Blog Archive

Impingement Syndrome Symptoms May 27th, 2105

Impingement syndrome symptoms are very common.  In fact, these symptoms are perhaps the most common shoulder symptoms that bring patients to the doctor. This is likely because almost any shoulder problem, including isolated impingement syndrome, can have these same symptoms.  Often, however, these symptoms occur alone.  Either way, the impingement syndrome symptoms...

Which Sports Medicine Treatment Is Right for You? Apr 14th, 2021

When you suffer from a sports injury, you may wonder which treatments can help and whether you need surgery. You may even worry that your injury will keep you on the sidelines for weeks or months.  At Town Center Orthopaedic Associates, located in Reston and Centreville, Virginia, our orthopedic team...

9 Conditions That Improve With Foot and Ankle Care Mar 15th, 2021

Your foot and ankle help you balance, stand, and walk. These complex body parts are made up of many bones, ligaments, joints, muscles, and tendons that work together to keep you on your feet.  When trouble strikes, it’s important to seek help from foot and ankle care experts with the...

10 Conditions That Improve With Foot and Ankle Care Mar 10th, 2021

Your foot and ankle help you balance, stand, and walk. These complex body parts are made up of many bones, ligaments, joints, muscles, and tendons that work together to keep you on your feet.  When trouble strikes, it’s important to seek help from foot and ankle care experts with the...

Understanding Sesamoiditis Feb 12th, 2021

If you’re like most people, you take your feet for granted … until something goes wrong. And since the foot is complex, made up of 26 bones, 33 joints, and over 100 muscles, tendons, and ligaments, it's hard to know what’s causing your foot pain.  When debilitating foot pain strikes,...

How Regenerative Medicine Is Revolutionizing Pain Management Jan 20th, 2021

Did you know at least 20% of American adults struggle with chronic pain each year? Sometimes this pain is so severe that it stops them from working, engaging in their regular activities, and getting a good night’s rest.  If this describes you, the team at Town Center Orthopaedic Associates can...

What to Expect From Total Joint Replacement Dec 2nd, 2020

Are you struggling with joint pain? You’re not alone! Debilitating joint pain affects millions of Americans every year. Over 55 million people in the United States have arthritis, and many others experience injuries or other diseases that affect their joint health and functionality.  If you’re suffering from joint pain, a...

Acute Joint Pain vs. Arthritis Nov 30th, 2020

If you're experiencing joint pain, it’s natural to wonder if it will pass or when it’s a sign of something more serious, like arthritis. At Town Center Orthopaedic Associates, our team of highly skilled orthopedic experts helps patients in the Centreville and Reston, Virginia areas by diagnosing and treating common...

What Ankle Fracture Treatment Is Right For You? Oct 14th, 2020

Ankle fractures are common. I discussed what they are, how they occur, and the symptoms of ankle fractures in previous posts. We will discuss ankle fracture treatment in this post.   There are two main types of ankle fracture treatment: Non-surgical and surgical management. Factors affecting treatment The three most important factors that determine the...

What to Know Before Undergoing Arthroscopy Oct 9th, 2020

Arthroscopy is a minimally invasive surgical procedure used to diagnose various problems within a joint or to repair damage to any part of the joint. The physician inserts the arthroscope, a small tube containing optical fibers and lenses, through small incisions — each about the size of a buttonhole —...

The 6 Most Common Causes Of Middle Age Nontraumatic Shoulder Pain Oct 3rd, 2020

Shoulder pain is common at all ages, in both active and sedentary people. There are numerous causes of shoulder pain, but as with most things, there are a handful of sources that account for most of the diagnoses. Often the diagnoses can be grouped according to age and cause, resulting...

Aging Happily And Healthfully Jun 20th, 2020

Everyone wants to age gracefully. Living to an old age, being financially and physically independent, and having lived a life well-lived, is on everyone’s bucket list. How to achieve all of this is way beyond my area of expertise. It involves focusing on many things that I am not qualified...

Recovery After Orthopaedic Surgery: Is It Progressing Properly? Jan 28th, 2020

Recovery… Jennie had surgery 3 months ago. She is now back to running but has persistent and similar pain. She’s frustrated because her pain is “unchanged” despite her surgery and doing everything asked of her postoperatively. Mr. Smith is 6 weeks after surgery. He is now concerned because his pain...

Treating The Irreparable Rotator Cuff Tear Jan 21st, 2020

In a prior post, I discussed what an irreparable rotator cuff tear was and why they can be so problematic. In this post, we will discuss the available treatment options. As with many other musculoskeletal issues, this problem can sometimes be treated successfully without surgery. Sometimes, however, surgery is needed. Let’s first take a look...

The Irreparable Rotator Cuff Tear Dec 6th, 2019

You’ve never had pain in your shoulder before.  Then you had a subtle injury.  It wasn’t even that bad.  But you are very uncomfortable, and you can barely lift your arm.  Your doctor told you that you have a large and very old rotator cuff tear.  You were also informed that the...

Hip Dislocation: Tua Tagovailoa’s Injury Nov 20th, 2019

A hip dislocation is a devastating injury… Late in the 2019 collegiate football season, Tua Tagovailoa, Alabama’s star quarterback, projected to be the first pick in the 2020 NFL draft, was sacked while playing Mississippi State and sustained a violent injury to his right hip. After being carted off the field,...

ACL Recovery: Your Return After Surgery Aug 30th, 2019

You had an ACL surgery.  Whew! The hard part is over…So you thought. Your ACL recovery takes a lot more than just surgery. The real work starts now. Your surgery is a significant component of your ultimate recovery, but it is only one aspect.  There are a number of other very...

