Avoiding Overuse Injuries

Understanding how to pace yourself while getting fit is key to staying healthy and enjoying physical activity throughout your life.

Overuse injuries can be any type of muscle or joint injury like rotator cuff injury, bursitis, tendonitis, or stress fractures that are caused by repetitive trauma. Overuse injuries are usually caused by biting off more than you can chew, or using bad form when you exercise.

When you take on too much physical activity too quickly, you can hurt yourself. Pushing too hard too soon or simply doing too much of one type of physical activity can strain your body and lead to an overuse injury.

The fear of overuse injuries should not prevent you from exercising. Here are some common sense ways you can avoid overuse injuries:

  • Get a physical before you start exercising. You may have muscular imbalances or medical conditions that can make you predisposed to developing an overuse injury.
  • Consider using a personal trainer. Using the correct technique is crucial to preventing overuse injuries. A good, certified personal trainer can help you begin a new, safe exercise regimen.
  • Use new/well-maintained shoes. When your shoes wear down, you don’t get the proper support, and this can contribute to overuse injuries.
  • Consider the tortoise and the hare. Easing into your new fitness routine/training will help you continue to stay active for years to come. Don’t try to do too much too soon.
  • Warm up, cool down, and stretch. A dynamic stretching warm-up of 5 to 10 minutes and a static stretching routine for 5 to 10 minutes at the end of the hour will do wonders for avoiding injuries. Consider ways to modify activities to fit your present fitness level.
  • Gradually increase your activity level. When changing your activity level or the amount of weight you’re using while strength training, keep it gradual — such as increases of no more than 10 percent each week until you reach your new goal.
  • Try a tri. Done correctly, triathlon training is a perfect balance of running, swimming, cycling, and core strength – a perfect balance to make you really fit and avoid overuse injuries. Even just following a triathlon training program will give you a nice balance of different forms of cardio, strength, and flexibility.

It’s great to set new fitness goals; don’t let overuse injuries sideline you. By working with your orthopedic physician and a personal trainer or physical therapist, easing into activities, and cross training, you can prevent overuse injuries.

Understanding Minimally Invasive Knee Surgery

Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.

Technical advances have led to high-definition monitors and high-resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopaedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Arthroscopy is done through small incisions. During the procedure, an orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope sends the image to a television monitor. On the monitor, your surgeon can see the structures of the knee in great detail. Your surgeon can use arthroscopy to feel, repair or remove damaged tissue.

Almost all arthroscopic knee surgery is done on an outpatient basis. Arthroscopy can be performed under local (numbs just your knee), regional (numbs below the waist), or general anesthesia (puts you to sleep). The anesthesiologist will help you decide which method would be best for you. If you have local or regional anesthesia, you may be able to watch the procedure on a television monitor.

The orthopedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopedic surgeon see your knee clearly and in great detail.

Your surgeon’s first task is to properly diagnose your problem. Your surgeon will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through another small incision.

Arthroscopy for the knee is most commonly used for:

  • Removal or repair of torn meniscal cartilage
  • Reconstruction of a torn anterior cruciate ligament
  • Trimming of torn pieces of articular cartilage
  • Removal of loose fragments of bone or cartilage
  • Removal of inflamed synovial tissue

Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Keep your leg elevated as much as possible for the first few days after surgery. Apply ice to relieve swelling and pain. Your surgeon will see you in a few days to check your progress, review the surgical findings, and begin your postoperative treatment program.

Your doctor will prescribe pain medication to help relieve discomfort and may also recommend medication such as aspirin to lessen the risk of blood clots.

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee. A formal physical therapy program may improve your final outcome.

Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes sooner. Higher impact activities may need to be avoided for a longer time. If your job involves heavy work, it may be longer before you can return to your job. Discuss when you can safely return to work with your doctor.

You will need to talk with your doctor before returning to intense physical activities. The final outcome of your surgery will likely be determined by the degree of damage to your knee.

Carpal Tunnel Syndrome

You’re working at your desk, trying to ignore the tingling or numbness you’ve had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. Just a passing cramp? More likely you have carpal tunnel syndrome, a painful progressive condition caused by compression of a key nerve in the wrist.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of the hand – houses the median nerve and tendons.

Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that affect the body’s nerves and make them more susceptible to compression are also at high risk.

Early diagnosis and treatment by an orthopedic doctor are important to avoid permanent damage to the median nerve. Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor’s direction. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.

Nonsteroidal anti-inflammatory drugs may ease symptoms. Other medications can be injected directly into the wrist or taken orally to relieve pressure on the median nerve, providing immediate, temporary relief.

