Dr. Carl Schillhammer Board Certified, Fellowship-trained Orthopedic Surgeon 305 W. Pennsylvania. Anaconda, MT 59711 Appointments and referrals: 406-563-8571 SportsMedMontana.com New treatment options for and Superior Capsule Reconstruction (SCR) Thankfully, there is a new technique called We specialize in:: offers new hope for rotator cuff tears Superior Capsule Reconstruction (SCR) that KNEE: It’s estimated that 40% of rotator cuff tears reconstructs the shoulder capsule so patients • knee cartilage preservation are classified as “massive”. With these specific can recover the use of the shoulder. With a large • arthroscopic rotator cuff reconstruction shoulder tears, if treatment isn’t done promptly, , the humeral head over time • ACL reconstruction • revision ACL reconstruction the injury can result in permanent atrophy of will gradually drift up and out of the socket. The • superior capsule reconstruction the muscles, resulting in an irreperable tear and rotator cuff helps depress the humeral head. But SHOULDER: lifelong problems including loss of strength, without the downward force of the rotator cuff, • shoulder instability ongoing shouder and increased arthritis. the head leaves the socket. The goal of SCR is to • revision shoulder surgery arthroscopy Consequently, massive rotator cuff tears reconstruct the with a graft of tissue from a • shoulder replacement (standard) • shoulder replacement (reverse) need to be treated quickly. The problem is that cadaver to reconstruct the capsule and prevent while shoulder replacement may be an option the head from coming out of position. for the older patient, longevity of an artificial After the surgery, the is joint is an issue for younger patients. Some immobilized for about six weeks. Therapy for Carl Schillhammer, MD research cites that 15% of patients with shoulder range of motion starts at about four weeks Board Certified Orthopedic Surgeon Fellowship-trained in replacement may need revision surgery after 10 post surgery, with active motion at six weeks. years because of the artificial joint wearing out. We’re pleased to be one of few centers in the Dr. Carl Schillhammer received his B.A. in Biol- Consequently, a patient in their 50s is likely to State of Montana to provide this new shoulder ogy from Dartmouth College. After graduat- need revision surgery within their lifetime. treatment option for rotator cuff tears. ing from Dartmouth College, he attended the University of Washington School of Medicine Knee symptom charts online for patients in Seattle, then completed his residency training at the State Uni- Recognizing that people will self-diagnose themselves, and often with the wrong information, we have an online symptom guide at SportsMedMontana.com that outlines acute and chronic knee pain versity of New York (SUNY). Dr. Schillhammer then completed an Orthopedic Sports Medi- symptoms, and when theS patientymptom needs to char see a kneet for or acuteshoulder specialistknee pain to prevent further damage to the joint. Patients and referral sources can download the educational PDFs off our Internet site. cine Fellowship at Taos Orthopedic Institute in New Mexico where he treated complex ski START HERE injuries and other sports related issues. Did the knee pain begin Does the knee joint You may have a fracture or Stop what you are doing immediately and go to a hospital emergency room YES YES suddenly, with an injury, appear deformed, or dislocated patella. or an orthopedic surgeon specializing in knee problems. In his fellowship, Dr. Schillhammer spe- slip, fall, or collision? out of position? If possible, splint the leg to limit the movement of the knee until you reach cialized in shoulder and knee procedures, NO the doctor. Do not put any weight on the knee. Use a wheelchair, a cane, or including minimally invasive arthroscopic NO crutch to prevent putting any weight on the leg, which might cause further damage to the joint. cases; rotator cuff repair; labrum repair;

GO TO meniscus repair; cartilage restoration; ACL FLOW CHART #2 reconstruction; knee replacement; and Go to an orthopedic surgeon Stop what you are doing. Continuing activity despite the feeling that the knee ON CHRONIC KNEE Did you hear a “pop” YES immediately, you may have is unstable can cause additional damage to other , meniscus , and shoulder replacement. By living in the New PROBLEMS THAT DEVELOP and does your knee feel torn your anterior cruciate, or cartilage. Try ice on the knee to control swelling. Take anti-in ammatories OR WORSEN OVER TIME. unstable or wobbly? other ligaments in the knee. like Advil or Nuprin until your doctor’s appointment. About a third of Mexico mountain community, Dr. Schillham- tears get better with exercises, a third may need a brace, and a third may need sur gery. mer became proficient in NO treating trauma and joint in- Use R•I•C•E for sore jury related to skiing, hiking, Does your knee hurt YES You may have damaged the articular Try anti-in ammatories, as directed on the bottle, for two days to reduce R: Rest as you bend it? cartilage on the bottom of the the chronic in ammation. biking and running. I: Ice femur, top of the tibia, or inside the NO k neecap. There may be a small bone Restrict activity which causes pain. Call a specialist for a more in-depth Dr. Schillhammer’s C: Compression chip causing in ammation. E: Elevation diagnosis and treatment. family was drawn to the Montana region both by Remember, those who Try anti-in ammatories, as directed on the bottle, for two days to reduce choose to self-diagnose Does it hurt when You may have damaged a the chronic in ammation. its natural beauty and themselves, assume YES meniscus. If pain does not go away, responsibility for their w alking or when you put weight on your knee? this injury may require surgery. Call a knee specialist. A serious can require surgery. small town values. His actions. Always consult 2017 with a specialist to © assess the cause of your family enjoys the local symptoms. NO Try anti-in ammatories to reduce the chronic in ammation. trails, ski slopes, rivers

Also, use ice to reduce swelling. RIGHT PRIZM Other types of knee pain or discomfort that develop over a short period of and lakes. His interests time may mean that you have tendinitis or a ligament . In fact, PY

