Orthopedic Education & FAQ
Physical therapy is the treatment of musculoskeletal and neurological injuries to promote a return to function and independent living. Physical therapy incorporates both exercise and functional training. Exercise restores motion and strength while functional training facilitates a return to daily activities, work, or sport.
A tendon is a band of tissue that connects muscle to bone. A ligament is an elastic band of tissue that connects bone to bone and provides stability to the joint. Cartilage is a soft, gel-like padding between bones that protects joints and facilitates movement.
Non-steroidal anti-inflammatory drugs (NSAIDs) are non-prescription, over-the-counter pain relievers such as aspirin, ibuprofen, and naproxen sodium. They are popular treatments for muscular aches and pains, as well as arthritis. NSAIDs not only relieve pain, but also help to decrease inflammation, prevent blood clots, and reduce fevers. They work by blocking the actions of the cyclooxygenase (COX) enzyme. There are two forms of the COX enzyme. COX-2 is produced when joints are injured or inflamed, which NSAIDS counteract. COX-1 protects the stomach lining from acids and digestive juices and helps the kidneys function properly. This is why side effects of NSAIDs may include nausea, upset stomach, ulcers, or improper kidney function.
An epidural is a potent steroid injection that helps decrease the inflammation of compressed spinal nerves to relieve pain in the back, neck, arms or legs. Cortisone is injected directly into the spinal canal for pain relief from conditions such as herniated disks, spinal stenosis, or radiculopathy. Some patients may need only one injection, but it usually takes two or three injections, given two weeks apart, to provide significant pain relief.
Cortisone is a steroid that is produced naturally in the body. Synthetically-produced cortisone can also be injected into soft tissues and joints to help decrease inflammation. While cortisone is not a pain reliever, pain may diminish as a result of reduced inflammation. In orthopedics, cortisone injections are commonly used as a treatment for chronic conditions such as bursitis, tendinitis, and arthritis.
Ice should be used in the acute stage of an injury (within the first 24-48 hours), or whenever there is swelling. Ice helps to reduce inflammation by decreasing blood flow to the area in which cold is applied. Heat increases blood flow and may promote pain relief after swelling subsides. Heat may also be used to warm up muscles prior to exercise or physical therapy.
X-rays are a type of radiation, and when they pass through the body, dense objects such as bone block the radiation and appear white on the x-ray film, while less dense tissues appear gray and are difficult to see. X-rays are typically used to diagnose and assess bone degeneration or disease, fractures and dislocations, infections, or tumors. Organs and tissues within the body contain magnetic properties. MRI, or magnetic resonance imaging, combines a powerful magnet with radio waves (instead of x-rays) and a computer to manipulate these magnetic elements and create highly detailed images of structures in the body. Images are viewed as cross sections or “slices” of the body part being scanned. There is no radiation involved as with x-rays. MRI scans are frequently used to diagnose bone and joint problems. A computed tomography (CT) scan (also known as CAT scan) is similar to an MRI in the detail and quality of image it produces, yet the CT scan is actually a sophisticated, powerful x-ray that takes 360-degree pictures of internal organs, the spine, and vertebrae. By combining x-rays and a computer, a CT scan, like an MRI, produces cross-sectional views of the body part being scanned. In many cases, a contrast dye is injected into the blood to make the structures more visible. CT scans show the bones of the spine much better than MRI, so they are more useful in diagnosing conditions affecting the vertebrae and other bones of the spine.
An orthopedic surgeon is a medical doctor who has received up to 14 years of education in the diagnosis, treatment, rehabilitation, and prevention of injuries and diseases of the musculoskeletal system (bones and joints, muscles, ligaments, tendons, and cartilage). Some orthopedic surgeons practice general orthopedics, while others specialize in treating certain body parts such as the foot and ankle, hand and wrist, spine, knee, shoulder, or hip. Some orthopedists may also focus on a specific population such as pediatrics, trauma, or sports medicine.
ACL reconstruction is a surgical procedure that repairs a torn anterior cruciate ligament (ACL), one of the four ligaments that help stabilize the knee. The ligament is reconstructed using a tendon that is passed through the inside of the knee joint and secured to the upper leg bone (femur) and one of the two lower leg bones (tibia). The tendon used for reconstruction is called a graft and can come from different sources. It is usually taken from the patient’s own patella, hamstring, or quadriceps, or it can come from a cadaver. ACL reconstruction is most often performed through arthroscopic surgery.
Shoulder surgery for rotator cuff problems usually involves one or more of the following procedures: debridement, subacromial decompression, rotator cuff repair. Debridement clears damaged tissue out of the shoulder joint. Subacromial decompression involves shaving bone or removing spurs underneath the tip of the shoulder blade (acromion). This creates more room in the space between the end of the shoulder blade and the upper arm bone so that the rotator cuff tendon is not pinched and can glide smoothly. If the rotator cuff tendon is torn, it is sewn together and reattached to the top of the upper arm bone.
