Shoulder pain traced to AC joint

November 30th — admin

I thought I had a shoulder problem. The doctor says it’s the AC joint. My shoulder still hurts. What’s the difference between these two problems?

The true shoulder joint is where the head of the upper arm bone (humerus) inserts into a shallow cup in the shoulder blade. The cup is called the glenoid cavity. It’s a ball and socket joint.

Just above the true shoulder joint is a bony projection coming around from the back of the shoulder blade. This piece of bone is called the acromion. The end of the acromion meets the collarbone to form a shelf over the shoulder.

Pain from any of the structures around or above the shoulder joint can cause pain that seems like it’s coming from the joint. A careful exam by your doctor can pinpoint the exact cause. This is helpful information so the right problem is treated.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Ballet dancer suffers from repetitive kneecap dislocation

November 28th — admin

I am a professional ballet dancer with dislocating kneecaps. I never know when one or both of my kneecaps will pop off to the side. Although I can push them back in place, my knees are painful for at least two days afterward, and I can’t dance. I read a magazine article that suggested “conservative treatment” for this problem. What is conservative treatment, and could it help me?

Conservative treatments are those that do not involve surgery. When the knee bends and straightens, the kneecap, or patella, moves up and down in a straight track over the knee joint. If the fibers holding the patella in place are torn or damaged from injury, the patella can get pulled to the outside. If the patella moves completely off its track, it becomes dislocated.

Sometimes exercises to strengthen the muscles around the knee can help with this problem. Learning how to stand and use the leg with good alignment and proper patellar tracking may help. Sometimes a soft brace or knee support helps hold the patella in place while you retrain the muscles and change the way the patella moves.

However, when the patella dislocates over and over, conservative treatment is not likely to help. Surgery to repair the surrounding structures and realign the patella may be necessary.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Delay in surgery for hip fracture could be fatal

November 25th — admin

I heard a report that older folks who break a hip on Sunday are more likely to die. Is there some religious significance to this?

The answer to this question lies more in the fact that a fracture on the weekend may not get treated until Monday at the earliest. Often the surgery schedules are full for Monday and the patient must wait until Tuesday.

Surgical delays caused by low staffing on weekends are the real culprit, not the fact that the break occurred on a Sunday. A recent study of over 18,000 patients with hip fracture showed a much higher chance of dying in patients whose surgery was delayed two days or more.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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No “drive-through sign” after shoulder surgery is a good thing!

November 24th — admin

What is the “drive-through sign?” I read the surgeon’s report after shoulder surgery and this is listed.

The surgeon was most likely doing arthroscopic surgery. This means a special tool (an arthroscope) was inserted into the joint to allow the doctor to look inside.

The drive-through sign refers to the ability to pass the arthroscope easily between the humeral head (round ball at the top of the upper arm) and the glenoid cavity. The glenoid cavity is the shallow cup the humeral head fits into. Together the humeral head inside the glenoid cavity forms the shoulder joint.

The location of a positive drive-through is at the bottom of the joint. This is where the lowest part of the glenohumeral ligament is located.

If the arthroscopic probe can move easily through the joint from back to front it’s a positive drive through sign. This sign tells the doctor the shoulder is loose or unstable. After treating the shoulder, the doctor looks to see if the drive-through sign is gone. If it is, this is means the shoulder is tight enough.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Knee pain may be due to Q-angle

November 23rd — admin

My 14-year-old daughter has been having knee pain and complains of a “crunching” feeling under her kneecap when she straightens her knee. Her pediatrician says this may be coming from the position of her kneecap called the “Q-angle.” Can you explain this to me?

Q-angle–or quadriceps angle–is the angle between the quadriceps muscle (front of the thigh) and the patellar tendon (just below the kneecap). This angle can be determined using X-rays. More often, it is measured by placing the person flat on a table with the hips, knees, and feet in a neutral position. A line is drawn from the pelvic bone to the middle of the kneecap. A second line is drawn from the middle of the kneecap through the large bump on the shin (called the tibial tubercle). The angle formed by the crossing of these two lines is called the Q-angle.

Normally, the Q-angle is between 13 and 18 degrees when measured this way. Boys and men usually have smaller angles than girls and women. With a larger than normal Q-angle, the kneecap (patella) moves up and down over the knee joint in such a way that it can cause wear and tear of the cartilage. This causes crepitus, or the crunching feeling people describe when straightening the knee.