Root Tears Of The Meniscus (Video) Jul 5th, 2019

Root tears are unique types of meniscal tears. In previous posts, we have discussed the various types of meniscal tears, mainly degenerative and traumatic.  Additionally, we discussed a specific type of tear – the bucket handle tear. Now I’d like to discuss another kind – the root tear. What Are Root Tears?...

Subchondroplasty – Is It Right For You? Mar 3rd, 2019

Do you have arthritis?  Has someone told you that you might be a candidate for subchondroplasty?  What is subchondroplasty? What does it treat? How does it work? Let’s take a look… In a prior post, I described what osteoarthritis is.  In short, osteoarthritis is a degeneration of your joint.  It affects the...

I Have A Swollen Knee. What’s Wrong? (Video) Feb 3rd, 2019

A swollen knee… It is a common concern. First things first – What are we talking about when we say a “swollen knee”? As far as most joints are concerned, swelling outside the joint and swelling inside the joint have different meanings to your doctor because they imply different potential diagnoses. For this post,...

Distal Biceps Tear: What You Should Know (Video) Nov 30th, 2018

Your carrying something.  You feel a sudden pop in the front of your elbow.  There is immediate pain and a deformity of your biceps. What did you do?  Well, you may have torn your distal biceps. What is a distal biceps tear? A distal biceps tear refers to the partial or...

Biceps Problems In The Shoulder Jun 19th, 2018

Your biceps is an atypical muscle.  Other than your triceps, it is the only muscle that crosses both your elbow and shoulder joints.  Along with its unique anatomy, comes unique function…and susceptibility to some problems. In this post, we will look at the issues that can occur to your biceps at...

Is Exercise Enough To Lose Excess Weight? Jan 26th, 2018

This year is no different than others; every January, the gyms fill up with people trying to fulfill their New Years’ resolution – to “get in shape.” So there they are on the treadmill trying to burn off their holiday pounds and improve their health. I always encourage people to exercise.  For...

Golfer’s Elbow Treatment Jan 23rd, 2018

The principles of golfer’s elbow treatment are simple. The great majority of cases will resolve with time.  If the damaged tissue heals, you will be fine.  If not, your symptoms are likely to persist. In that case, only surgical removal of the damaged and painful tissue will help. But until...

Shoulder Arthritis Treatment Dec 22nd, 2017

There is no such thing as the correct shoulder arthritis treatment. Once the diagnosis is known, the proper care for any given patient is not necessarily a medical decision but rather a personal choice.  The best treatment shouldn’t be doctor “directed” but rather patient “requested”.  Like other forms of degenerative arthritis, shoulder arthritis treatment options consist of ignoring the problem,...

Golfer’s Elbow: Causes, Symptoms & Diagnosis Dec 18th, 2017

Golfer’s elbow (Medial Epicondylitis), like it’s cousin, tennis elbow, is an overuse problem of the elbow. Like tennis elbow, golfer’s elbow leads to pain and sometimes stiffness.  Unlike tennis elbow, golfer’s elbow sometimes can also cause nerve symptoms.  Let’s take a look… Definition Golfer’s elbow describes a degenerative process.  It affects...

What Is A Patellar Tendon Tear? (Video) Nov 14th, 2017

What is a patellar tendon and what does it do? Side View Of The Knee The patellar tendon runs from your kneecap (patella) to the top and front of your shin bone, usually at a bump called the tibial tubercle.  Since it essentially runs from a bone to a bone,...

What Are The Common SLAP Tear Symptoms? Sep 3rd, 2017

SLAP tears are a unique type of labral tear.  The acronym S-L-A-P stands for Superior Labral tear Anterior to Posterior. In short, the labrum is a cartilage ring that surrounds the periphery of the cartilage surface of your shoulder socket (Glenoid).  The lower (inferior) labrum is an attachment point for ligaments that connect the ball...

Frozen Shoulder Treatment Jun 13th, 2017

You have frozen shoulder.  Well, it is natural to wonder what the available frozen shoulder treatment options are. So let’s take a look. In an earlier post, I discussed what frozen shoulder is and what you can expect the natural course of this disorder to be….But let’s review. Frozen shoulder is a common problem.  It...

Two Boneheads Video Series: The MCL Sprain Apr 28th, 2017

MCL Sprain: Anatomy Ligaments are thick bands of tissue that connect and stabilize two or more bones.  The MCL (Medial Collateral Ligament) is one of the four main knee ligaments. The other main ligaments are the LCL (Lateral Collateral Ligament), ACL (Anterior Cruciate Ligament) and the PCL (Posterior Cruciate Ligament). The MCL and the LCL are the two collateral ligaments.  The collateral ligaments are...

Resilience And Your Sports Medicine Recovery (Video) Apr 8th, 2017

Resilience is one of those new buzzwords. It’s defined as the ability to get up when knocked down – to recover after a defeat and then to come back even stronger. Along with grit, another buzzword, resilience has been shown to be a critical factor in succeeding in work, academics, athletics, and life. Much of the reason...

Partial Thickness Rotator Cuff Tears (Video) Feb 18th, 2017

Rotator Cuff Anatomy As you may recall from an earlier post, the rotator cuff is a group of four tendons. These tendons start on the shoulder blade as mostly muscle and then extend out to the upper arm (humerus) where they attach as a combined group of tendons (“cuff”). The rotator cuff tendons are...

Impingement Syndrome: Two Boneheads Video Jan 23rd, 2017

Shoulder Anatomy Traditionally, it was thought that a spur on the undersurface of your acromion (the bone that makes up the roof of your subacromial space) dug into the underlying rotator cuff. First, causing impingement syndrome and then later rotator cuff tears. More recently, we have come to realize that impingement syndrome is not so much...

