore the function of the shoulder.

 

Instability of the Shoulder

Instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of sudden injury or from overuse of the shoulder ligaments.

The two basic forms of shoulder instability are subluxations and dislocations. A subluxation is a partial or incomplete dislocation. If the shoulder is partially out of the shoulder socket, it eventually may dislocate. Even a minor injury may push the arm bone out of its socket. A dislocation is when the head of the arm bone slips out of the shoulder socket. Some patients have chronic instability. Shoulder dislocations may occur repeatedly.

Patients with repeat dislocation usually require surgery. Open surgical repair may require a short stay in the hospital. Arthroscopic surgical repair is often done on an outpatient basis. Following either procedure, extensive rehabilitation, often including physical therapy, is necessary for healing.

 

Fractured Collarbone and Acromioclavicular Joint Separation

A fractured collarbone and acromioclavicular separation are common injuries of children and others who fall on the side of their shoulder when playing. Most of these injuries are treated nonsurgically with slings or splints. Severe displaced fractures or acromioclavicular joint separation may require surgical repair.

 

 

 

Fractured Head of the Humerus (Arm Bone), or Proximal Humerus Fracture

A fractured head of the humerus is a common result of falls on an outstretched arm, particularly by older people with osteoporosis. If fragmented or displaced, it may require open surgical repair and possibly replacement with an artificial joint (prosthesis).

 

 

 

 

Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis and rheumatoid arthritis can destroy the shoulder joint and surrounding tissue. They can also cause degeneration and tearing of the capsule or the rotator cuff. Osteoarthritis occurs when the articular surface of the joint wears thin. Rheumatoid arthritis is associated with chronic inflammation of the synovium lining which can produce chemicals that eventually destroy the inner lining of the joint, including the articular surface.

 

 

 

Shoulder replacement

Shoulder replacement is recommended for patients with painful shoulders and limited motion. The treatment options are either replacement of the head of the bone or replacement of the entire socket. Your orthopaedic surgeon will discuss with you the best option.

 

 

Orthopaedic Evaluation

The orthopaedic evaluation of your shoulder consists of three components:

  • A medical history to gather information about current complaints; duration of symptoms, pain and limitations; injuries; and past treatment with medications or surgery.
  • A physical examination to assess swelling, tenderness, range of motion, strength or weakness, instability, and/or deformity of the shoulder.
  • Diagnostic tests, such as X-rays taken with the shoulder in various positions. Magnetic resonance imaging (MRI) may be helpful in assessing soft tissues in the shoulder. Computed tomography (CT) scan may be used to evaluate the bony parts of the shoulder.

Your orthopaedic surgeon will review the results of your evaluation with you and discuss the best treatment. You and your doctor may agree that surgery is the best treatment option. He or she will explain the potential risks and complications that may occur. Your doctor may discuss donating your own blood to be used if needed during surgery.

Some surgical procedures require hospitalization for a number of days. Your doctor may discuss planning for the period after surgery. You may need to either stay in an extended care facility or have someone help you when you return home.

Preparing for Surgery

  • No food or drink after midnight before surgery.
  • Discuss with your doctor what to do about medications taken in the morning.
  • An hour before surgery, you will be assessed in the preoperative area by a nurse anesthetist or anesthesiologist.

Types of Surgical Procedures

You may be given the option to have an arthroscopic procedure or an open surgical procedure.

Arthroscopy

Arthroscopy allows the orthopaedic surgeon to insert a pencil-thin device with a small lens and lighting system into tiny incisions to look inside the joint. The images inside the joint are relayed to a TV monitor, allowing the doctor to make a diagnosis. Other surgical instruments can be inserted to make repairs, based on what is with the arthroscope. Arthroscopy often can be done on an outpatient basis. According to the American Orthopaedic Society for Sports Medicine, more than 1.4 million shoulder arthroscopies are performed worldwide each year.

