23. April 2016 10:56
Rotator Cuff refers to a group of muscles and tendons in the shoulder joint which join the shoulder blade to the upper part of the arm (humerus). It not only stabilizes the shoulder joint but also enables it to move. There are four main muscles in the rotator cuff and injury to any one of them may further lead to development of Arthritis as well accumulation of fluids in the shoulder joint over time.
There are different types of injuries that may affect the rotator cuff:
- Rotator Cuff Impingement: The rotator cuff tendons get compressed between the humerus and the acromion.
- Rotator Cuff Tear: It refers to a tear in the tendon. The injury may range from mild stretching of the tendon to a complete tear.
- Frozen Shoulder: The upper part of the arm, called the humerus, gets fixed into the shoulder blade making movement difficult and painful.
- Rotator Cuff Tendonitis: Overuse and repetitive motions such as lifting the arms above the shoulders may lead to strains in the muscles and tendons.
- Wear and tear due to the aging
- Overuse injuries
- Falling on the shoulder
- Automobile accident
- Repeated activities such as throwing a ball or lifting weights
- Bone spurs
- Disruption of blood supply to the rotator cuff muscles
- Pain in the shoulder and the arm, particularly during overhead movements
- Restricted range of motion
- Weakness in the shoulder or arm
- Physical examination of the joint
- MRI scan may be an effective method to assess any soft tissue damage
- X-ray may be done to check for bone displacement, fracture or bone spurs
- Arthrogram: Injecting a dye in the joint to get a better image during an X-ray
- Painful Arc Test: The injured arm may be moved away from the body to check for pain
- Application of ice packs to relieve pain and inflammation
- Rest the injured arm and shoulder
- Prescription of muscle relaxants, pain killers and anti inflammatory drugs
- Heat therapy may also be used
- Injecting corticosteroids directly into the shoulder
- Specific exercises may help to improve joint flexibility and strength
- Arthroscopic surgery may be performed to repair the torn tendons and remove bone spurs
- Joint replacement surgery may be required in case of severe injuries. It may help to relieve pain and restore complete stability and movement in the shoulder joint. Prosthesis or an artificial part is used to replace the damaged part within the joint.
For treatment of Rotator Cuff Injury and other shoulder injuries, visit Dr. Kouyoumjian in Plano, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 985 – 1072.
27. November 2015 12:03
Like Anterior Cruciate Ligament (ACL), the Posterior Cruciate Ligament (PCL) is an important ligament in the back of the knee. The primary function of PCL ligament is to stabilize the knee and prevent it from moving backwards, particularly when the knee is bent. Injuries to PCL are not as frequent as ACL injuries, but if they occur, treatment should be sought immediately. The ligament can get sprained due to trauma or injuries such as falling on a bent knee. PCL injury can be classified into different grades depending on the severity of the condition.
- Grade I: It may be defined as a minor injury characterized by microscopic tears. The injury usually does not affect the weight bearing ability of the knee. It often heals within a few days.
- Grade II: Grade II PCL injury is a partial tear that makes the knee unstable. The knee may tend to give out while walking and standing. The injury can be treated non-surgically.
- Grade III: In this, the PCL is completely torn or separated from the bone. The knee becomes unstable and many other surrounding ligaments are injured along with PCL.
- Sudden stretching of the ligament
- Twisting of knee
- Powerful blow or impact to the bent knee
- Hyperextending the knee
- Landing on the flexed knee
- Shifting weight from one leg to the other
- Stopping suddenly while running
- Trauma or hitting the dashboard during car accident
- Swelling and stiffness
- Inability to walk and climb stairs
- Popping sensation
- Pain on putting weight on the knee
- Unstable knee
An orthopedic physician may physically examine your knee and ask certain questions related to the injury. He may check the knee movement and recommend some imaging tests to know the extent of damage caused to the ligament.
The orthopedic physician may suggest you to rest your knee and discontinue any activity that puts stress on the knee. He may recommend you to keep the affected knee elevated and gently compressed to promote healing. The physician may also suggest you to use crutches to avoid putting weight on the knee muscles. To get relief from pain and inflammation, you may use ice packs at regular intervals.
The physician may prescribe certain anti-inflammatory medicines to provide relief from pain and swelling. If these options do not ease the symptoms or the injury is severe, surgery may be recommended to reconstruct the torn ligaments. Post-surgery, you may be referred to a physiotherapist who will help you recover from the injury by suggesting some stretching and strengthening exercises.
For diagnosis and treatment of PCL injury, visit Dr. Kouyoumjian. To schedule an appointment with the orthopedic surgeon in Frisco, TX, you can call at (214) 618 – 5502.