Why Is My Shoulder Stiff After Rotator Cuff Surgery? (Video) Jan 22nd, 2017

In prior posts, I have discussed what rotator cuff tears are, what causes them and how they are best treated, both non operatively and with rotator cuff surgery. What I haven’t yet discussed, in detail, are the problems that can occur with rotator cuff tear treatment.  Paramount among those problems is stiffness.  Stiffness unfortunately often occurs after...

Ankle Fracture Symptoms: What Are They? Dec 22nd, 2016

Ankle Fracture Symptoms Many of the ankle sprain symptoms and ankle fracture symptoms are similar.  Often it is not possible to definitively distinguish between the two diagnoses without an X-ray. So if there is any doubt, I suggest getting an evaluation by your Orthopaedist.  With that said, there are some common ankle fracture symptoms.  So...

Two Boneheads Video Series: Second Opinions Dec 18th, 2016

Second opinions are common in medicine.  In fact they are common in many other areas as well.  I go to to multiple stores before buying shoes.  However, the specific purpose of second opinions in healthcare is particularly unique. Let’s take a deeper look: Second Opinions There are a two major reasons patients...

Dr. Pateder Performs First Case In The Us Using New Fda Approved Minimally Invasive Spinal Device Dec 11th, 2016

First in U.S.! LinkSPINE is announcing the first U.S. implantation of the FacetLINK MINI, a titanium device that uses two screws and an expandable cross-connector assembly to stabilize the lumbar spine after a tissue-sparing midline decompression. Dhruv Pateder, M.D., an orthopedic spinal surgeon, performed the first U.S. MINI case at...

Announcing New Saturday Pt Hours Dec 10th, 2016

Town Center Orthopaedic Associates is proud to announce that beginning October 15th we will be offering PT hours on Saturday mornings at our Reston office. The hours will be between 8:00AM and 12 Noon. We are happy that we can offer these services to better service our patients. Please ask...

New In Motion Publication Available Dec 6th, 2016

In Motion, a quarterly publication from the American Orthopaedic Society for Sports Medicine, is now available online here on our website. In Motion is published on a quarterly basis, and is designed to highlight relevant information for multiple age groups from exercise and rehabilitation to nutrition and psychology. To view...

SLAP Tears: Two Boneheads Video Series Nov 29th, 2016

SLAP tears are a frequently diagnosed source of shoulder pain.  Unfortunately, they are likely over-diagnosed.  As I have mentioned before, SLAP tears are a unique type of labral tear. The labrum of your shoulder is a cartilage ring around the socket of your shoulder.  At the top of the ring, one of your proximal...

Two Boneheads Video Series: Tennis Elbow Nov 28th, 2016

Tennis elbow is a very common source of elbow pain.  Medically, it is referred to as lateral epicondylitis.  This term refers to an inflammatory source, but actually tennis elbow is a degenerative process that results from overuse of the tendons responsible for extending your wrist and fingers. There often is associated inflammation and this can be a contributing cause of your...

First Time Shoulder Dislocations: How Are They Treated? (Video) Nov 27th, 2016

We’ve talked before about shoulder dislocations.  What they are, how they occur, their symptoms and what we do in surgery.  All important information for understanding your shoulder instability. But one of the controversial issues about this topic is how you should be treated after your first dislocation. Why is this controversial? Well,  It is well known that in...

Sprained Ankle Treatment: Fast Or Slow Nov 26th, 2016

So you’ve twisted your ankle and suffered an ankle sprain.  Now you’re wondering what is the appropriate sprained ankle treatment.  Well like most sports medicine injuries…it depends. As you may recall, a sprained ankle is torn ligaments around the ankle.  Additionally, there often is associated local bone bruising and soft tissue swelling. All of...

Ankle Fracture – Definition, Anatomy & Causes Nov 13th, 2016

Ankle fractures are very common injuries. An ankle fracture is a break in one or more of the three bones of the ankle.  Many think fractures and broken bones are different…they are not.  A fracture of a bone is a break in that bone. With that said, not all ankle fractures are the same.  Let’s take a look… Ankle Fracture...

I Have A Baker’s Cyst: Should I Worry? Nov 1st, 2016

You went to your doctor and they examined your knee or perhaps you had an MRI or ultrasound of your knee and were told you had a Baker’s Cyst. Should you be worried?  No.  Well, at least not usually… Baker’s (Popliteal) Cyst A Baker’s cyst (sometimes called a popliteal cyst) is a walled-off collection of...

Do I Need To Stop Running? (Video) Oct 20th, 2016

If you exercise, you will get injured. It’s unavoidable.  I tell my patients that if they want to absolutely avoid any injuries during their leisure activities, they probably should take-up chess.  Most other activities carry some risk. So if they are going to play any sports or exercise in any manner, they should expect some injury, at some...

Shoulder Arthritis Symptoms Oct 5th, 2016

For many of you who have advanced shoulder arthritis, your shoulder arthritis symptoms can often be disabling. Fortunately, not all who have arthritis have such severe arthritis.  For those with less symptomatic arthritis, your shoulder arthritis symptoms may be more tolerable. Like the symptoms of most forms of arthritis, shoulder arthritis symptoms may include pain, grinding, stiffness and deep swelling....

Bucket Handle Meniscal Tears (Video Series) Oct 3rd, 2016

Bucket handle meniscal tears are unique types of meniscal tears.  These types of tears are large, follow the shape of the meniscus, often along its periphery and result in a significant portion of the meniscus displacing into the joint.  This displacement usually occurs when the torn portion of the meniscus flips over...