Open Surgery

Open surgery may be necessary and, in some cases, may be associated with better results than arthroscopy. Open surgery often can be done through small incisions of just a few inches.

Recovery and rehabilitation is related to the type of surgery performed inside the shoulder, rather than whether there was an arthroscopic or open surgical procedure.

Possible Complications After Surgery

There are always some risks with any surgery, even arthroscopic procedures. These include possible infection, and damage to surrounding nerves and blood vessels. However, modern surgical techniques and close monitoring have significantly minimized the occurrence of these problems.

After surgery, some pain, tenderness, and stiffness are normal. You should be alert for certain signs and symptoms that may suggest the development of complications.

  • Fever after the second day following surgery
  • Increasing pain or swelling
  • Redness, warmth, or tenderness which may suggest a wound infection
  • Unusual bleeding (some surgical wound drainage is normal and, in fact, desirable
  • Numbness or tingling of the arm or hand

Prevention of Future Problems

It is important that you continue a shoulder exercise program with daily stretching and strengthening. In general, patients who faithfully comply with the therapies and exercises prescribed by their orthopaedic surgeon and physical therapist will have the best medical outcome after surgery.

Your orthopaedic surgeon is a medical doctor with extensive training in the diagnosis and nonsurgical and surgical treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles, and nerves.

Using your shoulder after surgery

You had surgery on your shoulder to repair a muscle, tendon, or cartilage tear. The surgeon may have removed damaged tissue. You will need to know how to take care of your shoulder as it heals, and how to make it stronger.

What to Expect at Home

You will need to wear a sling when you leave the hospital. You may also need to wear a shoulder immobilizer. This keeps your shoulder from moving. How long you need to wear the sling or immobilizer depends on the type of surgery you had.

Follow your surgeon’s instructions for how to take care of your shoulder at home. Use the information below as a reminder.

Self-care

Wear the sling or immobilizer at all times, unless the surgeon says you do not have to.

  • It is ok to straighten your arm below your elbow and move your wrist and hand. But try to move your arm as little as possible.
  • Your arm should bend at a 90° angle (a right angle) at your elbow. The sling should support your wrist and hand so that they do not extend past the sling.
  • Move your fingers, hand, and wrist around 3 to 4 times during the day while they are in the sling. Each time, do this 10 to 15 times.
  • When the surgeon tells you to, begin taking your arm out of the sling and let it hang loosely by your side. Do this for longer periods each day.

If you wear a shoulder immobilizer, you can loosen it only at the wrist strap and straighten your arm at your elbow. Be careful not to move your shoulder when you do this. DO NOT take off the immobilizer all the way unless the surgeon tells you it is OK.

If you had rotator cuff surgery or other ligament or labral surgery, you need to be careful with your shoulder. Ask the surgeon what arm movements are safe to do.

  • DO NOT move your arm away from your body or over your head.
  • When you sleep, raise your upper body up on pillows. DO NOT lie flat. You can also try sleeping on a reclining chair.

You may also be told not to use your or hand on the side that had surgery. For example, DO NOT:

  • Lift anything with this arm or hand.
  • Lean on the arm or put any weight on it.
  • Bring objects toward your stomach by pulling in with this arm and hand.
  • Move or twist your elbow behind your body to reach for anything.

Your surgeon will refer you to a physical therapist to learn exercises for your shoulder. To learn more about TOCA’s Physical Therapy Team Click HERE

  • You will probably start with passive exercises. These are exercises the therapist will do with your arm. They help get the full movement back in your shoulder.
  • After that you will do exercises the therapist teaches you. These will help increase the strength in your shoulder and the muscles around your shoulder.

Consider making some changes around your home so it is easier for you to take care of yourself. Store everyday items you use in places you can reach easily. Keep things with you that you use a lot (such as your phone).