Stretching and strengthening exercises supervised by a physical therapist, who is trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being, may be ordered by your orthopedic physician.

Alternative therapies such as acupuncture and yoga have been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

Carpal tunnel release is one of the most common surgical procedures in the U.S. Generally recommended if symptoms last for 6 months, surgery involves releasing the ligament around a portion of the wrist that compresses the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay.

Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take several months. Patients should undergo physical therapy after surgery to restore wrist strength.

Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely.

You can help to prevent this disabling occupational illness by performing stretching exercises, taking frequent rest breaks, wearing splints to keep wrists straight, and by being mindful to maintain correct posture and wrist position.

Common Foot and Ankle Conditions

Our feet and ankles support our bodies and enable us to move about. While walking, the pressure on your feet can exceed your body weight. When you’re running, it can be three or four times your body weight.

The average person takes 8,000 to 10,000 steps a day – the equivalent of walking several miles. Those steps add up to about 115,000 miles in an average lifetime. That’s like walking around the world four times.

The 26 bones in your feet make up a quarter of all the bones in your body. Each foot also contains 33 joints. More than 100 muscles, tendons and ligaments hold this intricate structure together and allow it to move in a variety of ways.

These numerous small bones are vulnerable to fracture. Some of the most common fractures include ankle fractures, heel bone fractures, midfoot fractures, pilon fractures, shinbone fractures, stress fractures of the foot and ankle, and toe fractures.

The foot and ankle are often the site of injury during sports activities. And whether active in a sport or not, twisting the ankle is an extremely common injury for adults and children alike. About 60 percent of all foot and ankle injuries reported by the U.S. population older than 17 years are sprains and strains of the ankle.

Whether caused by rheumatoid arthritis, post-traumatic arthritis or osteoarthritis, the ankle is an especially vulnerable to the debilitating degenerative joint condition of arthritis.
Other common causes of foot and ankle pain include bunions, plantar fasciitis, heel spurs, hammer toe, and Achilles tendonitis and rupture.

An orthopedic physician can provide both surgical and non-surgical treatments to patients suffering from foot and ankle conditions, including proper shoe recommendations, oral anti-inflammatory medication, anti-inflammatory injection therapy, and surgical correction for severe cases.

Treat ankle sprains by following RICE (rest, ice, compression, elevation). If pain is severe and you cannot bear weight on the sprained ankle, you should see an orthopedic doctor for an exam and X-rays to determine the extent of the injuries.

Your feet mirror your general health. Underlying conditions such as diabetes and nerve and circulatory disorders can show their initial symptoms in the feet. Foot ailments may be your first sign of more serious medical problems.

Whether caused by these underlying conditions, or because of common injuries or ill-fitting footwear, foot and ankle pain is a leading cause of visits to an orthopedic specialist.

Considering Hip Surgery?

Surgery involving the hips is often necessary to restore mobility as well as alleviate pain. Hip surgery can correct a physical defect or repair damage sustained in an accident. There are several different types of hip surgery that are common today, ranging from hip repair to full hip replacement.

Some forms of hip surgery are aimed at repairing fractures somewhere on the femur. Hip pinning and hip fixation are two examples. Screws are inserted to mobilize the fracture and facilitate the healing process.

Hip fractures usually occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking.

Hip arthroscopy may be performed before any major hip surgery. Arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a joint. This helps surgeons diagnose and even treat joint problems with minimally invasive surgical techniques.

During hip arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.

When it comes to arthroplasty procedures for the hip, there are a few major varieties that are currently employed. These procedures can range from a partial replacement, or “hemi-arthroplasty,” to a full replacement, called a “total hip” arthroplasty.

Hip arthroscopy has emerged as an alternative to more invasive hip replacement surgeries. Hip arthroscopy has been a special focus of my practice for the past five years.

Total hip replacement may be an option if your hip pain interferes with daily activities and more conservative treatments haven’t helped. Arthritis damage is the most common reason to need hip replacement.

If you have exhausted all non-invasive treatments to alleviate your hip pain, consult with an orthopedic surgeon on procedures that may be right for you. As with any surgery, consulting an orthopedic physician experienced in hip surgery procedures will result in the most successful outcome. Physical therapy following surgery will help you return to your optimal level of functionality, and your fastest return to normal activities.

Types of Orthopedic Surgery

There are many types of joint reconstruction and replacement surgery. Some of the most common surgical procedures are explained here.

Total joint replacement
Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint, such as a knee joint, are removed and replaced with an artificial joint that moves like a healthy joint.

