29. April 2017 07:38
Ankle Instability is a condition that occurs when the outer ligaments that support the ankle joint are injured or damaged. The condition can be either mechanical or functional. In case of mechanical instability, the ligaments become loose resulting in laxity. However, in functional instability, the ankle joint is anatomically stable but the patient has a constant feeling of joint weakness. The ligaments that get affected in this condition are the anterior talofibular ligament and the calcaneofibular ligament.
- Ligament tear, stretch or rupture
- Repeated episodes of ankle sprain
- Arthritis of ankle joint
- Damage to nerves that surround the ankle
- Osteochondral lesions that develop in the talus and thus damage the joint cartilage
- Conditions like Flat Foot or Hindfoot Varus Alignment
- Presence of loose ligaments in the ankle
- Sports activities that involves a lot of jumping and high impact movement
- Bone spurs may impinge upon the ligament
- Bone fractures in leg or foot
- Inflammation of synovium lining within the joint
- Inability to bear body weight on the ankle and foot joint
- Constant pain on the outer part of inside the ankle
- A constant feeling of the ankle rolling outwards whenever moved
- Swelling and stiffness
- Change in gait and development of a limp
- Hypermobility of the joint
- Analysis of the symptoms and medical history
- Weight bearing X-ray imaging
- MRI and CT scans may be required
- The exact location of pain may be assessed through palpation
Conservative treatment methods include the following
- Wearing an ankle brace for joint support
- Painkillers and anti inflammatory medicines may be prescribed
- All physical movements that stress the joint need to be avoided for some time
- Physical therapy may help to improve joint function and strength
- Compression of the joint using a soft bandage is necessary
- Use proper foot wear and shoe inserts that help support the joint
- Ankle splinting and taping may be helpful
- Ankle Proprioception- Special therapy that improves brain and ankle coordination
Steroids may be injected directly into the joint
Surgical methods of treatment include the following
- Brostrom Procedure- Surgical tightening or shortening of the injured ligaments.
- Replacement of the damaged tissue using donor tissue which may have been extracted from a body part or artificially synthesized
- Calcaneal Osteotomy helps to realign the hindfoot by cutting the heel bone and fixing it in correct alignment using screws
6. February 2017 04:09
Bowed Legs, or Genu Varum, is a structural deformity of the lower limbs in which the knees are pulled apart while the feet are joined together. It is commonly observed in toddlers and is evident due to the large spacing between the legs as well as knees. The condition may affect either one or both the legs and usually subsides on its own by the age of 3-4 years.
- Congenital defects- Folding of the legs in the mother’s womb may lead to bow leg formation in babies
- Rickets- A bone disease that occurs due to deficiency of Vitamin D or Calcium and phosphorus
- Blount’s Disease- Abnormality of the growth plate in tibia
- Fractures of the leg that have not healed properly
- Visibly deformed legs that may tend to curve outwards
- Abnormal gait
- Symptoms are more apparent when the child walks or stands
- Intoeing or inward turning of the feet while walking
- Tendency to trip while walking
- If the condition persists in adolescence, it may out stress on the hips, knee, ankle and pelvis
- Detailed physical examination of the child, birth history and medical condition, if any
- The doctor may check if the bowing is symmetrical (occurs in both legs equally) or asymmetrical (one leg bends more than the other). This is done by measuring the distance between the knees while making the child lie on the stomach
- X-ray imaging may be required to assess the bone structure and underlying cause
- Blood tests may be done to check for conditions like Rickets
- Regular clinical assessments every few months may be recommended to keep a check on the progress of the condition
- Bracing of the legs may be helpful if Blount’s Disease is diagnosed during early childhood
- Specific medication may be prescribed to control effects of Rickets
Surgical intervention may be needed in case the condition worsens and does not subside with conservative treatment. This may include:
- Tibial Osteotomy- Realigning or reshaping the shin bone and holding it in correct anatomical position using pins, plates, screws etc.