When to Call the Doctor

Call your surgeon or nurse if you have any of the following:

  • Bleeding that soaks through your dressing and does not stop when you place pressure over the area
  • Pain that does not go away when you take your pain medicine
  • Swelling in your arm
  • Your hand or fingers are darker in color or feel cool to the touch
  • Numbness or tingling in your fingers or hand
  • Redness, pain, swelling, or a yellowish discharge from any of the wounds
  • Fever of 101°F (38.3°C), or higher
  • Shortness of breath and chest pain

 

For questions about your shoulder pain or to schedule an appointment call the dedicated TOCA Team at: 602-451-4051!

For more articles and information about your shoulder consider reading more on our shoulder page and/or additional articles such as: Shoulder Pain: When to Worry and Shoulder Injury Prevention Tips

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD #shoulderpain #painfree #shouldersurgery

 

http://orthoinfo.aaos.org

Sciatica

If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg, you may have a protruding (herniated) disk in your spinal column that is pressing on the nerve roots in the lumbar spine. This condition is known as sciatica.

What is sciatica?

Sciatica (pronounced sigh-at-eh-kah)  is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and can radiate down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.

Symptoms

Sciatica may feel like a bad leg cramp, with pain that is sharp (“knife-like”), or electrical. The cramp can last for weeks before it goes away. You may have pain, especially when you move, sneeze, or cough. You may also have weakness, “pins and needles” numbness, or a burning or tingling sensation down your leg.

Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms are usually based on the location of the pinched nerve.

Causes

Sciatica rarely occurs before age 20, and becomes more commonplace in middle age. It is most likely to develop around age 30 and 50.

Perhaps because the term sciatica is often used loosely to describe leg pain, estimates of its prevalence vary widely. Some researchers have estimated it will affect up to 43% of the population at some point.

Often, a particular event or injury does not cause sciatica—rather it tends to develop over time.

The vast majority of people who experience sciatica get better within a few weeks or months and find pain relief with nonsurgical sciatica treatment. For others, however, the leg pain from a pinched nerve can be severe and debilitating.

Seeing a doctor for sciatica pain is advised, both for learning how to reduce the pain and to check for the possibility of a serious medical issue.

While sciatica is most commonly a result of a lumbar disc herniation directly pressing on the nerve, any cause of irritation or inflammation of the sciatic nerve can produce the symptoms of sciatica. This irritation of nerves as a result of an abnormal intervertebral disc is referred to as radiculopathy. Approximately 1 in every 50 people will experience a herniated disk at some point in their life. Of these, 10% to 25% have symptoms that last more than 6 weeks. In rare cases, a herniated disk may press on nerves that cause you to lose control of your bladder or bowel, referred to as cauda equina syndrome. If this happens, you may also have numbness or tingling in your groin or genital area. This is an emergency situation that requires surgery. Phone your doctor immediately. Aside from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle, internal bleeding, infections in or around the lumbar spine, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.

6 Most Common Causes of Sciatica

When discussing sciatica, it is important to understand the underlying medical cause, as effective treatment will focus on addressing the pain’s root cause as well as alleviating acute symptoms.

  • Lumbar herniated disc
    A herniated disc occurs when the soft inner material of the disc leaks out, or herniates, through the fibrous outer core and irritates or pinches the contiguous nerve root.

Other terms used to refer to a herniated disc are slipped disc, ruptured disc, bulging disc, protruding disc, or a pinched nerve. Sciatica is the most common symptom of a lumbar herniated disc.

  • Degenerative disc disease
    While some level of disc degeneration is a natural process that occurs with aging, for some people one or more degenerated discs in the lower back can also irritate a nerve root and cause sciatica.

Degenerative disc disease is diagnosed when a weakened disc results in excessive micro-motion at that spinal level, and inflammatory proteins from inside the disc become exposed and irritate the nerve root(s) in the area.

Bone spurs, which may develop with spinal degeneration, also may press against a nerve, resulting in sciatica.

  • Isthmic spondylolisthesis
    This condition occurs when a small stress fracture allows one vertebral body to slip forward on another; for example, if the L5 vertebra slips forward over the S1 vertebra.