When Less Is More – Two Boneheads Video Series Sep 29th, 2016

We are an over-tested and over-diagnosed society.  Part of this is our doctor’s fault, part is the fault of advertisers promoting various diseases, medications, hospitals and procedures and, I’m sorry to say, a large part is our fault, all of us patients. Unfortunately, this overtesting and overdiagnosing can lead to over-treatment and unnecessary complications. Which can lead...

Bankart Repair Procedure: Here’s How It’s Done Sep 24th, 2016

A Bankart repair procedure is sometimes necessary to treat shoulder instability. Typically, it is indicated when a Bankart lesion exists and the injury is in a young person involved in “at risk” activities (ie. contact sports, gymnastics, etc.), there is recurrent shoulder instability or there is a sizable glenoid (socket) fracture associated with the labral tear (the so-called bony Bankart...

Early Single Sport Specialization (Video) Sep 18th, 2016

Single Sport Specialization – “intense training in a single sport to the exclusion of others should be delayed until late adolescence to optimize success while minimizing risk for injury and psychological stress.” – N Jayanthi , et al Sports Health 2013 Our children are getting injured at alarming rates.  They are burning out from...

Torn Rotator Cuff Recovery – Surgical Approach Sep 12th, 2016

Torn Rotator Cuff Recovery: Surgical Approach There are cases where rotator cuff surgery is absolutely required – the acute traumatic tear for instance. But beware…torn rotator cuff recovery after surgery is not easy.  It is painful.  It is restrictive…and it is long. During surgery, the torn tendon is reattached to the...

Two Boneheads Video Series: Hamstring Strains Sep 1st, 2016

Hamstring strains are very common injuries.  They usually occur while sprinting, jumping or landing from a jump. There typically is acute pain in the back of the thigh.  More rarely there may be pain in your butt (Yes, a real pain in the a#@) or on the inner side of your upper...

PRP – The Good, The Bad & The Ugly (Video) Aug 28th, 2016

PRP (Platelet Rich Plasma) is all the rage. But should it be?  PRP is a treatment that has been discussed widely in the news and particularly in our sports media.  It is a modification of your own blood that is intended to promote healing in slow to heal tissues. Platelets are one of the three common cell types found in...

Two Boneheads Video Series: ACL Graft Options Aug 26th, 2016

This is the second installment of this series.  Dr. Howard Luks and I discuss the various ACL graft options for ACL (Anterior Cruciate Ligament) reconstruction surgery. ACL Graft Options ACL reconstructions replace the torn ACL (See a video of surgery here).  This procedure is very common.  During the surgery a graft is used in place of the native ACL....

Do Degenerative Meniscal Tears Require Surgery? Aug 16th, 2016

Degenerative meniscal tears differ from other meniscal tears in that they occur more due to “wear and tear” than due to an acute injury.  In younger people, the menisci – those cartilage rings in your knee that sit between the end of your thighbone and the top of your shin bone – are strong and firm.  As we...

Two Sports Medicine Docs Were Having a Conversation…. (Video) Aug 15th, 2016

The Two Boneheads Dr. Howard Luks and I have both been practicing sports medicine and orthopaedics for nearly 20 years.  That’s 40 years of experience between us. During that time, we have developed a tremendous amount of insight into our area of specialization, orthopedics and healthcare in general…and we’d like to...

Torn Rotator Cuff Recovery – Nonsurgical Approach Jul 31st, 2016

Torn rotator cuff recovery can be difficult.  How difficult and what it requires depends on whether you have or have not had surgery.  As you may recall, not all rotator cuff tears require surgery.  Some are degenerative. This means that they developed slowly over time, from years of use – just like an old...

Impingement Syndrome Surgery (Video) Jul 16th, 2016

Fortunately the need for impingement syndrome surgery is rare.  I estimate that only about 1 in10-20 people ultimately requires surgery.  However, when nonoperative treatment fails, there really are only two choices:  live with the symptoms or have impingement syndrome surgery.  What defines failure of nonoperative treatment is really up to you and your doc.  There...

Glenohumeral Arthritis – Anatomy & Causes Jul 9th, 2016

Glenohumeral arthritis is arthritis of the main shoulder joint.  As you may recall from earlier posts (here and here), arthritis is the deterioration of a joint.  A joint is where two opposing ends of your bones meet.  When the joint is healthy, cartilage covers the bone ends.  Cartilage is the slippery, smooth, white substance we see...

Arthritis: Diagnosis and Treatment May 9th, 2016

As I discussed in a previous post, arthritis is a common problem.  As you may recall it is a progressive destruction of a joint.  The primary problem is the deterioration of the cartilage that lines the ends of the bones at the joint.  In more advanced cases, the bone and soft tissues of...

Doc, Is It A Sprain Or A Strain? Apr 19th, 2016

Sprains and strains are two of the most common musculoskeletal problems.  I see them all the time.  In fact, a good portion of my day is spent diagnosing, treating…..and often explaining the difference between these terms. What Are Sprains? Sprains are ligament injuries. Ligaments are thick strong bands that connect and stabilize a joint....

Torn Meniscus Recovery Time Apr 13th, 2016

What is the normal torn meniscus recovery time?  It depends.  Perhaps you recall from an earlier post that some who have a torn meniscus are treated without surgery while some require surgery to get better.  Furthermore, there are two main types of torn meniscus surgery.  Each has its own length of recovery.  So, depending on...

Sprained Ankle Symptoms: What Are They? Apr 6th, 2016

Although ankle sprains are much more common than breaks of the ankle, sprained ankle symptoms are often confused with those of an ankle fracture.  As you may recall from an earlier post, ankle sprains are extremely common. In fact, they are perhaps the most common bone and muscle injury of all.  They can occur...

