Could knee pain be arthritis?

April 30th — admin

Whenever we get close to the ski season I start gearing up my exercise program. I notice the last two years I’ve had knee pain when squatting or practicing my wall sits. So far it doesn’t bother me when I ski. What could be causing this pain?

There are several possible causes of knee pain in these positions. Early arthritic changes with thinning of the joint surface is the first that comes to mind. This is more likely in the middle-aged to older adult groups.

Patellofemoral pain syndrome (pain involving the kneecap) is probably the most common in younger people. Muscle weakness or imbalance and postural changes cause the kneecap to slide up and down over the knee slightly off center. Compression and irritation of the soft tissues leads to pain.

If you are planning to continue your skiing activities, it might be a good idea to have this checked out. A specific exercise program may help alleviate the pain and prevent
injury.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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Best exercises for strengthening hip abductor muscles

April 29th — admin

I’m 74-years old and fit as a fiddle. I want to keep up my leg strength. What’s the best way to strengthen the muscles along the sides of my hips?

Hip exercises are commonly prescribed for older adults after hip injury or surgery. Even without hip problems, it’s also a good idea to maintain muscle strength as we get older. Keeping muscles and balance tuned can help prevent falls and fractures.

Physical therapists at the University of Kentucky compared six different hip exercises for the gluteus medius muscle. This is a hip abductor (moves the leg away from the body). It’s located on the outside of the hip.

Three of the exercises were done without putting weight on the leg. Three were done in the standing position while putting full weight on the leg. It turns out that the standing weight-bearing exercises activate the muscle the most.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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What the Bernoulli effect means to arthroscopic shoulder surgery

April 28th — admin

What is the Bernoulli effect? The doctor’s report on my shoulder surgery says “pressure was used to minimize the Bernoulli effect.” I’ve never heard of such a thing. What does this mean?

The Bernoulli equation comes from Newton’s laws of motion. It deals with flowing fluids and says that when a gas such as air flows, its pressure drops. For fluid in the joint the Bernoulli effect means the pressure is lower in a moving fluid than in a fluid that’s still.

In the shoulder during arthroscopic surgery, fluid is pushed through the tube of the scope into the joint. This technique helps with several things. First, it clears the joint of any blood obstructing the surgeon’s view. Second it pushes the joint open and gives the surgeon more room to work.

Finally, lower pressure means less damage in the joint. Each hole that is made in the joint capsule to allow the scope to enter the joint leaves an opening. Fluid can leak out of the joint into the nearby tissues. Keeping fluid flowing through the joint reduces pressure, and keeps the fluid from escaping.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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Why is climbing up easier on the knees than climbing down?

April 27th — admin

I notice climbing up hills is much easier on the knees than coming down. Why is that?

Runners and hikers have all noticed that stiffness is worse the day after going downhill compared to going up. Going downhill puts much more strain on the muscle fibers and connective tissue compared with moving over a flat route. Downhill running can be damaging because of the greater eccentric muscle contractions that occur. Let me explain.

When your foot hits the ground, the muscles in the thigh contract to support you. But the nature of the downhill action is such that although the muscle is contracting, it’s forced to lengthen at the same time. Contracting while lengthening a muscle at the same time is called an eccentric contraction. It can cause trauma and damage to muscle fibers.

Trauma to the muscles and connective tissue around the muscles causes tiny tears of the tissue fibers. Stiffness occurs as a result of muscle damage and breakdown of nearby connective tissue.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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How often do total hip replacements dislocate?

April 26th — admin

I heard that total hip replacements dislocate easily. How often does this happen?

Loosening and dislocation of the implant are the two most common problems faced by patients after a total hip joint replacement. The rate of dislocation varies from study to study. One study reports 0.6 percent (fewer than one patient every 100).

Other studies report up to seven percent. A very large study placed this closer to 2 percent. The wide ranges in figures may be explained by who did the surgery. Doctors in large centers or hospitals who do more hip joint replacements have lower rates of dislocation.

Most studies report numbers from these large reviews. However, most hip replacements are done by surgeons who treat fewer patients.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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How late is too late to treat rotator cuff tear?