With a combination of disc space collapse, the fracture, and the vertebral body

  • Lumbar spinal stenosis
    This condition commonly causes sciatica due to a narrowing of the spinal canal. Lumbar spinal stenosis is related to natural aging in the spine and is relatively common in adults older than age 60.

The condition typically results from a combination of one or more of the following: enlarged facet joints, overgrowth of soft tissue, and a bulging disc placing pressure on the nerve roots, causing sciatica pain.

Lumbar spinal stenosis commonly occurs along with spinal arthritis, and arthritis can also cause or contribute to sciatica symptoms.

  • Piriformis syndrome
    The sciatic nerve can get irritated as it runs under the piriformis muscle in the buttock. If the piriformis muscle irritates or pinches a nerve root that comprises the sciatic nerve, it can cause sciatica-type pain.

This is not a true lumbar radiculopathy, which is the clinical definition of sciatica. However, because the leg pain can feel the same as sciatica or radiculopathy, it is sometimes referred to as sciatica.

  • Sacroiliac joint dysfunction
    Irritation of the sacroiliac joint—located at the bottom of the spine—can also irritate the L5 nerve, which lies on top of the sacroiliac joint, causing sciatica-type pain.

Again, this is not a true radiculopathy, but the leg pain can feel the same as sciatica caused by a nerve irritation.

What are risk factors for sciatica? What are sciatica symptoms?

Risk factors for sciatica include degenerative arthritis of the lumbar spine, lumbar disc disease, and slipped disc, and trauma or injury to the lumbar spine.

Sciatica causes pain, a burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg. The result is lumbar painbuttock painhip pain, and leg pain. Sometimes the pain radiates around the hip or buttock to feel like hip pain. While sciatica is often associated with lower back pain (lumbago), it can be present without low back pain. Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down. The pain relief by changing positions can be partial or complete.

When Sciatica Is Serious

Certain sciatica symptoms, while rare, require immediate medical, and possibly surgical, intervention. These include, but are not limited to, progressive neurological symptoms (e.g. leg weakness) and/or bowel or bladder dysfunction (cauda equina syndrome). Infection or spinal tumors can also cause sciatica.

Because sciatica is caused by an underlying medical condition, treatment is focused on addressing the cause of symptoms rather than just the symptoms. Treatment is usually self-care and/or nonsurgical, but for severe or intractable pain and dysfunction it may be advisable to consider surgery.

How do health-care professionals diagnose sciatica?

Diagnosis begins with a complete patient history. Your doctor will ask you to explain how your pain started, where it travels, and exactly what it feels like.

A physical examination may help pinpoint the irritated nerve root. Your doctor may ask you to squat and rise, walk on your heels and toes, or perform a straight-leg raising test or other tests.

X-rays and other specialized imaging tools, such as a magnetic resonance imaging (MRI) scan, may confirm your doctor’s diagnosis of which nerve roots are affected.

Nonsurgical Treatment

The condition usually heals itself, given sufficient time and rest. Approximately 80% to 90% of patients with sciatica get better over time without surgery, typically within several weeks.

Nonsurgical treatment is aimed at helping you manage your pain without long-term use of medications. Nonsteroidal anti-inflammatory drugs such as ibuprofen, aspirin, or muscle relaxants may also help. In addition, you may find it soothing to put gentle heat or cold on your painful muscles. It is important that you continue to move. Do not remain in bed, as too much rest may cause other parts of the body to feel discomfort.

Find positions that are comfortable, but be as active as possible. Motion helps to reduce inflammation. Most of the time, your condition will get better within a few weeks.

Sometimes, your doctor may inject your spinal area with a cortisone-like drug.

As soon as possible, start stretching exercises so you can resume your physical activities without sciatica pain. Your doctor may want you to take short walks and may prescribe physical therapy.

Surgical Treatment

You might need surgery if you still have disabling leg pain after 3 months or more of nonsurgical treatment. A part of your surgery, your herniated disk may be removed to stop it from pressing on your nerve.

