Naples Orthopedic Surgeon - Dr. Robert J. Zehr » Uncategorized

Am I at risk for shin splints?

admin — Tue, 03 Nov 2009 22:20:13 +0000

I want to train for a marathon. I’ve heard that long-distance runners can get shin splints from the constant strain on the leg muscles. How do I know if I’m at risk?

It’s true that injuries are fairly common among distance runners. Up to 57 percent of recreational runners get injured over the course of a year. Most of these injuries (up to 75 percent) are from overuse.

A recent study identified gender and foot posture as risk factors for medial tibial stress syndrome (MTSS), commonly known as shin splints. In a group of 125 high school cross-country runners, 12 percent showed signs of MTSS. Injured runners were overwhelmingly female. They also tended to be pronators.

How do you know if you’re a pronator? A doctor or sports trainer can do tests to find out. If pronating seems to be a problem in your case, you may want to look into orthotics. These shoe inserts can be designed to support your feet against pronation as you run. Preventive measures like these can improve your chances of avoiding overuse injuries for the long run.

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.

How can I control the pain after hip replacement surgery?

admin — Thu, 01 Oct 2009 17:52:14 +0000

I had a total hip replacement last year. The first few days after the operation were very painful. I don’t like using drugs. Is there any other way to control the pain?

Pain control is one of the biggest challenges after surgery of any kind. Some doctors are using a much smaller incision to do some hip replacements. It depends on the type of hip implant being used. With a small incision there’s less damage to the muscles and less pain. Ask your doctor if you might be a candidate for this mini-incision operation.

Other methods of pain control are used such as acupuncture, electrical stimulation, hypnosis, and patient controlled analgesia (PCA). A recent study from Japan suggests using constant cold therapy for the first four days. A cooling pad is placed over the surgical site. A computer keeps it at a constant temperature.

More than half the patients were pain free by the end of the third day. This reduced painful days by at least two full days. Tell your doctor about your concerns. Find out what’s available at your hospital or surgery site.

How did I get adhesive capsulitis – a frozen shoulder?

admin — Fri, 25 Sep 2009 16:44:51 +0000

My doctor diagnosed my tight shoulder as “adhesive capsulitis.” What is this, and how did it happen?

Adhesive capsulitis, also called “frozen shoulder,” is a condition in which the shoulder becomes tight and painful, making it difficult to do daily activities.

With frozen shoulder, inflammation in the joint causes the lining surrounding the joint to stick together. This causes the shoulder to “freeze” and seriously limits movement.

It’s hard to say how you got a frozen shoulder. Most cases can’t be traced to one event. One theory is that this condition is caused by an auto-immune reaction. An auto-immune reaction happens when the body’s defense system, which normally protects it from infection, mistakenly begins to attack the tissues of the body.

A frozen shoulder may arise gradually, with no injury or warning. It sometimes happens to people who’ve had past shoulder problems, such as rotator cuff tendonitis or bursitis. Others are affected after surgeries unrelated to the shoulder–even after heart attacks. The condition likely results when pain or inflammation in the shoulder causes a person to start using the shoulder less, setting the stage for a frozen shoulder.

Where exactly is the posterior cruciate ligament (PCL)?

admin — Tue, 15 Sep 2009 16:42:56 +0000

Where exactly is the posterior cruciate ligament (PCL)? Why don’t I hear about it as much as the anterior cruciate ligament (ACL)?

The cruciate ligaments are two ligaments that cross inside the knee joint. (“Cruciate” means cross). By connecting the thighbone (femur) with the shinbone (tibia), they help stabilize the knee. The ACL is in front. It protects the tibia from going too far forward in relation to the femur. The PCL crosses behind the ACL. It’s made up of two bands that work together to stabilize the knee when the lower leg is moving backward or rotating outward.

You hear more about the ACL because ACL injuries are more common. They also tend to result in more pain and symptoms than PCL injuries. However, recent studies suggest that PCL injuries may be more common than previously thought, accounting for roughly 20 percent of all knee injuries. Researchers have recently turned more of their attention to PCL injuries, to develop more effective treatments.

Is 42-years old too young for a hip replacement?

admin — Thu, 10 Sep 2009 14:29:45 +0000

I’m 42-years old and have one very bad hip. For some unknown reason my right hip is deteriorating. I know I’m too young for a hip replacement. Is there anything that can give me relief from the pain and a chance to keep my active lifestyle?

If you’ve been turned down by your surgeon for a hip joint replacement, then you’ve probably been advised about pain medications. If not, be sure and ask your doctor what over-the-counter or prescription drugs would be helpful.

Research continues to look at joint replacement in younger patients. In the meantime, hip fusion is emerging as a possible alternative operation. When hip fusion is done with the hip in a good position, pain relief and improved function are the results. With a solid fusion you’ll have steady pain relief.