- Guided Growth- Surgical procedure to stop the growth of the healthy side of the shin bone to facilitate recovery on the damaged side of the leg
- Physical therapy may be helpful post-surgery to regain strength and stability of the leg
- The child may be advised to use walker or crutches for some time to avoid weight bearing
For treatment of Bowed Legs and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the orthopedic surgeons in McKinney, TX, you can call at (972) 727 – 9995.
10. January 2017 13:26
Radiculopathy is a medical condition that occurs when a nerve in the spine gets pinched or irritated. There are several nerves or ‘nerve roots’ that emerge from the intervertebral joints and spread out into different parts of the body, thus controlling their movement as well as sensation. Radiculopathy may affect the cervical, thoracic or lower spine. However, it is most commonly observed in the lumbar portion. The cervical spine controls the neck and the arms, the abdomen and chest are controlled by the thoracic spine while the legs, hips and the feet are affected by the lumbar spine. The location of the pinched nerve determines which part of the body will have the symptoms.
- Activities that lead to overuse or excessive stressing of the spine
- Injury during contact sports
- Genetic traits may predispose family members to develop Radiculopathy
- Doing excessive labor work or lifting heavy weights
- Disc Herniation may pressurize the nerve as it emerges out of the joint spaces within the spine
- Osteophytes or bone spurs may put pressure on the spinal nerves
- Thickening of the ligaments supporting the spine
- Osteoarthritis of the spine
- Bone tumor
- Spinal infection
- Abnormal curvature of the spine developed due to Scoliosis
- External trauma
- Pain which is generally localized depending on the nerve that is pinched. It may occur in the lower back or the neck and may radiate down into the arms, legs, thighs and buttocks
- Numbness or tingling sensation in the legs and arms
- The affected part of the spine may feel tender when touched
- The muscles controlled by the nerve tend to get weak and may also result in Paralysis
- The medical and family history of the patient may be taken into consideration
- A detailed physical examination and analysis of the symptoms reported. The orthopedic doctor may test the range of motion, muscle strength and abnormalities in reflexes, if any
- X-ray imaging may be done to identify tumors, changes in spine structure, osteophytes etc.
- MRI or CT scan may be conducted to analyze the location of the affected nerve and condition of soft tissue structures, discs or ligaments
- An EMG test may be recommended to identify nerve damage
- The patient may be advised to take rest and avoid any activity that causes stress to the back or neck
- A physical therapy program may be initiated to educate the patient about good postural habits, techniques to perform physical tasks without stressing the spine and exercises to strengthen the supporting structures
- Lumbar traction may be recommended in some cases to alleviate the nerve compression and create more intervertebral space
- Injecting steroids directly into the affected part of the spine may help to relieve pain
- Anti-inflammatory medicines may be prescribed by the doctor
- Laminectomy- Surgical removal of the bone that compresses the nerve
- Discectomy- Surgical removal of the Herniated Disc that may be pressing upon the nerve root
For treatment of Radiculopathy and other spine conditions, visit OrthoTexas. To schedule an appointment with the orthopedic surgeons in McKinney, TX, you can call at (972) 727 – 9995.
25. November 2016 17:51
Mallet Toe refers to a deformity of the distal interphalangeal (DIP) joint located near the tips of the toe. The condition causes the distal end of the toe to start pointing downwards and the middle portion of the toe to rise upwards. It can affect any of the small toes and hamper the normal functionality of the foot. Mallet Toe is most commonly observed in women.
- Wearing tight shoes may contract and shorten the tendons that hold the foot joints. It may also cause rigidness of the supporting muscles which do not allow the toe to straighten
- Use of high heels for prolonged period of time
- Rheumatoid Arthritis
- Previous foot injuries may damage the muscular balance of the joint or alter the shape of the bones
- Visibly deformed or clawed toe that begins to curl towards the floor
- Bunions may also be formed
- Pain in the toe, particularly while wearing closed shoes
- Calluses may develop as the middle of the toe rises like a bump and rubs against the shoe
- Redness and swelling may be seen
- Change in gait as the toe hurts while walking
- Physical examination of the affected toe
- Details of past injuries, type of shoes worn, duration spent standing or walking, medical conditions etc. may be taken into consideration
- X-ray scan of the joint can reveal changes in the bone and soft tissue structure
- The orthopedic doctor may attempt to straighten the toe manually to check if the deformity is rigid or flexible
- Doppler ultrasound test may be conducted to check the flow of blood to the joint
In case of flexible deformity, Mallet Toe can be treated by conservative methods. For rigid deformities and those caused due to other associated conditions, surgery may be required.
