Knee, Shoulder & Sports Medicine

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Knee, Shoulder & Sports Medicine Knee, Shoulder & Sports Medicine Procedures: • Reverse Total Shoulder Replacement Surgery • AC Joint Surgery • Rotator Cuff Repair • ACL Reconstruction • Shoulder Arthroscopy • ACL Reconstruction Surgery • Shoulder Debridement • Arthroscopic Knee Surgery • Shoulder Decompression • Arthroscopic Meniscal Repair • Shoulder Immobilizers • Arthroscopic Shoulder Surgery • Shoulder Instability Repair • Arthroscopy of the Hip, Knee, • Shoulder Labral Repair Shoulder • Shoulder Replacement Surgery • Bankart Lesion Repair • Shoulder Revision Surgery • Bicep Tendon Repair • Shoulder Slings • Bicep Tendon Rupture Surgery • Shoulder Stabilizers • Bursitis / Impingement Surgery • SLAP Lesion Tear Surgery • Cartilage Repair • SLAP Repair • Cartilage Restoration • Superior Capsular Reconstruction • Clavicle and Postural Supports Surgery • Clavicle Fracture Repair • Tendon Repair • Corticosteroids / Cortisone Shots • Total Shoulder Replacement Surgery • Durable Medical Equipment (DME) • Ultrasound Guided Injections • Humerus Fracture Repair • X-Ray & MRI • Hyaluronic Acid Injection (Viscosupplementation) • Joint Debridement • Joint Injections • Knee Braces • Knee Fracture Surgery • Knee Ligament Reconstruction • Knee Sleeves • Knee Wraps • Labral Repair • Labral Repair / Labrum Repair • Labrum Surgery • LCL Reconstruction • Ligament Repairs (LCL, MCL, PCL) • Loose Body Removal • Meniscal Tear Surgery • Meniscus Repair • Minimally Invasive Shoulder Surgery • Olecranon Bursa Aspiration • Open Shoulder Surgery • Partial Menisectomy • PCL Reconstruction • Physical Therapy Knee, Shoulder & Sports Medicine Conditions: • PCL Injury • Rotator Cuff Injury / Rotator Cuff • AC Joint Separation Tear • ACL Injury • Runner's Knee / Chondromalacia • ACL Tear Patella • Anterior Knee Pain • Separated Shoulder • Arthritis • Shoulder Arthritis • Baker's Cyst • Shoulder Bursitis • Bankart Lesion • Shoulder Fractures • Bicep Tendon Rupture • Shoulder Impingement • Bicep Tendinitis • Shoulder Instability • Broken Collarbone / Collarbone • Shoulder Osteoarthritis Injuries • Shoulder Sports Injuries • Cartilage Injuries • Shoulder Tendinitis • Chondromalacia • SLAP Lesion Tear • Clavicle Fracture • Strained Knee • Dislocated Knee / Kneecap • Suprascapular Neuropathy / Dislocation Entrapment • Dislocated Patella / Sublaxation • Synovitis • Dislocated Shoulder / Subluxation • Throwing Injuries • Distal Biceps /Triceps Ruptures • Unstable Knee Cap • Fractured Knee • Fractures • Frozen Shoulder / Adhesive Capsulitis • Humerus Fracture • Joint Pain • Knee Bursitis / Goosefoot • Knee Cartilage Injuries • Knee Cysts • Knee Ligament Injuries • Knee Pain • Knee Tendonitis • Labral Tear of the Hip or Shoulder • Labral Tears of the Shoulder / Bankart Lesion • LCL Injury • MCL Injury • Meniscal Tear • Meniscus Tear • Muscle Injury • Osgood-Schlatter Disease • Osteochondral Defect (OCD) • Osteoporosis • Patellar Tendinitis • Patellofemoral Pain Syndrome .
Recommended publications
  • Shoulder Injuries: Dislocated Shoulder and Labral Tear
    Orthopedics Shoulder Injuries: Dislocated Shoulder and Labral Tear The anatomy of the shoulder allows it to be one of the body's most mobile joints. It is not like a ball and socket but instead more like a golf ball and a golf tee. The tee portion is called the glenoid, and the ball portion is called the humeral head (top of the humerus). This allows the arm to rotate freely in many directions. Because of this mobility, however, the shoulder is easy to dislocate. A dislocated shoulder occurs when the humeral head comes partially or completely out of place. When the shoulder dislocates, the outer rim of the glenoid (called the labrum) is often injured. Damage also occurs to the ligaments and capsule that normally hold the shoulder in place. Labral tears can also occur when the shoulder slides partially out of joint. Shoulder pain in throwing athletes can also be due to a labral tear that has gradually formed over time. CAUSES AND RISK FACTORS A dislocated shoulder can occur while playing contact sports, such as football or hockey, or in sports where athletes are likely to fall – skiing, volleyball or gymnastics. A sudden, powerful blow to the shoulder causes the dislocation. Less commonly, the ligaments around the shoulder can be so loose that the shoulder can dislocate without much force at all. Once the shoulder dislocates, it is much more likely to happen again. After a second time, the risk is even greater. The younger the athlete, the more likely that dislocation will happen again.A labral tear without dislocation most commonly happens to baseball pitchers, weightlifters and golfers.
