What happens during a shoulder manipulation?

July 29th — admin

Can you tell me how they do a shoulder manipulation? I know I’ll be asleep for the operation but what happens exactly?

Surgical manipulation of a joint refers to a procedure whereby the surgeon moves the joint slowly and gently through its full range of motion. The patient is anesthetized to allow for full relaxation of the muscles, which would hold and contract otherwise to avoid the pain of movement. Once you are asleep, the surgeon moves your arm carefully through each motion: flexion, extension, and rotations (internal and external). The arm will also be moved across the body. This movement is called horizontal adduction. Adhesions and fibrous scar tissue will be torn in the process. The surgeon feels and hears the snapping, popping, grating sound called crepitus that signals release of the adhesions. Once the adhesions are released, the shoulder will move more smoothly and fully. The manipulation procedure is complete when the affected shoulder has the same range-of-motion as the uninvolved side.

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 a 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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Knee creaks after ACL repair. Is this normal?

June 22nd — admin

I had an ACL repair done about 18 months ago. The knee works fine but it creaks and cracks a lot when I move it. Is this normal?

You may be describing what’s called crepitus. This sound or feeling occurs when the back of the kneecap grates against the bone. This finding is more common before the ACL repair is done rather than afterwards.

Any snaps, clicks, crepitus, or joint sounds should be reported to the surgeon. The same goes for locking or giving way of the knee joint. Crepitus or similar sounds could occur when the extensor mechanism of the quadriceps muscle isn’t working quite right. This can occur when scar tissue forms or if the tendon has been shortened too much.

The doctor will be able to tell the difference between sounds caused by scar tissue and those caused by cartilage rubbing against bone. There may be some treatment that can help you. It’s not a normal sound and should be taken care of before it gets worse.

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 »

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.

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