19. October 2015 11:23
The anterior cruciate ligament (ACL) is one of the four ligaments that connect the femur to the tibia in the knee joint. It helps to prevent sudden twisting and hyperextension of the knee as well as provides rotational stability to the joint. ACL injury occurs when the ligament gets torn or stretched due to excessive stress. The injury may be the result of a sudden fall or change of direction with a foot planted on the ground.
Though there are many causes for an ACL injury, certain risk factors may increase the likelihood of suffering the injury. Some of these are:
- Gender: Women have a tendency to bend their knees towards the middle of the body while doing athletic movements such as pivoting, twisting or landing. The medical term for this phenomenon is ‘valgus knee angle’. This can make the ACL saggy, thereby, making it susceptible to injury. Differences in pelvis and lower extremity alignment, increased ligament laxity, muscular strength and neuromuscular control can also increase the risk for ACL injury.
- Environmental factors: Although a higher level of friction between the ground surface and shoes is associated with a good sports performance, this can increase the risk of ACL injuries. Therefore, grounds having artificial grass will pose a greater threat to the ACL.
- Age: ACL injuries are most commonly seen in people between the age group of 15 and 45 years. This may be due to a physically active life and participation in sports activities.
- Muscular imbalances: Any kind of muscular imbalance in the knee can put pressure on the ACL ligament. During sports activities, women tend to use quadriceps more as compared to hamstrings. The quads are majorly responsible for straightening the knee and landing on their support causes a straight leg. This stiff posture can lead to damage in the ACL.
- Excessive physical fatigue: Playing only a single sport throughout the year puts the same physical demands on your body repetitively. This can ultimately lead to biomechanical changes and muscle imbalances. When stress on the knee muscles increases, it can increase the risk for an ACL injury.
For comprehensive diagnosis and treatment of ACL injury, visit Dr. Kouyoumjian. To schedule an appointment with the orthopedic surgeon in Frisco, TX, you can call at (214) 618 – 5502 or visit 5757 Warren Pkwy Suite 180, Frisco, Texas 75034.
15. September 2015 10:32
Knee is one of the most used and vital joints of our body, bearing most part of) our weight and enabling us to walk, run, climb stairs etc. Knee pain is a common problem that may occur in any part of this complex joint - bones, cartilage, tissues or the ligaments. The condition can affect people of any age. Knee pain is usually serious but evading treatment for a long stretch of time may cause damage to the joint.
- Acute injury
- Excessive use
- Muscle Overuse
- Motor Vehicle Accidents
- Mild to acute pain
- Swelling and redness around the joint
- Inability to walk or move the knee
- Locking of the knee
- Clicking sound while trying to move the knee
- Rest: Giving rest to the knee can help in relieving discomfort. If the pain is due to over exertion, chances are it will subside on its own when knee is rested properly.
- Physical therapy: Physiotherapy may be recommended in some cases to strengthen the knee muscles. Application of hot and cold packs may also provide relief from pain and swelling.
- Medications: Taking a prescribed course of anti-inflammatory medicines may help in reducing pain and inflammation.
- Surgery: If non-surgical treatment does not provide relief, the orthopedic doctor may recommend any of the following surgical procedures:
- Arthroscopic: A keyhole sized incision enables the doctor to look inside the knee joint through a camera and repair loose bones or cartilage.
- Partial Knee Replacement: The surgeon may replace the damaged parts of the knee with plastic or metal prosthetics.
- Total Knee Replacement: This involves replacing the entire damaged bone and cartilage with an artificial implant.
The best way to keep this joint in perfect condition is to exercise, even when there is no problem in it. Leading a healthy lifestyle goes a long way in keeping bones and muscles strong.
In case of pain, an orthopedic doctor will take the decision best suited to your condition after he has examined all symptoms and once the exact cause is established, recovery process will begin. While most knee pains go away once the knee has been relaxed, if the pain persists and causes great difficulty while motion, it is best to be under supervision of a doctor so that cure is permanent and effective.
For treatment of acute or chronic knee pain, visit Dr. Kouyoumjian. To schedule an appointment with the orthopedic surgeon in Plano, TX, you can call at (972) 985 – 1072.
24. July 2015 07:05
Knee is a complex joint that allows the movement of the leg. As the knee supports the body weight and assists in movement, it is susceptible to injuries and pain. The knee joint can suffer injuries due to overuse, wear and tear, ageing, falls, trauma and other medical conditions. Knee injuries are common among sports persons and people who perform repetitive squatting and bending in routine activities.