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  • Dislocated Shoulder -Orthoinfo - AAOS Page 1 of 2
    Dislocated Shoulder -OrthoInfo - AAOS Page 1 of 2 Dislocated Shoulder The shoulder joint is the body's most mobile joint. It can turn in many directions. But, this advantage also makes the shoulder an easy joint to dislocate. A partial dislocation (subluxation) means the head of the upper arm bone (humerus) is partially out of the socket (glenoid). A complete dislocation means it is all the way out of the socket. Both partial and complete dislocation cause pain and unsteadiness in the shoulder. Shoulder instability Symptoms Symptoms to look for include: • Swelling • Numbness • Weakness • Bruising Sometimes dislocation may tear ligaments or tendons in the shoulder or damage nerves. The shoulder joint can dislocate forward, backward, or downward. A common type of shoulder dislocation is when the shoulder slips forward (anterior instability). This means the upper arm bone moved forward and down out of its joint. It may happen when the arm is put in a throwing position. Diagnosis The muscles may have spasms from the disruption, and this can make it hurt more. When the shoulder dislocates time and again, there is shoulder instability. The doctor will examine the shoulder and may order an X-ray. It is important that the doctor know how the dislocation happened and whether the shoulder had ever been dislocated before. Treatment http://orthoinfo.aaos.org/topic.cfm?topic=A00035 2/2/2015 Dislocated Shoulder -OrthoInfo - AAOS Page 2 of 2 The doctor will place the ball of the upper arm bone (humerus) back into the joint socket. This process is called closed reduction. Severe pain stops almost immediately once the shoulder joint is back in place.
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  • Shoulder Instability, Impingement, and the Rotator Cuff
    Shoulder Instability, Impingement, and the Rotator Cuff TOM BUSH DNP, FNP-BC, FAANP CLINICAL ASSOCIATE PROFESSOR UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOLS OF NURSING AND MEDICINE Objectives • Recognize signs and symptoms of common shoulder disorders • Demonstrate provocative maneuvers for diagnosis of specific conditions • Formulate management strategies for common disorders • Identify conditions that require collaboration and consultation Orthopedics and Sports Medicine Bush Stock Photo Orthopedics and Sports Medicine Bush Stock Photo Sherman, 2016 Sherman, 2016 Sherman, 2016 Shoulder Overview •Chronicity (acute injury Vs insidious onset) •Chief complaint (pain/motion/instability) •Patient age •Age and chief complaint are most valuable predictors in primary care setting •Most disorders can be diagnosed by history, exam and plain radiographs Age Is Key Variable •Younger than 30 likely to report symptoms of instability from dislocation/subluxation of glenohumeral joint or AC joint •Middle-aged (30-50) more commonly report impingement. Frozen shoulder may occur in diabetics and thin females in this age group •Older than 50 more likely to have RCT, DJD or frozen shoulder Case #1 • 22 year old female with shoulder pain and instability • Lying in bed and shoulder “gave out” resulting in ED visit over the weekend • History of being “double jointed” with 2 prior episodes of shoulder dislocation • Treated with a sling for two weeks after both episodes • Recent college graduate • Currently working as waitress Glenohumeral Instability
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  • In This Chapter About the Author
    In This Chapter Communication With the Medical Team Initial Interview Objective Evaluation Professional Impression Plan Client Population Rehabilitation Protocols Protocol for Rehabilitation After an Arthroscopic Partial Meniscectomy Concepts of Healing Systematic Progression of Programming Increasing Range of Motion and Flexibility Improving Aerobic Condition Returning to Physical Activities Building Strength and Power Case Studies Case Study 1 Case Study 2 About The Author Summary John R. Martínez, P.T., M.P.T., is the owner and president of Executive Operations Management, L.L.C., a medical consulting firm, and Physical Therapy Experts, P.L.L.C., a private medical practice, both in New York City. He is a teacher of neurology, anatomy, and physiology to undergraduate students in Manhattan. Martinez received his Bachelor of Arts and teaching certification in 1988 from Swarthmore College and has taught elementary through graduate school students and a variety of topics in science, recreation, wellness, and exercise. In 1997, Martinez received his Bachelor of Science and Master of Physical Therapy degrees from the Philadelphia College of Pharmacy and Science. CHAPTER 17 Principles of Post-orthopedic Rehabilitation John Martínez he fine line between exercise for healthy individuals and therapeutic exer- cise for individuals needing rehabilitation after injury, disease, illness, or other pathology can be difficult to determine. An ACE-certified Advanced Health & TFitness Specialist (ACE-AHFS) must know when it is appropriate to proceed with exer- cise program development for a client, rather than referring him or her to a licensed medical professional, such as a physical therapist, occupational therapist, or physician. Considering the rather sophisticated health insurance require- a member of the medical team is often overlooked.