Arthritis: What Is It & What Are The Symptoms? Mar 28th, 2016

Arthritis is extremely common. If we live long enough, we’re all bound to get it sometime somewhere. Even so, very few really know much about it. So let’s take a look. Essentially, arthritis is the deterioration of a joint. As the process advances, this deterioration will involve the cartilage that covers the...

SLAP Tear – Definition, Anatomy & Causes Mar 9th, 2016

I have previously discussed labral tears of the shoulder.  A SLAP tear is a particular type of labral tear.  SLAP stands for “Superior Labrum from Anterior to Posterior”.  When the superior (top) part of the labrum is torn within its substance or from its attachment at the top of the shoulder socket, a SLAP tear exists. This tear may extend...

Patellofemoral Syndrome Treatment Feb 15th, 2016

Patellofemoral syndrome treatment starts with identifying its cause. The story you tell your doctor can often give this away. Did you start a new activity? Are you playing on two teams rather than one this season? Have you had a recent leg injury? Are you pregnant? Have you recently been ill? Have you...

Achilles Tendon Rupture Treatment Feb 14th, 2016

Achilles Tendon Rupture Treatment As discussed in an earlier post, the Achilles tendon is the largest tendon in the body.  Even so, because of it’s poor blood supply and the potential forces generated within the tendon during activities, it is susceptible to tearing.  Achilles tendon ruptures most often occur while running and...

What Are The Common Runner’s Knee Causes? Feb 5th, 2016

In an earlier post, we discussed what that nagging pain in the front of your knee might be.  Here I will explain, in more detail, why it may have started. As you may recall, runner’s knee or patellofemoral pain syndrome is a common overuse injury to the knee, specifically to the knee cap joint.  It...

Overcoming the Obstacles in Your ACL Recovery Jan 25th, 2016

Welcome to another installment of our web-based symposium about physical therapy following ACL Reconstruction. Our panel: Chris Drew, PT, DPT – Website Paul Frizelle PT, DPT, MS, OCS, MTC, CSCS – Twitter Duncan Gerhard PT, DPT – Website, Facebook, Twitter Jesse Lewis PT, DPT,OCS, CSCS – Website Anna Marie Hammond PT, DPT, ATC – Website, Facebook Chris Marino PT, DPT – Website Robyn O’Connor PT,...

Shoulder Separation: An AC Joint Injury (Video) Jan 18th, 2016

A shoulder separation is a common and very painful injury.  Fortunately it usually heals completely without surgery.  Let’s take a look at what it is, how it occurs and what’s the best method to treat it. Shoulder Separation: Anatomy The main shoulder joint is supported by a number of associated muscles, ligaments, bones and...

10 Pearls For A Successful Doctor’s Visit Jan 12th, 2016

Everyone goes to the doctor at some point.  The visit is often brief, confusing and for many, stressful.  Furthermore, it’s often just downright unpleasant.  So if you must see your doctor, make the appointment worthwhile.  Here are ten recommendations that will help you get the most out of your doctor’s visit. Before the appointment,...

Causes Of Your Torn Rotator Cuff Dec 22nd, 2015

The cause of your torn rotator cuff can vary from person to person. This is important because the cause of the tear can impact the recommended treatment, it’s degree of urgency and its ultimate prognosis. You can read more about this in a prior post. Causes of Your Torn Rotator Cuff Also take...

Bankart Lesion – Definition & Causes (Video) Dec 13th, 2015

In a previous post, I discussed what labral tears of the shoulder are and what common symptoms they cause. A Bankart lesion is a particular type of labral tear of the shoulder. It has some unique characteristics. Let’s take a look. When the labrum gets injured, it often rips within its substance or from its attachment.  That’s...

Patellofemoral Pain Syndrome: Why The Front Of My Knee Hurts Dec 7th, 2015

Caitlin is a slim fourteen year old freshman cross country runner.  She has played sports for years but she had never run cross country before, surely not at a varsity level.  Now she is. Practice started 5 weeks ago and had been fun and challenging – until recently… Rob is forty-five. He had been relatively active...

Physical Therapy After Your ACL Surgery: What’s Most Important? Nov 29th, 2015

Welcome to the 4th installment of our web-based symposium about physical therapy. Our panel: Chris Drew, PT, DPT – Website Paul Frizelle PT, DPT, MS, OCS, MTC, CSCS – Twitter Duncan Gerhard PT, DPT – Website, Facebook, Twitter Jesse Lewis PT, DPT,OCS, CSCS – Website Anna Marie Hammond PT, DPT, ATC – Website, Facebook Chris Marino PT, DPT – Website Robyn O’Connor PT,...

MRI Readings: Fact or Fiction? Nov 23rd, 2015

The MRI has revolutionized medical imaging of the human body.  It is an incredible tool that can help see the inside of your body like nothing before it.  Unfortunately MRIs are not perfect….and worse, most people don’t know this. MRI images are not pictures like those from your camera or your phone. They are generated depictions produced by the...

Subacromial Impingement Treatment Oct 29th, 2015

Subacromial impingement treatment can be either with or without surgery.  Fortunately, most of those who have isolated impingement syndrome get better with nonoperative treatment.  For those who don’t, operative subacromial impingement treatment is usually successful. Subacromial Impingement Treatment:  Nonoperative Approach As I discussed in an earlier post, the symptoms of impingement syndrome, not associated with some other disorder...

Did I Screw It Up, Doc? Oct 5th, 2015

” Did I screw it up, Doc?”. I hear these words often. I understand. Several months ago I had an injury and although I have been treating patients with similar injuries for years, I still worried.  Every time I thought the problem was gone or I was getting better, there would...