 

The surgery (laminotomy with discectomy) may be done under local, spinal, or general anesthesia. This surgery is usually very successful at relieving pain, particularly if most of the pain is in your leg.

Rehabilitation

Your doctor may give you exercises to strengthen your back. It is important to walk and move while limiting too much bending or twisting. It is acceptable to perform routine activities around the house, such as cooking and cleaning.

Following treatment for sciatica, you will probably be able to resume your normal lifestyle and keep your pain under control. However, it is always possible for your disk to rupture again.

Physical Therapy and Exercise for Sciatica

Physical therapy exercises incorporating a combination of strengthening, stretching, and aerobic conditioning are a central component of almost any sciatica treatment plan.

When patients engage in a regular program of gentle exercises, they can recover more quickly from sciatica pain and are less likely to have future episodes of pain.

Sciatica exercises usually focus on three key areas: strengthening, stretching, and aerobic conditioning.

  • Strengthening exercises
    Many exercises can help strengthen the spinal column and the supporting muscles, ligaments, and tendons. Most of these back exercises focus not only on the lower back, but also the abdominal (stomach) muscles and gluteus (buttock) and hip muscles.

Strong core muscles can provide pain relief because they support the spine, keeping it in alignment and facilitating movements that extend or twist the spine with less chance of injury or damage.

  • Stretching exercises
    Stretching is usually recommended to alleviate sciatic pain. Stretches for sciatica are designed to target muscles that cause pain when they are tight and inflexible.

Hamstring stretching is almost always an important part of a sciatica exercise program. Most people do not stretch these muscles, which extend from the pelvis to the knee in the back of the thigh, in their daily activities.

Another stretch that is often helpful in easing sciatica is the Bird Dog move: After getting on their hands and knees, individuals extend one arm and the opposite leg. The arm and leg extensions are then alternated. A more advanced version of this exercise is the Plank Bird Dog move, in which the extensions are done once the person is in the plank position on their hands and toes.

  • Low-impact aerobic exercise
    Some form of low-impact cardiovascular exercise, such as walking, swimming, or pool therapy is usually a component of recovery, as aerobic activity encourages the exchange of fluids and nutrients to help create a better healing environment.

Aerobic conditioning also has the unique benefit of releasing endorphins, the body’s natural pain killers, which helps reduce sciatic pain.

These types of exercise may be done separately or in combination. Examples of types of exercise that may include both strengthening and stretching include yogatai chi, and Pilates.

For anyone in chronic pain or with a relatively high level of sciatica pain, one option for gentle exercise is water therapy, which is a controlled, progressive exercise program done in a warm pool.

When sciatica pain is at its most severe, patients may find the pain hard to bear and may need to rest for a day or two. However, resting for more than one or two days is generally not advised, as prolonged rest or inactivity can increase pain and will lead to deconditioning. Regular movement is important to provide healing nutrients to the injured structures that are causing the pain.

If you are experiencing back or neck pain the experts at TOCA are here to help! Call our dedicated team to schedule your consultation today at: 602-277-6211!

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD #backpain

Foot & Ankle Conditioning Program

After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. Following a well-structured conditioning program will also help you return to sports and other recreational activities.

This is a general conditioning program that provides a wide range of exercises. To ensure that the program is safe and effective for you, it should be performed under your doctor’s supervision. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals.

Strength: Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury.

Flexibility: Stretching the muscles that you strengthen is important for restoring range of motion and preventing injury. Gently stretching after strengthening exercises can help reduce muscle soreness and keep your muscles long and flexible.

Target Muscles: The muscle groups of the lower leg are targeted in this conditioning program, as well as the tendons and ligaments that control movement in your feet. These include:

  • Gastrocnemius-soleus complex (calf)
  • Anterior tibialis (shin)
  • Posterior tibialis (center of calf)
  • Peroneus longus (outside of lower calf)
  • Peroneus brevis (outside of lower calf)
  • Soleus (calf)
  • Dorsiflexors (ankle)
  • Plantar flexors (ankle)
  • Invertors (ankle)
  • Evertors (ankle)

Length of program: This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your feet and lower legs. Performing the exercises three to five days a week will maintain strength and range of motion in your foot and ankle.