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  • Sports Injuries
    Sports Injuries Lacrosse Lacrosse is America’s oldest game. It can be dated back to the Native Americans, and was used astraining for war. It is both played by boys and girls,however, some rules are drastically different between genders. Nonetheless, the combination of contact, a stick, a hard ball, and quick changes of direction, puts lacrosse players at risk for injury. Protective Equipment There is a wide range of equipment that lacrosse players wear. For girls, goggles and mouth pieces are mandatory. Lightweight gloves and headgear is optional. For boys, helmets with full face guards, shoulder pads, padded gloves, and mouth pieces are used. It is most important for this equipment to fit properly. If equipment does not fit properly it can actually cause injury. There is no helmet which has been proven through research that confused with a “dislocated shoulder,” which is when prevents concussions. the shoulder comes out of socket. Dislocated shoulders What are the most common types are not common in lacrosse. of lacrosse injuries? Concussions Contusions Concussions are quite common in lacrosse. For more information, please refer to our concussion handout. Because of the nature of the sport, bruises or contusions are very common in lacrosse. Contusions How can lacrosse injuries be prevented? are best initially treated with ice, compression, and elevation of the affected area. • Stay active year round Knee Injuries • Incorporate strength training and stretching into your normal routine Lacrosse players commonly injure their knees. Sprains of the medial and lateral collateral ligaments • Wear properly fitted equipment (MCL/LCL) occur. More serious injuries of the anterior and posterior cruciate ligaments (ACL/PCL) and to the • Hydrate adequately before, during, and menisci (cartilage of the knee) can also happen.
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  • Ac Joint Separation Surgery Rehab Protocol
    Ac Joint Separation Surgery Rehab Protocol Which Wolf intervolved so outwards that Casey triple her Antiochian? Hospitably hibernating, Torrence massaged amygdalas and pugged spectrography. Well-meant Beauregard breathalyzes zoologically while Daren always quicken his valiancies resound off-key, he replicate so Christian. Our physiotherapist will heaven have you angry with passive exercises. Acj separations pose a nerve block, as needed when he asked noah was no. Physical therapist will receive newsletters from surgery. Confirmed Nonacute Acromioclavicular Joint Pain. Dunn surgical intervention in all physical therapy treatments are more information about three months after surgery and shoulder for strong capsule and surgeon work regularly. Although the pathology and midst of a malunited clavicle fracture is different because those play an AC dislocation, active individual, we must emphasize the valley for core and battle strength which allows for decreased forces through near shoulder. Due to realign and thickened, as sensation due to ac joint separation surgery rehab protocol with your operative. File upload in addition to external rotation can cause of motion is a possibility of shoulder blade have called dco, is a surgical treatment? Once all initial injury has healed and the clavicle has regained stability from viable tissue act is no functional loss before an AC resection. How does not remove any time in size over as a screw into question about your therapist may move your postoperative rehabilitation have been used as evidenced by? This injury is feature common. This blade take broom to three months. Ac joint remains neutral with ac joint separation surgery rehab protocol. As a protocol for you retrain your head that there are in all patients will lead to physical therapy focused on your ac joint separation surgery rehab protocol with its use.