Physical Therapy: After Your Rotator Cuff Surgery Sep 1st, 2015

Welcome to the 3rd installment of our web-based symposium about physical therapy. Our panel: Chris Drew, PT, DPT – Website Paul Frizelle PT, DPT, MS, OCS, MTC, CSCS – Twitter Duncan Gerhard PT, DPT – Website, Facebook, Twitter  Anna Marie Hammond PT, DPT, ATC – Website, Facebook Chris Marino PT, DPT – Website Robyn O’Connor PT, DPT, OCS, CSCS – Website, Facebook, Twitter In prior posts,...

Tennis Elbow Treatment: Nonoperative Approach Aug 18th, 2015

Nonoperative tennis elbow treatment is often misunderstood.  This type of tennis elbow treatment is not designed to heal the problem but rather to “buy” time until the damaged tissue heals itself. In nonoperative tennis elbow treatment, our goal is to provide comfort, protection from further injury and rehabilitation to minimize future harm. As you...

Patellar Dislocation Surgery Aug 4th, 2015

Fortunately, patellar dislocation surgery is not often needed.  Approximately only 15-40% of people who dislocate their kneecap the first time, will have another dislocation.  Only about 50% of those, will go on to have further dislocations. Therefore, unless there are associated injuries or personal issues that make it necessary, most of the time, patellar dislocation...

NSAIDs: To Take Or Not To Take? Jul 21st, 2015

The FDA has recently strengthened its warning about non steroidal anti-inflammatory medications (NSAIDs) and their risk for contributing to cardiovascular events (i.e.. heart attack, stroke and heart failure).  You know these medications as Lisinopril, Advil, Motrin, Ibuprofen, Aleve and a number of other prescription and nonprescription formulations. The FDA’s warning noted that: The risk...

Get Healthy And Wealthy By Being Wise Jul 18th, 2015

Early to bed, early to rise, makes a man healthy, wealthy and wise. – Benjamin Franklin, 1735 With all respect to Benjamin Franklin, a great mind and a national hero, life is somewhat more complicated than it was in 1735.  At least when it comes to becoming healthy and wealthy.  How much...

Physical Therapists: When Do You Need Them? Jul 1st, 2015

Welcome to the 2nd installment of our web-based symposium about physical therapy. Our panel: Chris Drew, PT, DPT – Website Paul Frizelle PT, DPT, MS, OCS, MTC, CSCS – Twitter Duncan Gerhard PT, DPT – Website, Facebook, Twitter  Anna Marie Hammond PT, DPT, ATC – Website, Chris Marino PT, DPT – Website Robyn O’Connor PT, DPT, OCS, CSCS – Website, Facebook, Twitter As...

Frozen Shoulder Symptoms Jun 27th, 2015

Frozen shoulder symptoms vary over time.  As you may recall from an earlier post, frozen shoulder (adhesive capsulitis as it is termed medically) is a problem commonly occurring in patient’s with particular characteristics and resulting in inflammation and shortening of the lining of the shoulder joint as well as inflammation in the bursa on...

Shaun Livingston’s Recovery: Lessons For The Injured Athlete Jun 21st, 2015

One of the most exciting NBA Championship series in recent times was the one that ended the 2015 season. Not only was the competition fierce and the outcome unpredictable, but there were also a number of uplifting personal interest stories involving many of the players.  The best of which, in my view, was the story...

Physical Therapy: It’s Crucial To Your Recovery May 11th, 2015

For many orthopaedic injuries and surgeries, the difference between a good and poor outcome is frequently the quality of physical therapy.  Unfortunately, I often find that many of my patients either don’t know how important physical therapy is to their recovery, don’t fully understand what physical therapy is or have had a bad...

Manny Pacquiao & His Rotator Cuff Tear May 9th, 2015

Some have questioned if Pacquiao even had a rotator cuff tear during the Saturday night bout. If so, how could he have fought (even as little as he did :-)),  The truth is that people with smaller tears or tears that occur through attrition (occurring slowly over time from wear and tear), often can...

Doctor’s Orders May 6th, 2015

Fractures of the upper end of the arm at the shoulder are typically painful.  In fact, Jane’s fracture was particularly bad and so predictably very painful.  Her proximal humerus was broken into three large pieces.  Two of the pieces remained attached to tendons and as a result were pulled away from one another as well as...

Meniscal Tears: What, Where, Why & When (Video) May 3rd, 2015

As I previously discussed, meniscal tears are common causes of knee pain.  Expectedly, most patients don’t always understand what they are, how they occur and the best ways to diagnose and treat them. Below, I’ve included a video in which I try (:-)) to explain all of this.  I hope you find it helpful....

Achilles Tendon Rupture Symptoms Apr 27th, 2015

Achilles tendon rupture symptoms are often very similar from patient to patient. As you may recall from an earlier post, the Achilles tendon is the largest tendon in your body.  It is located at the back of your leg and connects your calf muscles to your heel bone (calcaneus).  This tendon...

Buy Smaller Clothes?…I Don’t Think So Apr 22nd, 2015

Those who shop and purchase small-sized clothing, live longer.  Not those that shop – which with its modest exercise would seem to be responsible for any existing health benefit – but those who actually buy smaller clothing.  At first, this doesn’t necessarily make sense.  Why would purchasing anything other than perhaps a bullet proof jacket, protective head gear or a basket of vegetables affect...

Tennis Elbow Symptoms: What Are They? Mar 13th, 2015

Tennis elbow symptoms are a very common cause of doctor’s office visits.  In fact, tennis elbow is the number one most common elbow problem.  I previously discussed the anatomy and cause of tennis elbow in a prior post, but let’s briefly review here. Tennis Elbow Tennis elbow is an overuse injury of the tendons...