The good news is that manyk nee injuries are simply strains from overuse. The three knee CO are sometimes mistaken for a broken bone. The signs of a include t endons at risk for pain are the patellar tendon, the quadriceps tendon, and the popliteus. also include mountain- joint pain which increases with movement; tenderness to the touch; and Dancers, cyclists, and runners frequently experience bouts of t endinitis, when heavy rapid swelling. These may be followed by a black and blue discoloration. usage stretches out their tendons. This can include patellar tendinitis or patellofemeral eering, mountain biking, Sprains in the knee involve partial tears to the A CL, PCL, MCL, and L CL. pain syndrome. Neither requires surgery. When you return to activity, keep in mind that Rapid acceleration or deceleration causes strains. A strain is characterized rock climbing, canoeing, in sports like t ennis, strains are often caused by poor footwork. Consider a tennis lesson by a sharp pain or “stitch.” The area becomes sore and sti within a few with a pro who can improve your preparation and anticipation so there is less need for hours or moments of straining. Pain accompanies further movement but hunting, fly fishing, and lunging and uncoordinated stops and starts. often improves within days. baseball. Copyright 2019 • PrizmDevelopment.com • Centers of Excellence for better healthcare On the campus of Community Hospital of Anaconda 305 W. Pennsylvania, Anaconda, MT 59711 Appointments & referrals: Phone: 406-563-8571 Web: SportsMedMontana.com UNDERSTANDING JOINT PAIN SYMPTOMS & WHEN YOU NEED TO SEE THE DOCTOR TRAUMA, FALL, FRACTURE: TRAUMA: Any time there is trauma (fall, impact, car accident) HAND: along with pain, a bone or joint could have fractured. NUMBNESS/WEAKNESS IN / HAND: X-rays will be needed to check for broken bones. See an Numbness or weakness in the arm or hand can orthopedic specialist or an Emergency Room. be an emergency symptom related to a herniated disc in the . Left untreated, the symptom can become permanent. You should see a spine SHOULDER: specialist within 3 days. FROZEN SHOULDER can develop from NUMB FINGERS: Numbness in the tips of the overuse or inflammation. fingers can relate to Carpal Tunnel Syndrome. BURSITIS can make it difficult to raise the Watchful waiting with the use of a brace can be arm with twinges of pain. tried for a couple months. Numbness, if ignored TENDONITIS is inflammation of the over several months, can become permanent tendon which connects muscle to bone. and lifelong, along with weakness in grip. Self care for all three can include anti- Treatment can include a 30-minute surgery to inflammatories and R-I-C-E: Rest, Ice, relieve the tightness in the wrist. Compression & Elevation. Rest your shoulder for a day or so, using ice for 10 PAIN not linked to dislocation due to trauma, fall or car minutes at a time. Compress the shoulder accident, is often linked to bursitis (inflammation of the joint) snugly with an elastic band (not tightly) or degeneration of the hip joint due to arthritis which damages and lie down with the shoulder elevated. the surface of the top of the bone and the socket within An orthopedic surgeon can provide a the pelvis. steroid injection to improve motion and • Self care for hip joint pain can include: anti-inflammatories; relieve pain. rest; ice or heat; and . • Visit an orthopedic surgeon for a thorough evaluation for the cause of your hip joint pain and treatment options. You should KNEE: HIP: see a doctor when you have a hip joint that appears deformed, TORN ACL: A torn anterior cruciate if you are unable to move your leg or hip, or bear weight on ligament can involve an audible the leg. “pop” followed by a feeling of nausea • Long term treatment for an arthritic hip joint is hip joint and instability. A complete ACL replacement through artificial hip replacement or mini hip tear will require surgery where a replacement. Hip replacement is often delayed where possible new ligament is harvested from the to minimize the likelihood of the patient outliving the artificial hamstring or patellor tendon. joint which would require a complex revision surgery and a BURSITIS can cause inflammation of second artificial joint surgery. the “bursae” in the joint resulting in pain upon movement. PAIN at the back of the leg above the ankle can involve pain on the be related to a sprained or ruptured Achilles tendon, lower leg following exercise or stress. which can be accompanied by a pop while performing DISLOCATION occurs with an injury an activity, followed by intense pain and impaired ability or fall moving the knee “out of joint.” to walk. A torn Achilles tendon may require surgery. TORN MENISCUS can be caused by ANKLE SWELLING following activity or awkward an injury during activity. landing on the ankle can relate to a sprained ankle. If the ARTHRITIC KNEE can be common swelling and pain does not self resolve over several days, with age and can worsen when the an orthopedic surgeon should evaluate the ankle. Other person is overweight or obese. Long persistent ankle joint pain can be caused by arthritis. term treatment may include knee PAIN IN THE HEEL is often plantar fascitis and may replacement. ANKLE: require an orthopedic surgeon evaluation & treatment. Self care for many knee pain ailments PAIN IN THE BIG TOE JOINT can caused by a bunion can include anti-inflammatories and (bone spur) that causes a deformed and painful toe joint. ice. An orthopedic surgeon can Surgery may be required to remove the bunion. provide a knee injection to relieve : pain, or drain the knee of excess accumulated fluid in the knee. A NUMBNESS/WEAKNESS IN LEG OR FOOT: person should see an orthopedic Numbness or weakness in the leg or foot can be an surgeon for a complete evaluation emergency symptom related to a herniated disc in to determine the cause of knee pain. the back. Left untreated, the symptom can become permanent. You should see a spine specialist within 3 days.

Those who self diagnose and self treat themselves do so at their own risk. We accept no responsibility for any problems that may result from the use or misuse of educational information intended to be helpful guidance. Copyright © 2018 Prizm Development Inc. • All Rights Reserved