Ask your doctor about seeing a physical therapist. Using taping techniques, shoe inserts (orthotics), or muscle strengthening exercises, the therapist may be able to help your daughter learn how to keep the patella in the middle.  These measures can help reduce pain, swelling, and the crepitus sensation.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Three factors affecting rotator cuff surgery recovery

November 19th — admin

There were two employees in our office who had surgery to repair a torn rotator cuff in the shoulder. One person had a great result and has come back to work already. The other worker is still off with pain, depression, and loss of function. How do you account for the differences?

Many things can affect the outcome of rotator cuff repairs. First, the severity of the tendon tear is important. A full tear can require a more complicated operation. A partial tear with a small repair may heal faster and rehab sooner.

Second the type of surgery makes a difference. Did the doctor use an arthroscope and go into the joint with a special tool to make the repair? Or was a full cut needed to open the joint up? Arthroscopy usually means faster recovery.

Third, what’s the general health of the patient? Anyone with other health problems may be facing some extra complications. For example the client who has diabetes, high blood pressure, or lung or heart problems may have some special problems after the operation. There’s always a concern about infection, poor wound healing, and blood clots after an operation of any kind. Patients with any of the problems listed here can be at increased risk for these complications.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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Which knee ligament is really torn – ACL or MCL?

November 18th — admin

It has been 20 years since I was diagnosed with a partial tear of my medial collateral knee ligament. My knee gives out every once in a while, keeping me from the activities I enjoy. I just turned 63, and I like to keep active by skiing and playing golf. Should I have the ligament replaced?

It is questionable whether you merely tore your medial collateral ligament (MCL) when you were first hurt. Had you only injured the MCL, chances are it would have scarred down and not given you much trouble.

From what you describe, it is more likely that you also stretched or tore the anterior cruciate ligament (ACL). In either case, you might not be a candidate for ligament surgery given your age. Instead, a surgeon specialist will probably want to have you use a brace and do exercise treatments. If these aren’t helpful, surgery might be a last resort.

Age is one factor your surgeon will consider. So is activity. Your surgeon may treat you as he or she would a younger patient, given your level of activity.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

Posted in Knees. Tags: , , , , . No Comments »

How can I tell if I have arthritis?

November 17th — admin

How can I tell if I have arthritis? Seems the older I get, the stiffer I am, and the more joint pain I notice.

Aging is linked with osteoarthritis (OA) of the joints. The hip and knee are affected most often.

Stiffness is also common as we get older. There are many reasons for this. Tendons and ligaments have less water in them. The drying effect makes the joints seem stiff. The cells that make up soft tissues are called collagen. Fewer new collagen cells are formed so we lose some elasticity in the joints and muscles.

There are other changes going on in the joints. The cartilage loses strength. Changes in the cells of the cartilage lead to OA. There is a thinning of the joint space as the cartilage breaks down. This loss in joint space can be seen on X-ray. It’s the most common way to diagnose OA.

A medical doctor will use tests of motion and strength along with X-rays to make the diagnosis. An early diagnosis is best so that early treatment can limit problems.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

Posted in Hips, Knees. Tags: , , , . No Comments »

Injury to one shoulder affecting the other?

November 16th — admin

I injured my left shoulder in a hang gliding accident. It’s odd, but I feel as if my right shoulder is affected by my left shoulder problems. Is this possible? The right shoulder just doesn’t seem to move as smoothly as before the accident.

Of course it’s possible some minor damage occurred in the right shoulder at the time of the accident. Perhaps an injury is present but undiagnosed. Be sure and ask your doctor to check this for you.

It is possible that you are experiencing a change in the joint position sense. This is the ability of the joint to tell where it is in relation to the body. It’s called proprioception. Proprioception also tells the joint where it is as it moves.

Proprioception is regulated centrally by the nervous system. If one side is injured, the other side is also affected. Usually patients aren’t aware of any difference, but testing reveals the change.

A recent study from Germany suggests the shoulder is able to regain its own sense of joint position after surgery to repair the injury. In fact, even the proprioception in the uninjured arm improves. Researchers aren’t sure why this happens, but future studies are planned.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com.

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What is “water on the knee”?

November 13th — admin
What do people mean when they talk about “water on the knee”?
This usually describes pre-patellar bursitis. This is when fluid builds up in the bursa sac that lies in front of and below the kneecap. The front of the knee may look like a goose egg.

There are also conditions when the knee joint itself fills with fluid. A joint capsule encloses the bones of the knee joint. When the capsule fills with fluid, it may give the appearance of “water on the knee.” This can happen with problems like arthritis or infection.

An injury to the structures inside the knee can cause bleeding and swelling to fill the inside of the joint. In these instances, there will be fullness in the tissues of the knee, rather than simply a goose-egg appearance in the front of the knee.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com. 

Posted in Knees. Tags: , , . No Comments »
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