Treatment options may include:
- The patient may be advised to wear open footwear, low heels, soft soled shoes that allow the toes to stretch and do not rub against them
- Customized shoes with increased foot arches or shoe inserts may be recommended
- Pain killers and anti-inflammatory medicines may be prescribed to reduce swelling and tenderness
- Buddy taping- The deformed toe can be taped with the adjoining one to provide support and allow it to straighten
- Certain orthotic devices like toe splints or caps can protect and keep the toe straight
- The patient may gently pull the deformed toe in a straight position and hold it for some time. This exercise can be done repeatedly to alter the shape of the toe.
- Towel curls- Place a towel on the floor and try to crumple it with the toes. This is a an effective exercise that can strengthen the tendons and restore joint flexibility
- Surgical release of the tendons that cause the toe to bend
- Arthroplasty- A part of bone may be removed from the toe joint to correct the deformity
- Arthrodesis- Surgical fusion of the joint which allows new bone mass to grow
- Physical therapy may be recommended after both surgical and conservative treatment to help restore joint functionality.
The foot specialists at OrthoTexas provide complete treatment for Mallet Toe and other medical conditions. Patients in McKinney, TX can call at (972) 727 – 9995 to schedule an appointment.
30. September 2016 08:47
Distal femur is the lower end of the thigh bone which lies just above the knee joint and resembles an inverted funnel. The end of the bone is lined by a thick slippery substance called cartilage which allows it to slide across other bones that constitute the joint. It also helps in movement of the distal femur when the knee is bent.
A crack or a break in this part of the bone is medically referred to as the Distal Femur Fracture of the Knee. In case the force causing the fracture is strong enough, it may also damage the kneecap. Such fractures are commonly observed in people aged above 50 years as their bones are relatively weaker. However, younger populace is at an equal risk although the causative factors may vary. The injury can be classified as follows:
- Closed Fracture- The skin is not ruptured
- Open Fracture- The skin is cut open during the injury and a part of the bone may stick out
- Comminuted Fracture- The injury causes the bone to shatter into multiple pieces
- Transverse Fracture- The crack or breakage occurs straight across the bone
These fractures may not only damage the femur but also affect the tendons and ligaments that surround it. The hamstring and the quadriceps muscles may tend to snap and shorten when the bone breaks.
- A fall from a height
- Vehicular accident
- Loss of bone strength and density as age increases
- Direct hit to the knee
- Sports injuries
- Severe pain
- Inability to stand or bear body weight
- The injured area may be tender when touched
- Visible deformity
- Change in gait as the leg may become crooked or shorter
- Clinical evaluation of the injured leg by an orthopedic doctor
- Evaluation of the mode of injury, patient’s medical records and the symptoms
- The blood supply to the nerves and their ability to feel sensations may be tested
- X-ray imaging, CT scan or MRI may be performed
- If the bone is in a relatively stable condition and does not involve multiple fracture, it may be treated by using a cast or plaster
- The doctor may attach a traction pin to the bone and tie weights with a pulley. This may help to hold the bone in place.
- Surgery may be required in case of an open fracture to avoid infection.
- The broken bone may be put in place using external fixator devices (screws and pins) which are fixed on a frame attached to the leg. Internal fixation may also be done by making surgical incisions. A metal rod may be inserted to keep the femur in place
- Severely damaged bone may need a bone graft which involves extraction of a piece of bone from the pelvis. Artificial bone fillers or allograft may be used in some cases
- Knee replacements may be recommended for elderly patients
- Physical therapy may be required in the post-operative phase to aid healing and restore flexibility as well as strength in the leg
For effective treatment of Distal Femur Fracture of the Knee and other injuries, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in McKinney, TX, you can call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.