Some of the common knee injuries are:
- Patellofemoral Pain Syndrome: The front of the knee or back of the kneecap can be affected by this overuse injury. Commonly known as Runner’s Knee, this condition occurs due to weak muscles, abnormal limb alignment, tight muscles or overuse trauma from physical training. The treatment includes proper rest and avoiding activity, sport or exercise that puts pressure on the knee. The orthopedic doctor may prescribe anti-inflammatory medications and soft braces to relieve pain and swelling.
- Bursitis: This condition is caused when the Bursa, a sac that produces joint fluid, is inflamed or injured. It can be treated with ice compresses, anti-inflammatory medications and in severe cases surgical removal of the infected fluid.
- Patellar Tendonitis: This injury, also known as Jumper’s Knee, causes the patellar tendons and quadriceps, which help in straightening the knees, to weaken. The condition causes pain while performing activities such as jumping, running, squatting, stair climbing etc. Rest from strenuous activities, wearing knee support and anti-inflammatory medication can be prescribed for treatment of the condition.
- Muscle Strain: This injury affects the quadriceps and hamstring muscles responsible for straightening and bending the knee. Athletes, who play contact sports such as basketball, soccer, softball, etc., are more susceptible to muscle strains. The doctor may recommend rest, R.I.C.E therapy and medication to ease the symptoms.
- Meniscus Tear: The meniscus is a cartilage in the knee joint that acts as a cushion between the thigh and shinbone. Any trauma, sudden twisting or high impact on the knee can lead to Meniscus Tear, which is quite painful. R.I.C.E therapy, anti-inflammatory medications and in severe cases surgery, can be prescribed to treat a Meniscus Tear.
For any knee injury diagnosis and treatment in Plano, TX, you can visit Dr. Kouyoumjian. To schedule an appointment with the knee surgeon, call at (972) 985 - 1072.
19. June 2015 05:00
Shoulder joint replacement also known as Shoulder Joint Arthroplasty, is a surgical procedure involving the replacement of the parts of the joint with artificial ones. It is recommended for patients who experience joint dysfunction for a prolonged period of time. The surgery is helpful in relieving pain and increasing the range of motion of the joint.
The orthopedic surgeon makes an incision on the shoulder to remove the head of the humerus. He then widens the tube of the humerus to make it ready for the prosthesis. The glenoid cavity is similarly prepared and bone cement is applied to the parts which are to receive prosthesis. The artificial parts are inserted and the incision is sealed back.
Shoulder joint replacement may be required in case of certain health conditions which cause severe damage to the joint. These conditions can be as follows:
- Shoulder Arthritis
- Rheumatoid Arthritis
- Severe fractures
- Recurrent Shoulder Instability
Types Of Shoulder Replacement
There are different types of shoulder replacement surgeries on the basis of different parts that have to be replaced. Some of these are:
- Hemiarthroplasty: This surgery involves replacing the humerus with a prosthetic metal implant. It is mostly recommended for fractures.
- Shoulder Resurfacing: It is the surgery where a smaller part of the bone has to be removed. A metal cap is fitted over the ball part of the joint during the procedure of this surgery.
- Total Arthroplasty: This surgery is where both the upper arm ball and shoulder blade socket are replaced with prosthesis.
- Reverse Anatomy Arthroplasty: This kind of surgery includes fitting the artificial socket part to the humerus and the ball part to the shoulder blade. It is used in severe cases of Arthritis.
Shoulder replacement surgery can be helpful in the following ways:
- Pain: It can be helpful for patients suffering from persistent pain due to an injury or other degenerative shoulder condition.
- Movement: People who suffer from health conditions where the movement of the joint is restricted, shoulder replacement surgery can be helpful in improving the range of motion of the shoulder.
- Strength: This surgery is helpful in restoring the strength in the joint which may be decreased due to some health problem. People, who could not get involved in sports activities due to their shoulder conditions, can play sports with less stress and fatigue in the joint.
It takes a few months to recover after a shoulder joint replacement. The patient may be recommended to undergo rehabilitation process to gain complete motion in the operated joint.
20. May 2015 04:11
Shoulder Impingement Syndrome, also known as Swimmer’s Shoulder, is a condition where the tendons of the rotator cuff muscles are intermittently trapped and compressed. The tendons become irritated and inflamed as they pass beneath the acromion, resulting in pain and loss of movement of the shoulder.