 

Getting Started

Warm up: Before doing the following exercises, warm up with 5 to 10 minutes of low impact activity, like walking or riding a stationary bicycle.

Stretch: After the warm-up, do the stretching exercises shown on Page 1 before moving on to the strengthening exercises. When you have completed the strengthening exercises, repeat the stretching exercises to end the program.

Do not ignore pain: You should not feel pain during an exercise. Talk to your doctor or physical therapist if you have any pain while exercising.

Ask questions: If you are not sure how to do an exercise, or how often to do it, contact your doctor or physical therapist

 

1. Heel Cord Stretch

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this stretch in your calf and into your heel

Equipment needed: None

Step-by-step directions

  • Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Your affected leg is straight and behind you, with the heel flat and the toes pointed in slightly.
  • Keep both heels flat on the floor and press your hips forward toward the wall.
  • Hold this stretch for 30 seconds and then relax for 30 seconds. Repeat.

Tip Do not arch your back.

2. Heel Cord Stretch with Bent Knee

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Soleus
You should feel this stretch in your calf, the sides of your ankle, and into your heel

Equipment needed: None

Step-by-step directions

  • Stand facing a wall with your unaffected leg forward with a slight bend at the knee. Your affected leg is behind you, with the knee bent and the toes pointed in slightly.
  • Keep both heels flat on the floor and press your hips forward toward the wall.
  • Hold the stretch for 30 seconds and then relax for 30 seconds. Repeat.

Tip Keep your hips centered over both feet.

 

3. Golf Ball Roll

Repetitions 1
Days per week Daily

Main muscles worked: Plantar fascia ligament
You should feel this exercise along the bottom of your foot

Equipment needed: Golf ball

Step-by-step directions

  • Sit on a stable chair with both feet planted on the floor.
  • Roll a golf ball under the arch of your affected foot for 2 minutes.

Tip Sit up tall and keep your foot toward your chair.

 

4. Towel Stretch

Repetitions 2 sets of 10
Days per week 6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this stretch in your calf and into your heel

Equipment needed: Hand towel

Step-by-step directions

  • Sit on the floor with both legs out in front of you.
  • Loop a towel around the ball of your affected foot and grasp the ends of the towel in your hands.
  • Keep your affected leg straight and pull the towel toward you.
  • Hold for 30 seconds and then relax for 30 seconds. Repeat 3 times.

Tip Sit up tall and keep your legs straight.

 

 

5. Calf Raises

Repetitions 2 sets of 10
Days per week6 to 7

Main muscles worked: Gastrocnemius-soleus complex
You should feel this exercise in your calf

Equipment needed: Chair for support

Step-by-step directions

  • Stand with your weight evenly distributed over both feet. Hold onto the back of a chair or a wall for balance.
  • Lift your unaffected foot off of the floor so that all of your weight is placed on your affected foot.
  • Raise the heel of your affected foot as high as you can, then lower.
  • Repeat 10 times.

Tip Do not bend the knee of your working leg.

 

5. Ankle Range of Motion

Repetitions 2 sets
Days per week Daily

Main muscles worked: Dorsiflexors, plantar flexors, invertors, evertors
You should feel this exercise at the top of your foot and throughout your ankle

Equipment needed: None

Step-by-step directions

  • Sit down so that your feet do not touch the floor.
  • Use your foot to write each letter of the alphabet in the air. Lead with your big toe.

Tip Keep the movements small, using just your foot and ankle.