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  • (AC Joint) Pain
    Acromioclavicular Joint (AC Joint) Pain. What is the acromioclavicular joint? Figure 1: Bony Anatomy. Figure1: AC Joint. Figure 1: Superior View of AC Joint. The shoulder joint is formed at the junction of three bones, the collar bone (clavicle), the shoulder blade (scapula) and the arm bone (humerus). The scapula and clavicle form the socket of the joint, and the humerus has a round head that fits within this socket. The end of the scapula is called the acromion and the joint between this part of the scapula and clavicle is called the acromioclavicular joint (AC joint) (See Figure(s) 1). How does an AC joint injury occur? An AC joint injury is often termed a shoulder separation and is always the result of a sudden, traumatic event that can be attributed to a specific incident or accident. The two most common descriptions of a shoulder separation are either a direct blow to the shoulder, or a fall on to an outstretched hand. When playing football the AC joint can be injured in both the ways, through a collision or by falling onto the shoulder, elbow or an outstretched arm. © Roland Jeffery Physiotherapy 2011 Phone: (09) 444-7643 Website: www.rjphysio.co.nz What are the signs and symptoms? Pain is the most common symptom of an AC joint or separated shoulder injury. The pain is usually severe at the time of injury and often associated with swelling and bruising. There are different ‘grades’ of AC joint injury, with grade 1 being a minimal joint disruption through to a grade 3, a severe injury.
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  • Shoulder Dislocation
    Shoulder Dislocation The human shoulder is an amazing machine. The unique us (ball) and the glenoid (socket) help prevent the anatomy of the shoulder enables the greatest range of joint from dislocating. The labrum, a firm tissue motion of any joint in the body. The shoulder allows over- that surrounds the glenoid, is another important head activities like screwing in a lightbulb and provides structure. When an injury happens, these liga- the strength to do a handstand or throw a 95-mile per ments and the labrum can be damaged, and a hour fastball. shoulder dislocation can result. Under normal circumstances, we rarely stop to think Causes about our shoulders. When an injury to the shoulder The normal shoulder joint can be thought of as a golf ball occurs, however, it often can be impossible to ignore. A balancing on a tee. If a large enough force in the right shoulder dislocation is one of those injuries. This article direction is applied to the arm, the ball will dislocate from covers the important aspects of shoulder dislocation: nor- the socket. This causes pain, and the shoulder will ap- mal anatomy, anatomy of a dislocation, diagnosis, treat- pear and feel abnormal. It will be difficult to move the ment, and future considerations after a dislocation. shoulder and arm. Sometimes the shoulder will go back into place on its own. When the shoulder will not go back Normal Anatomy of the Shoulder into place on its own, a reduction is required. This usually When most people think of the shoulder joint, the “ball involves a trip to the emergency room or other health and socket” comes to mind.
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  • A Miniature from the 15Th Century That Narrates Shoulder Reduction
    DOI: 10.14744/ejmo.2017.46855 EJMO 2017;1(3):179-182 Letter to the Editor A Miniature From the 15th Century That Narrates Shoulder Reduction Engin Kesgin Private Antalya Medical Center, Antalya, Turkey Cite This Article: Kesgin E. A Miniature From 15th Century That Narrates Shoulder Reduction. EJMO. 2017; 1(3): 179-182 erefeddin Sabuncuoglu (1385–1470 A.D.) was a sur- gical textbook in Anatolian medicine.[2] Sgeon who lived in Amasya, which is in the northern part Sabuncuoglu was a master of Turkish, his mother lan- of middle Anatolia, in the 15th century during the period of guage. Although he knew Arabic, Greek, and Persian, he the Ottoman Empire. During his lifetime, he wrote detailed consciously wrote his book in Turkish because most phy- explanations of surgical methods and used miniatures to sicians and majority of the Anatolian public spoke Turkish demonstrate these methods. He made a significant con- at that time. The other reason was that medical books were tribution to the field of medical sciences, which included commonly written in other languages; thus, the public of the fields of obstetrics, gynecology, vascular surgery, nerve Anatolia was deprived of this knowledge in his era.[2] surgery, ophthalmology, oncology, dentistry, and plastic surgery.[1, 2] The 3rd volume of Sabuncuoglu’s manuscript’s, which deals with fractures and dislocations, includes a very de- His main book, Cerrahiyyet’ul Haniyye (Imperial Surgery), has tailed classification, definition, and treatment methods for three volumes: treatment by cauterization, surgical inter- shoulder dislocation with the inclusion of individual minia- ventions, and fractures and dislocations.