6. August 2016 09:00
The shoulder joint comprises of bones and several soft tissue structures like tendons, muscles, ligaments and bursa. Small sac like fluid-filled structures which protect the shoulder bones are called bursae. Subacromial Bursitis is characterized by the inflammation of the subacromial bursa in the shoulder joint. It supports the rotator cuff muscles and enables the sideways as well as overhead movement of the arm
- Overuse injuries
- Sports activities that involve lifting weights, throwing or overhead movement of the arm
- Medical conditions such as Shoulder Impingement, Arthritis, bone spurs, Pseudogout etc.
- Deposition of excessive calcium within the joint spaces
- Instability of the glenohumeral joint
- Tearing of the rotator cuff muscles
- Tendon damage or degeneration
- Weakness in the upper arm muscles
- Trauma or injury
- Septic or infection in the bursa
- Falling on a hard surface
- Poor posture
- Pain while lifting the arm above the head or sideways
- Swelling in the shoulder, mostly on the outer side
- Limited range of motion
- Discomfort and pain while sleeping
- Tenderness in the upper part of the arm and shoulder
- The skin may be red and warm when touched
- Thorough clinical evaluation of the joint by palpation and movement of the arm in different directions
- The doctor may analyze the patient’s medical history and previous shoulder injuries
- X-ray imaging may be done to assess the bone structure and detect bone spurs
- MRI scan may help to reveal soft tissue damages
- An anesthetic may be injected into the area near the bursa. If it relieves pain and reinstates range of motion, it indicates Subacromial Bursitis
- Rest the arm
- Apply ice packs at regular intervals
- Take anti-inflammatory medicines prescribed by the orthopedic doctor
- Antibiotics may be given in case the bursa is infected
- Heat therapy may be helpful to relieve stiffness
- The arm may be immobilized with a removable sling
- In case of severe pain, steroids may be injected into the bursa
- Aspiration procedure may be performed to drain the infected fluid or calcium deposits from the bursae
- Physical therapy may help to strengthen the muscles and joint
- Surgical removal of the infected bursae may be required in some cases. This procedure is referred to as Bursectomy
- Subacromial decompression may be performed to create more space for the soft tissues in the joint
For diagnosis and treatment of Subacromial Bursitis, visit OrthoTexas in McKinney, TX. To schedule an appointment with our orthopedic surgeons, you can call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.
9. July 2016 15:19
Whether it is a sprain, strain, fracture or more severe orthopedic condition such as Osteoarthritis, Bursitis, ACL Tear etc., physical therapy helps to ensure a faster and healthier recovery for the patient. It is also effective in restoring the joint’s range of motion and strength after a surgical procedure. When combined with orthopedic treatment, physical therapy can be helpful to improve the overall health of an individual. The therapists evaluate the fitness level and specific health problem experienced by the patient to formulate a personalized as well as effective rehabilitation program.
Given below are some common physical therapy techniques and the benefits they offer:
- General Orthopedics Rehabilitation: This form of physical therapy is aimed at helping patients recover faster from orthopedic injury or surgery. The therapists focus on encouraging active participation of the patients for maximum results of physical therapy.
- Sports Injury Prevention: It aims at helping athletes maintain their form for better performance in sports. It also involves strength and resistance training to prevent injuries on field as well as during the practice sessions.
- Occupational Therapy: In this, the physical therapists diagnose and treat conditions that prove to be an obstruction in an individual’s daily activities. These may include walking, sitting, running, climbing stairs and other physical tasks.
- Functional Capacity Evaluations: The physical therapists perform functional capacity evaluations to determine the patient’s ability to return to work following an injury or surgery. With functional capacity evaluations, the patient can work more productively while minimizing the risk of recurrent injuries.