April 22nd — admin

Years ago, I tore my rotator cuff while lifting and carrying children in a daycare. I couldn’t take time off from work for physical therapy or surgery then. Now, I have chronic pain that’s worse at night. Is it too late for treatment?

Maybe not. Untreated rotator cuff tears can lead to wear and tear on the shoulder joint. A chronic tear with arthritis often results in restricted and sore shoulder motions. Severe pain is reported with daily activities and at night.

Doctors offer several methods of treatment for this problem. The joint can be cleaned out, fused, or replaced. Removing fragments of tissue, scraping off bone spurs, and opening the joint space can help. Fusion eliminates pain, but also restricts motion.

Replacing the joint is a third option. One or both sides of the joint is removed and replaced. If both sides are involved, it’s called a total joint arthroplasty. If only one side is altered, it’s a hemiarthroplasty.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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Alcohol abuse a factor in broken hip

April 22nd — admin

My 66-year old father fell and broke his hip. He was drinking at the time the accident happened. The doctors think the hip broke first and then he fell because he has osteonecrosis. What is this?

The term osteonecrosis refers to the death of bone and bone marrow. This occurs when there’s a loss of blood flow to the area. Two other terms for this condition are: avascular necrosis and aseptic necrosis. Avascular means “without blood” and aseptic means “without infection.”

Alcohol abuse leads to a change in how fat is broken down and used. This process is called fat metabolism. Tiny pieces of fat can break off like a blood clot and block the blood vessel. This is what happens in the case of osteonecrosis from alcoholism.

Once the blood flow to the hip is cut off, bone cells start to die. The bone weakens and collapses or breaks. A fall or other injury may be the first sign there’s a problem.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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Shoulder can dislocate even after surgery

April 20th — admin

I have a chronic dislocating shoulder that needs fixing. The doctor told me there’s still a 25 percent chance the joint can dislocate again even after repair. Why is that?

Studies show that shoulder dislocation after repair occurs anywhere from 12 to 24 percent of the time. There are different reasons for this. Sometimes it depends on the type of surgery done to repair the problem.

For example, an open incision allows the surgeon to repair the tear in the cartilage and tighten up the joint capsule at the same time. Arthroscopic surgery may only include repair of the damaged soft tissue while leaving the capsular laxity alone.

Another factor in repeat dislocations after surgery is the patient. It’s important to follow the surgeon’s instructions. A shoulder sling may be needed for up to four weeks. Exercises must be done daily. Doing too much too soon is a common way to undo the benefits of the surgery.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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Athletes’ knee injuries more likely in afternoon

April 19th — admin

Is there any truth to the idea that ski injuries are more likely in the afternoon than in the morning? I would have thought injuries occur in the morning before skiers are warmed up.

Studies do indeed show the greatest chances of injury to skiers occur in the afternoon. It’s also true that injuries to football players are higher in the third quarter of a game. Coincidence?

Researchers don’t think so. They say general fatigue in athletes may be the key factor in these injuries. Fatigue leads to a decline in knee proprioception. Proprioception is the joint’s sense of position. Fatigue and then decreased proprioception can result in ligament injuries.

Change in neuromuscular control may be a factor, too. This is the link between messages to the nerve telling the muscle what to do and when to do it. Special exercise to improve motor control may help reduce these “third quarter” injuries.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.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.

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

After total hip replacement, implant can loosen.

April 16th — admin

My wife had a total hip replacement two months ago. The doctor advised us that there is “possible evidence of loosening.” What does this mean? Either it’s loose or it’s not, right?

Right, but our ability to tell that from outside the body is limited. X-rays may show some changes that occur when the implant starts to loosen. In the early stages, the changes aren’t always large enough or clear enough to know for sure.

For the purposes of evaluating implants, the area around the joint implant is divided into zones. The socket or cup side has three zones, whereas, the femoral side has 14. A problem can occur in any one of these zones.

Sometimes, doctors must make an educated guess. In defining the problem, the doctor may say that here is definite, probable, or possible evidence of loosening. Further testing (and sometimes waiting) is often the next step.

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