 

 

6. Marble Pickup

Repetitions 20
Days per week Daily

Main muscles worked: Plantar flexors
You should feel this exercise at the top of your foot and toes

Equipment needed: 20 marbles

Step-by-step directions

  • Sit with both feet flat and place 20 marbles on the floor in front of you.
  • Use your toes to pick up one marble at a time and place into a bowl.
  • Repeat until you have picked up all the marbles.

Tip Do not place the marbles too far out in front or to the side.

 

 

7. Towel Curls

Repetitions 5
Days per week Daily

Main muscles worked: Plantar flexors
You should feel this exercise at the top of your foot and your toes

Equipment needed: Hand towel

Step-by-step directions

  • Sit with both feet flat and place a small towel on the floor in front of you.
  • Grab the center of the towel with your toes and curl the towel toward you.
  • Relax and repeat.

Tip You can make this exercise more challenging by placing a weight on the edge of the towel.

 

 

8. Ankle Dorsiflexion/Plantar Flexion

Repetitions 3 sets of 10
Days per week 3

Main muscles worked: Anterior tibialis, gastrocnemius-soleus complex
You should feel this exercise at your calf, shin, the back of your heel, and the top of your foot

Equipment needed: Use an elastic stretch band of comfortable resistance

Step-by-step directions

  • Sit on the floor with your legs straight out in front of you.
  • For dorsiflexion, anchor the elastic band on a chair or table leg, then wrap it around your foot.
  • Pull your toes toward you and slowly return to the start position. Repeat 10 times.
  • For plantar flexion, wrap the elastic band around your foot and hold the ends in your hand.
  • Gently point your toes and slowly return to the start position. Repeat 10 times.

Tip Keep your leg straight and heel on the floor for support.

 

If you are experiencing foot and/or ankle pain the experts at TOCA are here to help! View our website for more information or call our dedicated team to schedule an appointment today at: 602-277-6211!

 

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD#orthopedics #footpain #anklepain #injuryrecovery

 

What is Spinal Stenosis & How do I treat it?

What Is Spinal Stenosis?

Spinal stenosis is a condition, mostly in adults 50 and older, in which your spinal canal starts to narrow. This can cause pain and other problems.

Your spine is made up of a series of connected bones (or “vertebrae”) and shock-absorbing discs. It protects your spinal cord, a key part of the central nervous system that connects the brain to the body. The cord rests in the canal formed by your vertebrae.

For most people, the stenosis results from changes because of arthritis. The spinal canal may narrow. The open spaces between the vertebrae may start to get smaller. The tightness can pinch the spinal cord or the nerves around it, causing pain, tingling, or numbness in your legs, arms, or torso.

There’s no cure, but there are a variety of nonsurgical treatments and exercises to keep the pain at bay. Most people with spinal stenosis live normal lives.

 

Healthy Spine

The spinal canal has a rounded triangular shape that holds the nerve roots without pinching. Nerve roots leave the spinal canal through openings called nerve root canals which are also free of obstruction.

Affected Spine

New bone growth within the spinal canal causes compression of nerve roots, which leads to the pain of spinal stenosis.

 

Causes

The leading reason for spinal stenosis is arthritis, a condition caused by the breakdown of cartilage — the cushiony material between your bones — and the growth of bone tissue.

Osteoarthritis can lead to disc changes, a thickening of the ligaments of the spine, and bone spurs. This can put pressure on your spinal cord and spinal nerves.

Other causes include:

  • Herniated discs. If the cushions are cracked, material can seep out and press on your spinal cord or nerves.
  • Injuries. An accident may fracture or inflame part of your spine.
  • Tumors. If cancerous growths touch the spinal cord, you may get stenosis.
  • Paget’s disease. With this condition, your bones grow abnormally large and brittle. The result is a narrowing of the spinal canal and nerve problems.
  • Overgrowth of bone. Wear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal. Paget’s disease, a bone disease that usually affects adults, also can cause bone overgrowth in the spine.
  • Thickened Ligaments. The tough cords that help hold the bones of your spine together can become stiff and thickened over time. These thickened ligaments can bulge into the spinal canal.