Is it safe to play tennis after tearing one of my rotator cuff tendons?

admin — Fri, 07 Aug 2009 20:01:22 +0000

August 7, 2009 I tore one of the rotator cuff tendons in my left shoulder six months ago. I faithfully went to physical therapy and did my exercise program for the first two months. Once the pain was gone and I could move the arm freely, I stopped doing the exercises. Is it safe now to sign up for tennis lessons?

If you still have full motion without pain or other symptoms, you are probably safe to begin tennis. There is a risk of future injury, but there is no way to predict this. Warming up before exercise or activity (including tennis) is always a good idea. Spend about five or 10 minutes stretching the muscles of both shoulders, and move your arms through various tennis motions gently and slowly. Your therapist can retest the strength of your shoulder and prescribe a specific warm-up and exercise program for you. This may be a good way to prevent future injuries while still enjoying the fun of tennis.

Why can't I lift my arms fully over my head?

admin — Thu, 06 Aug 2009 13:21:35 +0000

At 69 years old, I’m in relatively good health. But ever since I was in my mid-40s, I have noticed increased joint stiffness, and now I can’t lift my arms fully over my head. Is this normal? What’s preventing me from having full motion?

Muscle and joint stiffness is very common in older adults. It is not clear whether this occurs as a consequence of aging, inactivity, degenerative disease, adhesion (glue-like) molecules in the tissues, or a combination of all these things. Having enough muscle bulk and strength is necessary for full joint motion. This requires healthy muscles and tendons with a good blood supply. Without these, raising the arms completely overhead becomes a challenge. Nutrition is important, and a strength-training program is recommended. Exercises will help offset the loss in muscle mass and strength typical of normal aging. Discuss this situation with your doctor. It is important to make sure nothing more serious is causing these changes. Ask about seeing a physical therapist for a muscle-strengthening program. This can improve your movement and flexibility while preventing reconditioning. Taking these steps now can help prevent future injuries.

How old is "old"? There is a biologic age.

admin — Thu, 30 Jul 2009 11:27:02 +0000

I read an article about hip fractures in the elderly. No specific ages were mentioned. What is considered “elderly” these days?

Some say you are as old as you feel. Still, there’s a biologic age that defines “old.” With the continued aging of America, the term “elderly” is being replaced with the word “aging.”

People who study aging adults are trying to define new age categories. This will help researchers identify risk for illnesses and injuries (like hip fractures) at each age level. Prevention programs can begin before adults reach the age with the greatest risk.

At the present time, the National Institute on Aging (http://www.nih.gov/nia/) has identified the following age categories. These may change slightly with more research:

Pre-elderly: 55-64 years
Young-old: 65-74 years
Middle-old: 75-84 years
Old: 75-84 years (Note: Whether someone is “old” or “middle-old” depends on health status.)
Frail-old: 75 years and up
Oldest-old: 85 years and up
Elite-old: 95 years and up

How does my hip function compare with other guys'?

admin — Wed, 29 Jul 2009 11:24:49 +0000

I’m a 46-year old man with severe hip osteoarthritis. I’ve always been active, but now the pain gets in the way. I can’t help but wonder how my hip function compares to other guys my age without arthritis. Is there any way to find out?

Maybe not directly, but we may have some information to offer. A recent study from Finland compared 27 men with hip osteoarthritis (OA) to 30 men of similar ages without OA. Hip motion and function were measured and compared.

Everyone was tested twice (on two separate days) with two to six weeks time in between the first test and the retest. Subjects stood on one leg to test standing balance. Marching in place with the knee lifting up to the hip level was another test. Stair climbing, knee bending and hip range of motion were also included.

It turned out that the men without OA were much more flexible than the men with OA. They had more hip motion, especially moving the legs out and rotating the hip in or out. Men with more hip deterioration had less motion. Men without OA also had better function when walking, climbing stairs, standing on one leg, or moving the hip.

Walking hurts – is it aging or is it osteoarthritis?

admin — Tue, 28 Jul 2009 11:09:26 +0000

I am only 54 years old, but already I’m noticing changes in the way I walk. I can’t seem to put my full weight into my left hip without twinges of pain. Is there anything I can do about this? I don’t want to lose any more ground.

The natural aging process does cause increased stiffness throughout the body, but usually this is equal on both sides. When you have pain or symptoms in one joint, you may be experiencing more than just natural aging.

Early degenerative arthritis of the hip, called osteoarthritis, can bring about changes in the way a person walks. The body compensates in order to take pressure off the problem joint. The stride gets shorter, so the person takes shorter steps at a slower speed. Sometimes the number of steps taken per minute decreases, too.

It may be wise to bring these changes to your doctor’s attention. He or she will evaluate you and determine if anything more serious is going on. If you have early arthritis, it is important to keep up exercise and physical activity. Your doctor may recommend a physical therapist who can help you find just the right program for your condition.