Too Much of a Good Thing… Mar 5th, 2015

He looked like any other 12 year old. Well, except for the way he was holding his right elbow…and his obvious pain. As I walked into the examining room and introduced myself, the tension was palpable. I had been here before. His mom was sitting in the corner quietly, almost...

Patellar Dislocation – Diagnosis & Treatment Mar 3rd, 2015

A patellar dislocation is a violent injury of the knee.  It describes when the knee cap (patella) comes out of the joint completely.  The patella almost always comes out towards the outer side of the knee.  Most frequently a patellar dislocation occurs during an athletic activity.  On occasion it can occur during a fall...

Frozen Shoulder – What Is It? (Video) Feb 20th, 2015

Frozen shoulder, also called adhesive capsulitis, is one of the most frequently seen shoulder problems. Unfortunately the frequency seems to be increasing.  Those with frozen shoulder, usually have significant pain and restricted motion. Fortunately, the symptoms often resolve on their own.  In many cases, treatment can frequently reduce the symptoms.  However, in persistent cases, surgery is sometimes needed to improve...

That’s Ok Feb 14th, 2015

Mr. Jones (obviously not his real name) recently came in with his wife to discuss treatment options for his arthritic shoulder.  I hadn’t seen him since last winter.  We used the initial time catching up on how he had spent the previous year (traveling and visiting his family around the country) and then...

Impingement Syndrome – Definition & Anatomy Video Feb 8th, 2015

You have pain on the side of your shoulder.  It tends to hurt more with overhead activities. As far as you can recall, there was no traumatic injury that brought it on.  If this sounds like you, then there is a good chance you have impingement syndrome. It is even more...

The Doctor’s Visit: What’s it all about? Jan 31st, 2015

I recently took my younger son to a doctor’s visit. The look of fear and concern in his eyes was the same look I occasionally see in my patient’s eyes during their doctor’s visit. Granted my son is barely nine years old, but a doctors visit can be scary to anyone,...

When is Rotator Cuff Surgery Recommended? Jan 27th, 2015

Degenerative rotator cuff tears are common.  When do they require surgery? When Is Rotator Cuff Surgery Recommended? For more information, you can read this panel discussion that discussed this very question.  In it, you can see my viewpoint as well as that of a number of other shoulder experts. Also you may wish to learn...

Torn Labrum Shoulder Surgery (Video) Jan 26th, 2015

Torn labrum shoulder surgery can be very successful when used to treat symptomatic labral tears.  Labral tears not causing symptoms do not require surgery. Therefore the key to treatment, and your shoulder specialist’s primary job, is to not only figure out if you have a labral tear, but also to try to determine if it is symptomatic. As you may...

Labral Tear Treatment in the Shoulder Jan 20th, 2015

Labral tear treatment isn’t necessarily difficult to institute if the diagnosis is known.  The hard part is diagnosing a labral tear and determining if it is the cause of your symptoms. How is that done?  First let’s clear up one common misconception: MRIs are not always the sole answer. This holds true for MRI arthrograms and any other imaging studies as well.  Although occasionally helpful...

Torn ACL Recovery: What You Need To Know Jan 2nd, 2015

Torn ACL recovery involves two stages. First is the initial recovery following your injury.  Everyone, no matter their ultimate treatment, must get through this stage.  The second stage is determined by the definitive treatment, either nonsurgical or surgical. Torn ACL Recovery: Stage I Everyone who tears their ACL will initially need nonoperative care to recover....

Shoulder Instability Treatment Dec 4th, 2014

Shoulder instability treatment is based on the type of instability,  which structures are injured, the age of the injured person, their activity level and their goals. There are three structures that stabilize the shoulder joint:  the bones (humerus and glenoid), the surrounding muscles and the labrum and ligament complex.  A deficiency in any of...

Rotator Cuff Tear Surgery (Video) Nov 8th, 2014

Rotator Cuff Tear Surgery If you’re young, active, you sustained a traumatic rotator cuff tear, or you simply have a rotator cuff tear that has not responded to nonoperative treatment to your satisfaction, then unfortunately, you will likely need rotator cuff tear surgery to get better. What Rotator Cuff Surgery do you need? Not all...

Torn Meniscus Treatment Options Nov 3rd, 2014

Not all meniscal tears require surgery… but many do.  If you have a meniscal tear, you probably want to know what the available torn meniscus treatment options are. Like many orthopedic injuries, there are both nonoperative and operative treatments available. Usually it will require an evaluation by a sports medicine knee specialist to determine...

Torn Meniscus Surgery (Video) Nov 3rd, 2014

Your doctor just told you you need torn meniscus surgery…Like any recommendation for surgery, this can be a little scary. But in this case, it Meniscal Repair doesn’t always need to be. Torn meniscus surgery is very effective and usually very safe. In another post, I discussed the reasons surgery may be needed....

Torn Rotator Cuff Treatment: Nonoperative Care Oct 28th, 2014

You’ve been told that you have a rotator cuff tear.  It is natural to wonder what is the correct torn rotator cuff treatment.  The answer is…It depends. When it comes to torn rotator cuff treatment, there are two basic options: with surgery or without surgery. In previous posts, I discussed what a rotator cuff tear is as...

ACL Tear Surgery: Controversies & Variations Oct 13th, 2014

“There are many paths to the Mountain top”.  This famous Chinese proverb couldn’t be more true than it is in Sports Medicine. There are a number of very good ways to do any one thing. As a result, not all Sports Medicine surgeons agree on everything, particularly when it comes to ACL tear surgery. Let’s take a...

