OCTOBER 12, 2017
Torn ACL? Don’t Rush to Knee Surgery
The anterior cruciate ligament (ACL) runs through the middle of the knee and toward the front. It keeps the tibia (shin bone) from sliding forward and helps control the back and forth motion of the knee joint. Although knee ligament injuries are considered sprains and can range in severity, the ACL is usually torn or nearly torn whenever it’s injured because it bears so much force.
Athletes in sports like football, soccer, skiing, and basketball are at higher risk for an ACL tear, and females in certain sports are also at higher risk due to a variety of physical as well as training variables. Regardless of the sport or activity, though, these most common ways of causing an ACL tear can put enough pressure on the knee to “pop” the ligament:
Sudden stop or slowing while running (or skiing) forward
Abrupt change of direction
Landing wrong from a jump
Collision directly to the knee
Symptoms of an ACL injury include a popping feeling and instability of the knee at the time of injury, followed quickly by pain and swelling. Tenderness and trouble walking also often happen within 24 hours. Seeing an orthopedic doctor specializing in the knee or sports medicine is important if you have these symptoms. Your doctor will examine you and likely order x-ray images and an MRI scan because it’s very common for other knee joint injuries to accompany an ACL tear.
Surgery is not always necessary for a torn ACL. Low activity patients may opt for bracing and physical therapy to strengthen the other structures of the knee in place of the weakened ACL. However, surgery is the most often recommended solution for those who want to return to sports or higher activity levels. Timing is key for these patients. The doctor may prescribe physical therapy in preparation for surgery because the knee must be allowed to return to a state of minimal swelling and even regain some range of motion BEFORE surgery takes place. Otherwise, range of motion may not return properly at all. Surgery is eventually performed using a tissue graft in place of the torn ACL. More physical therapy is prescribed after surgery. Our doctors have a physical therapy team in our office. They work closely with the therapists to make sure each patient is getting the right treatment every time.
SEPTEMBER 13, 2017
Hip Problems at a Younger Age
Many people think hip issues only afflict the older population, but they can affect younger people, too. A condition called hip dysplasia may actually be diagnosed anytime from birth into adulthood.
Although not all the causes of hip dysplasia are known, it can often occur when a baby is born with hips that are not seated all the way in the sockets. Being the first born child or being born in breech position allows less room for the legs and stretches the hips. Just being born a girl releases female hormones that contribute to looser ligaments, which in turn may not hold the hips in place firmly enough. A family history of hip dysplasia may also be a risk factor. The vast majority of hip dysplasia patients are women, as much as 80%.
Hip dysplasia can cause arthritis at a younger age or problems during sports and activities, even in childhood. While clicking and popping sounds in the hip may indicate hip dysplasia, most people see a doctor when their hips become painful. With better medical imaging, more treatment options, and longer-lasting hip replacement implants available now, more patients who are younger are seeking medical care for their hip problems.
It's okay to see a doctor before your hips become painful. While some hip noises are due to tight ligaments and may not cause additional problems, some can be warning signs of serious issues to come, if ignored.
It's recommended that you see an orthopedic doctor specializing in the treatment of hip problems for the right diagnosis and treatment. Hip dysplasia is diagnosed with x-rays, but they have to be taken at special angles to properly see the scope of the problem. A specialist is much more likely to take these images the first time around, detecting the problem earlier.
Because hip dysplasia causes a variety of problems, there are a variety of treatments ranging from conservative intervention, such as rest and over-the-counter medications, to surgery. You and your orthopedic doctor will need to decide which treatments are best for your health and lifestyle.
AUGUST 25, 2017
What’s Your Grade? Even Milder Wrist Pain May Needs a Doctor’s Care
Wrist sprains rank from mild to severe in a grading system:
Grade 1: Overstretched ligaments
Grade 2: Partially torn ligaments
Grade 3: Fully torn ligaments and sometimes a fracture
Wrist sprains occur after a fall on an outstretched hand and bent wrist. They're most common during sports or falling accidents. Symptoms such as swelling, pain at impact, pain that doesn’t go away, bruising, tenderness, a popping or tearing feeling, and feverish skin feelings are all important to note, but they don’t tell the whole story.
The tricky part about diagnosing a wrist sprain is that pain and appearance don't always correspond to the severity. A grade 3 sprain may have very little swelling but still require surgery to a torn ligament to avoid problems later. Grade 3 sprains can also have fractures that aren’t felt by the patient or even easily diagnosed by a general doctor looking at an x-ray. If left untreated, the wrist heals incorrectly and often requires corrective surgery by an orthopedic hand specialist.
Surgery requires a long period of immobilization followed by a hand therapy regimen with a specialist. Full recovery after surgery may take several months. Nonsurgical treatments include a shorter immobilization time followed by stretching exercises. Recovery varies from a few weeks to a few months.
Avoid potential lifelong pain and stiffness by having your wrist pain evaluated and treated as soon as possible by a board certified orthopedic doctor specializing in hand problems. This type of doctor is highly experienced and trained to properly diagnose and treat all levels of wrist sprains. He or she can also evaluate your overall arm and body mechanics (it’s all connected!) and prescribe the right treatment and recovery program to restore you to your best possible health.
Prevent wrist injuries by wearing protective gear during high-speed, high-risk sports, such as skating and skateboarding. Ski poles can also contribute to wrist sprains if not dropped when you fall. Take extra care not to fall or trip on wet surfaces, loose dirt or gravel, and uneven footing conditions.