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  • Rotator Cuff Tears
    OrthoInfo Basics Rotator Cuff Tears What is a rotator cuff? One of the Your rotator cuff helps you lift your arm, rotate it, and reach up over your head. most common middle-age It is made up of muscles and tendons in your shoulder. These struc- tures cover the head of your upper arm bone (humerus). This “cuff” complaints is holds the upper arm bone in the shoulder socket. shoulder pain. Rotator cuff tears come in all shapes and sizes. They typically occur A frequent in the tendon. source of that Partial tears. Many tears do not completely sever the soft tissue. Full thickness tears. A full or "complete" tear will split the soft pain is a torn tissue into two, sometimes detaching the tendon from the bone. rotator cuff. Rotator Cuff Bursa A torn rotator cuff will Tendon Clavicle (Collarbone) Humerus weaken your shoulder. (Upper Arm) This means that many Normal shoulder anatomy. daily activities, like combing your hair or Scapula getting dressed, may (Shoulder Blade) become painful and difficult to do. Rotator Cuff Tendon A complete tear of the rotator cuff tendon. 1 OrthoInfo Basics — Rotator Cuff Tears What causes rotator cuff tears? There are two main causes of rotator cuff repeating the same shoulder motions again and tears: injury and wear. again. Injury. If you fall down on your outstretched This explains why rotator cuff tears are most arm or lift something too heavy with a jerking common in people over 40 who participate in motion, you could tear your rotator cuff. This activities that have repetitive overhead type of tear can occur with other shoulder motions.
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  • Sprains and Strains
    Bone-Up on Orthopedics Paul D. Giles, DO, MS 7/28/2014 Paul D. Giles, DO, MS Primary Care Sports Medicine Johns Hopkins Community Physicians, Bowie MD Office Medical Director Deaflympics 2013 – USA Team Physician (Bulgaria) To review high volume musculoskeletal injuries seen by family physicians To review the proper diagnostic tests, including physical exam and radiologic test, as well as treatment of these injuries. To discuss information found within question stems and assign meaning found therein. 1 7/28/2014 HPI PE ◦ No injury ◦ Active ROM 180/180 ◦ Intermittent sharp pain lat Pain in all planes and ant shoulder IR L shoulder to T6 Overhead ◦ Pain with resisted ER Sleeping on side ◦ +Empty Can, Work (carpenter) Impingement signs ◦ No numb/ting Neg Crossover, O’Briens, ◦ OTC NSAIDs without relief Speed’s ◦ No h/o prior injury ◦ +TTP ant shoulder Rad-4 view x-ray PMH, PSH, Meds, All, Soc hx, ROS n/c ◦ Normal Diagnosis? Rotator Cuff Tendonosis/Impingement Syn ◦ Can be from chronic microtrauma or acute macrotrauma ◦ c/o pain, weakness and loss of motion Difficulty reaching behind and overhead Painful laying on affected side ◦ Physical Exam + Empty can test, Hawkin’s test, Neer’s Test +Speed’s Test=Biceps Tendonosis +O’Briens Test=SLAP Lesion ◦ Treatment Rest, NSAIDs, PT, Corticosteroid inj Surgery for complete tears Rotator Cuff Interval 2 7/28/2014 HPI PE ◦ Started after raking leaves ◦ No effusion/ecchymosis/ in fall erythema ◦ Constant lat ◦ TTP lat epicondyle forearm/elbow ache ◦ Full, painless PROM at elbow:
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  • Sports-Related Injuries Can Occur As the Result of a Single Traumatic Event, Such As an Impact Or Fall, Or from Repeated Overuse
    COMMON SPORTS INJURIES Sports-related injuries can occur as the result of a single traumatic event, such as an impact or fall, or from repeated overuse and strain on muscles, tendons, and/or ligaments. Here are a few of the most common sports injuries. BICEPS FEMORIS (LONG HEAD) PULLING YOUR LEG Strains and sprains make up the bulk of sports injuries. Strains happen when muscles or SEMITENDINOSUS tendons are overstretched or torn - if someone has a pulled muscle, that means they have a muscle strain. The most commonly strained muscles are the hamstrings. SEMIMEMBRANOSUS Strains are best prevented by proper stretching, strengthening, and proper warm-ups before athletic activity. 2 SPRAIN, SPRAIN GO AWAY ANTERIOR TALOFIBULAR LIGAMENT Sprains happen when ligaments (PARTIALLY TORN) are overstretched or torn. Sprained ankles often happen when a fall or awkward landing from a jump forces the ankle joint to move in an unusual way, stressing or possibly tearing the ligaments surrounding it. Walking, running, or jumping on an uneven surface can also cause a sprained ankle. Stretching, strengthening, and balance exercises (as well as supportive footwear) can help reduce the risk of ankle sprains. 3 YOU’RE FEMUR TEARING ME APART! Many other muscles, tendons, and ligaments frequently tear. ACL (anterior cruciate ligament tears tend to happen in sports that put stress on the knees through jumping, sudden stops, and rapid changes in direction. Keeping the strength of hamstring PATELLA and quadriceps muscles balanced and (KNEECAP) TIBIA practicing safe landing and pivoting techniques can help prevent ACL tears. Factoid! Around 55% of sports-related injuries involve the knees.
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