On average, artificial joints have a lifespan of 10 to 20 years. If you are in your 40s or 50s when you have joint replacement surgery, especially if you are very active, you are likely to need another joint replacement surgery later in life.
Joint replacement surgery is performed to replace an arthritic or damaged joint with a new, artificial joint called a prosthesis. The knee and hip are the most commonly replaced joints, although shoulders, elbows and ankles can also be replaced. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff and painful. Most people have joint replacement surgery when they can no longer control the pain in their hip or knee with medication and other treatments, and the pain is significantly interfering with their lives.
Arthroscopic surgery is one of the most common orthopedic procedures performed today. Through the use of small instruments and cameras, an orthopedic surgeon can visualize, diagnose, and treat problems within the joints. One or more small incisions are made around the joint to be viewed. The surgeon inserts an instrument called an arthroscope into the joint. The arthroscope contains a fiber optic light source and small television camera that allows the surgeon to view the joint on a television monitor and diagnose the problem, determine the extent of the injury, and make any necessary repairs. Other instruments may be inserted to help view or repair the tissues inside the joint.
The meniscus is a structure in the knee comprised of two C-shaped wedges of cartilage that cushion and stabilize the knee joint. The meniscus can easily become overused since its main purpose is to act as guard for the knee bones while bearing the body’s weight. The meniscus tear is a knee condition where the meniscus is partially of fully torn. In most people, the meniscus tear is caused by aging, but twisting the knee or a direct fall can also result in a meniscus tear. The symptoms usually include stiffness, swelling, and an uncomfortable pain in the knee. Additional symptoms include swelling, tenderness when the sides of the knee joint are pressed, a popping sound while moving, or limited mobility.
Knee arthroscopy is a minimally invasive surgical technique performed to diagnose and treat problems in the knee joint. The arthroscope, a tiny camera, is inserted into the knee, allowing the surgeon to thoroughly investigate the knee and address the issues using small instruments within the arthroscope. In general, knee arthroscopy is followed by a short recovery and almost no downtime. But, the recovery time and prognosis depend on the severity of the knee problem and the complexity of the procedure performed along with the knee arthroscopy.
Different activities can lead to different knee injuries. Most common injuries in both athletes and people who don’t participate in any sports activities are:
- Meniscus tear
- ACL tear
- Runner’s knee
- Patellar tendonitis
Acute, also known as sudden injuries, are cause by a direct trauma to the knee. They occur when the knee suffers an unusual twist, bend, or after a direct fall on the knee. While acute injuries occur during an activity, overuse injuries occur due to intense repetitive motions and prolonged pressure to the knee. The sports activities with running and jumping, climbing, bicycle riding are among top sources of irritation and inflammation in the knee.
The most effective knee pain treatment depends on the underlying cause of the knee pain. Oftentimes, the knee pain is treated with rest, heat or ice, and/or physical therapy. For severe knee conditions and injuries that don’t respond to the non-surgical treatments, knee surgery is the best treatment.
Depending on the condition, different symptoms can be seen. Typically, people with a developed knee condition experience one or more of the following symptoms:
- Disturbing pain that worsens with minimal activity
- Loss of motion
- Inability to bend or straighten the knee
- Painful and difficult walking
Yes, the knee pain is extremely common because the knee joint is essential for everyday activities and it bears an immense pressure while performing all activities.
The knee joint is the largest in the body, connecting the upper leg bone to the lower leg bone. The knee consists of bones, tendons, and ligaments, and in the front, it is protected by the knee cap. Cartilage covers the ends of both leg bones and the underside of the patella, or knee cap. When these surfaces are smooth, the joint glides easily and without pain.
Shoulder pain is common for people of all ages and professions. As the body ages, the tissues in the shoulder joint change, leading to various shoulder conditions that cause the shoulder pain. The most common cause is the shoulder overuse, typical in older people, sports players and people who perform repetitive over-the-head motions on a daily basis. Shoulder pain can be also caused by a shoulder condition that occurred as a result of a trauma (direct fall) to the shoulder.
The shoulder joint is one of the most important joints in human’s body as it provides flexibility and rotation to the arm in many positions. The shoulder joint consists of three important bones:
- Cracoid process
- Rotator cuff – formed of muscles and tendons that surround the shoulder, with a main function to support shoulder’s stability and allow a wide range motion
- Bursa – a small fluid sac that protects the tendons of the rotator cuff
- Labrum – it forms a cup for the humerus’s head to fit into