- Hand Therapy: It is beneficial in relieving pain in the hand or upper limbs. The therapy may be recommended for patients with various orthopedic conditions such as Carpal Tunnel Syndrome, Repetitive Motion Disorder, ligament tears, Tennis Elbow, Rotator Cuff Tear etc. With hand therapy, patients can restore the normal functionality of the upper limb and strengthen the muscles to prevent further injuries.
- Custom Splinting: This is also aimed at treating orthopedic conditions affecting the upper extremity joints. With the help of a splint, the therapists restrict the movement of the injured joint to avoid any jerky movement or excessive stress. This helps to prevent further damage to the joint and boost the healing process.
The physical therapists at OrthoTexas provide comprehensive rehabilitation services to the patients across McKinney, TX. To schedule an appointment with the physical therapists, you can call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.
13. June 2016 11:41
Biceps, also termed as the biceps brachii, refers to the thick muscle that lies in front part of the upper arm. It is connected both to the shoulder and the elbow by two different tendons that help attach muscles to the bones. The tendons are made up of collagen which gives them flexibility and a high tensile strength. The tendon that attaches the biceps muscle to the elbow is called the Distal Biceps Tendon. It connects the biceps to the radius bone which forms a part of the forearm. Tearing of this tendon and its detachment from the bone is referred to as Distal Biceps Tendon Rupture. In some cases the ruptured tendon may retract and pull towards the shoulder. The condition is mostly observed in men over 35 years of age and sportspersons such as weight lifters as well as body builders.
- Catching a heavy object falling from a height
- Tendonitis or weakening of tendons over a period of time may make them susceptible to ruptures
- Lifting heavy weights with the elbow bent
- Pain near the elbow
- A popping sound at the time of injury
- In case of a complete rupture, a hollow may be created near the elbow as the tendon retracts
- A lump may be formed in the upper arm
- Weakness may be felt in the arm
- Limited range of motion
- Difficulty in rotating the arm
- Bruising or discoloration
- Muscle spasms in the arm
- A feeling of warmth may spread in the elbow joint
- Clinical observation of the injured arm
- MRI scan
- X-ray imaging to check for bone damage or displacement
- Evaluation of the patient’s medical history
Distal Biceps Tendon Rupture can be treated both surgically and non-surgically.
Non-surgical or conservative methods may include:
- Use of a sling to support the elbow
- Prescription of anti-inflammatory medicines
- Physical therapy to strengthen the supporting muscles
- Resting the elbow and avoiding any stressful activity
- Applying ice packs
Surgical methods of treatment include:
- Direct Repair- The loose end of the tendon may be repaired and attached back to the elbow joint by making two incisions in the arm (at the front and back) above the elbow
- Suture Anchor Method which involves attaching the torn tendon to the radius bone by inserting a suture anchor
- Surgical reconstruction of the damaged tendon may be done by extracting a part of another tendon within the body
The shoulder specialists at OrthoTexas provide complete diagnosis and treatment for Distal Biceps Tendon Rupture. To schedule an appointment with the shoulder surgeons in McKinney, TX, you can call at (972) 727 – 9995 or visit 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.
15. February 2016 07:21
Whiplash refers to a neck injury caused due a sudden and jerky forward, backward or sideways movement of the head. The excessive force leads to stretching or tearing of the ligaments and tendons in the neck. Although the condition is not usually severe, it can cause long-lasting pain and discomfort to the patient. If the symptoms last for more than six months, it is referred to as Chronic Whiplash or Late Whiplash Syndrome.
- Rear-end road accidents
- Physical assault, such as being punched
- Shaken Baby Syndrome
- Horse riding
- Sports related injuries
- Direct blow to the head
- Pain in the neck
- Stiffness and decreased range of motion
- Muscle tension
- Inability to move the neck
- Headache that may radiate from the base of the skull to the forehead
- Numbness or tingling sensation in the arms
- Vision problems
- Constant tiredness
- Difficulty sleeping
- Ringing in the ears
The orthopedic doctor may conduct a physical examination to diagnose Whiplash. The patient may be asked to move his neck, head and arms so as to determine range of motion as well as stiffness. Imaging tests such as X-ray, CT scan or MRI may be conducted to rule out other medical conditions that may cause neck pain, such as a fracture or muscle strain.