Some people are born with spinal stenosis or diseases that lead to it. For them, the condition usually starts to cause problems between the ages of 30 and 50.

Symptoms

Spinal stenosis usually affects your neck or lower back. Not everyone has symptoms, but if you do, they tend to be the same: stiffness, numbness, and back pain.

When symptoms do occur, they often start gradually and worsen over time. Symptoms vary, depending on the location of the stenosis:

  • In the neck (cervical spine).Cervical stenosis can cause numbness, weakness or tingling in a leg, foot, arm or hand. Tingling in the hand is the most common symptom, and many people also report problems with walking and balance. Nerves to the bladder or bowel may be affected, leading to incontinence.
  • In the lower back (lumbar spine).Compressed nerves in your lumbar spine can cause pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down.

 

More specific symptoms include:

  • Sciatica. These shooting pains down your leg start as an ache in the lower back or buttocks.
  • Foot drop. Painful leg weakness may cause you to “slap” your foot on the ground.
  • A hard time standing or walking. When you’re upright, it tends to compress the vertebrae, causing pain.
  • Loss of bladder or bowel control. In extreme cases, it weakens the nerves to the bladder or bowel.

If you’re having symptoms, you might want to talk them over with your doctor. If you’re having a loss of bladder or bowel control, call your doctor at once.

Diagnosis and Tests

When you visit your doctor, she’s likely to ask you questions about your medical history. After that, she might order at least one of the following tests to figure out whether you have the condition:

  • X-rays. These can show how the shape of your vertebrae has changed.
  • Magnetic resonance imaging (MRI). By using radio waves, an MRI creates a 3-D image of your spine. It can show tumors, growths, and even damage to discs and ligaments.
  • Computerized tomography (CT scan). A CT scan uses X-rays to create a 3-D image. With the help of a dye injected into your body, it can show damage to soft tissue as well as issues with your bones.

Treatment

Your doctor may start off with nonsurgical treatments. These might include:

Medication: Common pain remedies such as aspirinacetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen can offer short-term relief. All are available in low doses without a prescription. Other medications, including muscle relaxants and anti-seizure medications, treat aspects of spinal stenosis, such as muscle spasms and damaged nerves.

Corticosteroid injections: Your doctor will inject a steroid such as prednisone into your back or neck. Steroids make inflammation go down. However, because of side effects, they are used sparingly.

Anesthetics: Used with precision, an injection of a “nerve block” can stop pain for a time.

Exercise: You can improve your flexibility, strength, and balance with regular activity. Your doctor may recommend a physical therapist to help you.

Assistive devices: You might get braces, a corset, or a walker to help you move about.

Surgery

Some people have severe cases. They struggle to walk or have issues with their bladder and bowel. Doctors may recommend surgery for these people. Procedures such as laminectomy and laminoplasty create space between the bones so inflammation can go down.

Surgery carries its own risks. You should have a talk with your doctor about how much it can help, recovery time, and more before taking that step.

Many patients also try nontraditional therapies, including chiropractic and acupuncture. Again, be sure your doctor knows if you’re trying a nontraditional approach.

What You Can Do at Home

Some things you can do to help ease symptoms of spinal stenosis include:

  • Exercise. Think about moderation — not 100 push-ups. Just take a 30-minute walk every other day. Talk over any new exercise plan with your doctor.
  • Apply heat and cold. Heat loosens up your muscles. Cold helps heal inflammation. Use one or the other on your neck or lower back. Hot showers are also good.
  • Practice good posture. Stand up straight, sit on a supportive chair, and sleep on a firm mattress. And when you lift heavy objects, bend from your knees, not your back.
  • Lose weight. When you are heavier, there will be more pressure on your back.

 

If you are experiencing back or neck pain the experts at TOCA are here to help! Call our dedicated team to schedule your consultation today at: 602-277-6211!

#Recovery #Results #Relief #MyOrthoDoc #TOCA #TOCAMD

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

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