Total knee replacement
If you have very severe arthritis, for example, total knee replacement surgery may be an option. When knee replacement surgery is performed, the cartilage of the knee joint is replaced with an implant.

Total hip replacement
This procedure involves removing the ball and socket of a joint with arthritis and inserting a new ball and socket to allow movement at the new joint.

Total shoulder replacement
This procedure involves replacing damaged bone and cartilage with an implant to improve range of motion at the shoulder joint.

Rotator cuff repair
The rotator cuff helps keep your shoulder anchored and helps it to move. A tear in the cuff can limit your range of motion and cause pain. These tears can be repaired with surgery to relieve pain and improve strength and functioning of the shoulder.

Arthroscopic surgery
Arthroscopy is a method of viewing or performing surgery on a joint by use of an arthroscope, which consists of a very small tube, a lens, and a light source using fiber optics to visualize the surgical area. Orthopedic surgeons perform shoulder, knee and other repairs with arthroscopy. The incision made for inserting the arthroscope is very small, and fewer stitches may be required. The advantage to arthroscopy is a smaller incision heals more quickly and there is less trauma to tissue.

Spine surgery
A variety of problems may lead to spine surgery. There are a number of procedures that can be performed to improve function and remove back pain, and these procedures are done if more conservative treatment, such as medication or physical therapy, don’t work. These include such common procedures as laminectomy, diskectomy, fusion, and spinal decompressions. Kyphoplasty is a less-invasive technique for the pain of spinal fractures often caused by osteoporosis.

Ankle surgery
A variety of problems with the ankles and wrists require surgical treatment. Overuse injuries, rheumatoid arthritis, stress fractures and sprains can often be treated with surgery if more conservative treatment fails.

ACL reconstruction
The anterior cruciate ligament (ACL) is the major stabilizing ligament of the knee. When it ruptures, reconstruction can be performed in a number of ways, including state-of-the-art tendon grafts.

Partial Knee Replacement Can Help Relieve Arthritis Pain

Over the course of their lifetimes, approximately one in five Americans will develop knee arthritis. Fortunately, a wide range of nonsurgical and surgical techniques are available to address the discomfort and disability that can accompany this condition.

Partial knee replacement is a reconstructive surgical treatment option that replaces (or resurfaces) only the damaged portion of the knee, while conserving knee ligaments and unaffected cartilage. Over the past 15 years, improvements in minimally-invasive surgical techniques and instrumentation have made partial knee replacement a viable option for a growing number of patients.

Patients with unicompartmental knee arthritis have cartilage degeneration in only one section or compartment of the knee. In cases where nonsurgical techniques do not provide sufficient symptom relief, surgeons can remove damaged cartilage and bone in the diseased area only, while preserving the ligaments that help support the knee joint.

A prosthesis—which may also be called an implant—takes the place of the damaged area of the knee, leaving the other compartments intact.

During partial knee replacement, the orthopedic surgeon makes a small incision to gain access to the affected compartment of the knee and then gently moves supporting structures of the knee out of the way. Damaged cartilage and bone tissue are removed from the surfaces of the tibia and the femur in the arthritic area. The surgeon then prepares these surfaces for insertion of the prosthesis components which are specifically sized to the patient’s joint. Cement is used to secure these components. All surrounding structures and tissues are restored to their anatomic position and the incision is closed.

Partial knee replacement is usually performed as an outpatient procedure in a surgical center with no overnight stay. Most patients are able to walk with assistance, or independently, on the same day as their surgery. Typically, the patient is given a cane within a week of surgery to allow for increased independence and begins outpatient rehabilitation. Medication helps manage post-surgical pain.

Partial knee replacement usually involves minimal blood loss and a low rate of complications. Most patients can expect to be back to their daily activities within three to six weeks. Many patients find that after undergoing physical rehabilitation, they are able to return to sports such as golf or bike riding within six to ten weeks.

There are no age restrictions for partial knee replacement, but in general, partial knee replacements are typically appropriate for patients over 40 years old and less than 60 but each case is evaluated according to the needs and activity of the patient. Partial knee replacement is generally restricted to patients who are not morbidly obese. Patients with rheumatoid arthritis are not candidates for partial knee solutions since inflammatory-type arthritis typically involves the entire joint. Also patient age is typically over forty and less than 60 but each case is evaluated according to the needs and activity of the patient.

Your orthopedic surgeon will perform diagnostic tests and determine with you whether partial knee replacement is your best treatment option.

Partial knee reconstruction is widely recognized as a technically demanding surgery. Choosing an orthopedic surgeon with extensive experience with this procedure will help to ensure the best possible outcome.