- Medications: Non-steroidal anti-inflammatory medications may be prescribed to relieve pain.
- Muscle Relaxants: These may help to eliminate pain, reduce muscle spasms and help restore normal sleep.
- Rest: The orthopedic doctor may advise the patient to take rest and keep the neck immobile for the first few hours following the injury.
- Neck Brace: Wearing a collar or neck brace may help to provide support to the neck. However, these should only be worn as prescribed by the doctor. Long term use of brace may weaken the muscles of the neck and delay recovery.
- Ice Or Heat: Applying ice or heat packs to the affected area may help to reduce swelling and pain.
- Physical Therapy: The orthopedic doctor may prescribe certain stretching exercises to restore the range of motion in the neck. Maintaining a good posture and learning relaxation techniques may help to strengthen muscles as well as prevent future injuries.
For comprehensive treatment of Whiplash and other back problems, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in McKinney, TX, you can call at (972) 727 – 9995 or visit McKinney Medical Village, 7300 Eldorado Parkway, Suites 165/165A, McKinney, TX 75070.
23. January 2016 07:07
Frozen Shoulder, or Adhesive Capsulitis, is a condition causing severe pain and stiffness in the shoulder. An injury, Diabetes, overuse or some other factors may lead to stiffening of tissues around the shoulder joint accompanied by formation of scar tissues which may lead to pain and restrict its movement.
The shoulder is a ball and socket joint in which the proximal humerus (rounded top of the arm bone) fits into a socket shaped scapula. In case of a Frozen Shoulder, the joint capsule thickens or swells, leading to restriction of motion of the bones. The condition is commonly observed in the people aged 40-60 years of age. The patient may take a year to recover from the effects of a Frozen Shoulder. There are three main stages of a Frozen Shoulder:
- Freezing Stage- The shoulder may feel stiff and pain increases with time. Movement is gradually restricted and the patient may experience maximum pain while sleeping
- Frozen Stage- The patient may feel pain as well as stiffness and motion is limited. The pain does not increase beyond this stage.
- Thawing Stage- Flexibility and range of motion may improve gradually as well as the pain may diminish.
- Direct injury or trauma to the shoulder
- Overuse of the upper arm or shoulder joint
- An after effect of menopause in women
- Health related issues such as Diabetes, Arthritis, Parkinson’s Disease, cardio-vascular problems or stroke
- Surgery or immobilization of the shoulder joint for a long period
- Fracture in the arm
- Hypothyroidism or Hyperthyroidism
- Injury to the rotator cuff
- Pain that increases gradually
- Loss of motion in the shoulder
- Difficulty sleeping due to severe pain
- A detailed examination of range of motion and symptoms by an orthopedic doctor
- Evaluation of the patient’s medical history to assess the potential underlying cause
- The doctor may press the affected joint to check for swelling and also move it in different directions to analyze range of motion
- MRI and X-ray may be recommended to evaluate damage to the joint
- Application of alternate hot and cold packs to reduce pain as well as swelling
- Prescription of anti inflammatory drugs
- Practicing gentle stretching exercises to restore flexibility and motion
- Transcutaneous Electrical Nerve Stimulation, i.e. application of electric pads to numb the pain causing nerve endings in the spinal cord
- Manipulation in which the patient’s arm is moved in various directions under the effect of general anesthesia to loosen the tight muscles
- Arthroscopic surgery to remove scar tissue or release the tight tissues
- Joint Distension, which involves injection of sterile water into the joint to stretch the tissues
OrthoTexas provides complete diagnosis and treatment for Frozen Shoulder. To schedule an appointment with our orthopedic surgeons in McKinney, TX, you can call at (972) 727-9995.