Torn ACL Surgery (Part 2): How? (Video) Oct 12th, 2014

If you’ve been following my earlier posts on Anterior Cruciate Ligament (ACL) tears, hopefully you have learned quite a bit about their anatomy and causes as well as the symptoms and diagnosis. In the first part of this series on torn ACL surgery, I also discussed why surgery may be needed and when it should be...

Torn ACL Surgery (Part 1): Why and When? Oct 10th, 2014

Up to now,  we have discussed the anatomy and causes, as well as the symptoms and diagnosis of ACL tears.  Now we’ll discuss the treatment of ACL tears, particularly torn ACL surgery. In the first part of this three part series,  let’s talk about why you should, or shouldn’t have surgery and if you do,...

Torn Rotator Cuff Symptoms Oct 1st, 2014

I previously discussed the rotator cuff anatomy and the causes of rotator cuff tears.  In this post, I will review the torn rotator cuff symptoms. First let’s review some rotator cuff basics: The rotator cuff is a group of four tendons deep in the shoulder The tendons attach muscles from the shoulder blade to...

Torn Meniscus Symptoms and Diagnosis Sep 29th, 2014

In an earlier post, I discussed the definition and causes of a torn meniscus.  Now let’s discuss the torn meniscus symptoms and their diagnosis. First, let’s review a little about the meniscus. Meniscal Anatomy There are two menisci in a healthy knee.  Both are rubbery like c-shaped structures that lie between the thighbone...

Shoulder Instability Symptoms (Video) Sep 16th, 2014

Shoulder instability symptoms vary depending on the cause and type of the instability.  As you may recall from an earlier post, there are several different types of shoulder instability. Let’s briefly recap: Shoulder Instability Types Traumatic (Subluxation or Dislocation) Due to repetitive micro-instability Multidirectional instability Traumatic instability is initially caused by a single traumatic injury. The most...

Torn ACL – Symptoms and Diagnosis (Video) Sep 11th, 2014

Pop! Ouch! No its not an old Batman episode.  If you were playing a team or racquet sport… Or were skiing and fell…Chasing your kids while playing tag…Or simply dancing.  If you felt a painful “pop” and you had to stop the activity…Your knee then began to swell and become stiff…Unfortunately, you likely have a torn ACL (Anterior...

ACL Tear – Definition, Anatomy and Causes (Video) Sep 7th, 2014

An ACL tear is used to describe any injury to the Anterior Cruciate Ligament.  Most commonly,  the ACL pulls away from its origin on the end of the thighbone.  It may also simply stretch or only be “partially” injured. The following  video shows the surgical (arthroscopic) appearance of an intact ACL followed by an ACL that has...

Labral Tears of the Shoulder – Anatomy and Causes (Video) Sep 7th, 2014

Labral tears of the shoulder are a common cause of shoulder pain, instability and sometimes catching or clicking.  Over the last 30 years, as arthroscopy and the use of MRI imaging has advanced, the ability to diagnose labral tears as a cause of shoulder symptoms has improved. Normal Labral Anatomy The...

Rotator Cuff Tears – Anatomy and Causes (Video) Sep 7th, 2014

Rotator cuff tears are extremely common.  About 5-40% of people with shoulder pain are thought to have rotator cuff tears. Nearly 2 million doctor visits in the US each year are due to rotator cuff problems. Tears of the rotator cuff describe any degree of disruption of one or more of the rotator cuff tendons.  These...

Torn Meniscus – Anatomy and Causes (Video) Sep 7th, 2014

A torn meniscus is one of the most common causes of knee pain. Meniscal tears can result from nearly any activity involving bending or twisting of the knee.  They often occur while performing athletics but can also frequently occur during nonathletic activities. Their incidence, like many orthopaedic ailments, increases with age. Normal Meniscus Anatomy...

Shoulder Instability – Anatomy & Causes (Video) Aug 18th, 2014

  Shoulder Instability – Definition Shoulder instability occurs when there is increased motion between the two primary bones of the shoulder, the humerus and glenoid, and there are symptoms due to this increased movement. There are several types of shoulder instability. Dislocation. The joint becomes completely displaced and often gets locked “out of the joint.” Subluxation.The joint is partially out of place. It usually slips back...

Tennis Elbow – Definition, Anatomy and Causes Aug 18th, 2014

Tennis elbow, known medically as lateral epicondylitis, is one of the most common causes of elbow pain.  Although not limited to those who play tennis, this disorder was so named because it often is found in those who repeatedly extend their wrist against resistance with the elbow straight, as seen during a tennis...

Patellar Instability – Anatomy and Causes Aug 16th, 2014

Patellar instability describes the kneecap sliding out of the joint either completely (dislocation) or partially (subluxation). It is a common source of knee problems and is much more common in people under the age of thirty.  In fact, patellar instability is rare in people older than 40 years of age. Front View Anatomy – Knee...

Sprained Ankle – Definition, Anatomy and Causes (Video) Aug 6th, 2014

Ankle Bones Anatomy – Normal Ankle The ankle is made of three bones: Tibia Fibula Talus These bones form a relatively stable joint that is secured even more by a number of strong, thick and flexible bands called ligaments. Ankle Ligaments These ligaments run from one bone to the other, helping to hold...

Achilles Tendon Rupture (Video) Aug 6th, 2014

Achilles Tendon Anatomy The Achilles tendon is the continuation of the calf muscles (Gastrocnemius, Soleus and often the Plantaris) as they run down the back of the leg and attach to the back of the heel bone (Calcaneus). The Achilles tendon’s primary function is to bring the heel up while pushing...