- Repetitive overhead movements
- Bone spurs under the acromion
- Swelling or thickening of the rotator cuff tendon
- Inflammation of the fluid-filled sac, bursa
- Difficulty in movement of shoulder, especially raising above 90 degrees
- Sudden pain when the arms are extended above the head
- Weakness in shoulder
- Minor pain, present both with activity and at rest
- Older age
- Sports like swimming, throwing, tennis, weightlifting, golf, volleyball and gymnastics
- Overhead work activities including painting, stocking shelves and mechanical repair
In order to diagnose Shoulder Impingement the orthopedic surgeon may conduct a thorough physical examination. To measure the range of motion of your shoulder, the doctor can move your arm in several different directions to test your arm strength. The surgeon may also review the patient’s medical history to confirm the cause of the condition. He may also perform certain imaging tests, such as X-rays or MRI and devise a treatment plan after determining the severity of the condition.
- Rest: The patient may be advised to take sufficient rest and avoid overhead activity to allow the injury to heal.
- Ice and heat packs: The doctor can prescribe applying ice or heat pack to the affected shoulder to ease the pain.
- Medications and injections: The orthopedic doctor may prescribe anti-inflammatory medications to reduce swelling and pain.
- Physical therapy: Physical therapy aims at strengthening the joints and the rotator cuff, thus relieving it from stiffness. Exercises and limited range of motion help in stabilization and normalization of the shoulder area.
If the condition is severe and non-surgical treatments do not offer relief the surgeon can recommend surgery. The aim of the surgery is to create more space in the rotator cuff by removing the inflamed portion of bursa. This is followed by post-surgical care and rehabilitation treatment.
11. April 2015 07:24
Activities like walking, climbing stairs, jumping, exercising and repeated motion, put a lot of pressure on the knee and can often lead to knee injury. Knee joints have many ligaments, bones, cartilages, which are susceptible to injuries. Such injuries are quite common among athletes who regularly run, jump or undergo extensive training.
Here are some tips to prevent knee injuries.
- Warm up: Before doing any exercise or athletic activity, it is essential to do a warm up session, which will prepare the muscles.
- Do stretching exercises: Make sure you stretch daily to gain flexibility. Do hamstring stretch, thigh stretch, calf stretch and outer thigh stretch after warming up the muscles.
- Strengthening exercises: Strengthen hamstring and thigh muscles to create a balance. By strengthening the hip muscles, you can avoid stress on the knee joint.
- Use proper exercising techniques: Exercising and weight bearing activities such as walking help you strengthen your knees and core muscles. However, make sure you use proper exercising techniques to avoid injuries. Wear knee braces during workout to keep your knees safe. Also, make sure you use exercise equipment that is appropriate for your size and strength.
- Maintain healthy weight: Extra weight puts undue pressure on the knee, so make sure you maintain a healthy weight. For this, eat healthy and nutritious diet and exercise in routine. Include plenty of minerals, vitamins, calcium, etc., in your diet.
- Wear proper shoes: To avoid slipping and skidding, wear footwear with good arch support and thick soles. Make sure you replace your running sneakers after two-three months or every 500 miles. Avoid wearing high heels, as heels cause misalignment of the hips and legs leading to instability of knees. You should rather wear flat or low-heeled shoes.
- Avoid carrying heavy load: To avoid straining your knee joint, avoid carrying heavy weight.
- Avoid repetitive activity: If you do any repetitive activities involving your knees, then try to limit the activities to ensure there is no excessive pressure on the joint.
- Land appropriately: Often athletes injure their knee by landing wrongly after jumping or while running. To avoid this injury, make sure you lean forward from your ankles and land on the midfoot. In addition, keep your knees bent and soft while landing to avoid any strain.
- Do not ignore the knee pain: If you experience knee pain or find it difficult to stand, then do not ignore it. Take rest and use ice packs to get relief from muscle soreness. If the pain persists, then you must consult an orthopedic doctor.
For knee injury treatment in Plano, TX, visit Dr. Adam L. Kouyoumjian. To schedule an appointment with the knee surgeon, call at (972) 985 - 1072.
19. March 2015 06:28
Knee pain is a common problem often experienced by elderly people, especially women. Knee Joint Replacement is a surgical procedure that is performed to replace a damaged, diseased or worn out knee. The surgery, which is also known as Knee Arthroplasty, helps in offering relief from pain, stiffness and restores functionality in the knee. The joint is surgically constructed and degenerated joints are replaced with artificial parts. The replacement lasts for 15 to 20 years and the surgery dramatically reduces the knee pain while improving the ability to walk and perform routine activities. Depending upon the damage to the knee, the surgeon can recommend either total knee replacement or partial knee replacement.
When is Knee Joint Replacement needed?
The surgery can be prescribed to anyone who has torn the joint and is unable to perform day-to-day activities. The type of surgery performed depends upon the degree of disability and severity of pain. If the condition does not improve with non-surgical treatment and the pain interferes with the quality of life then surgery becomes necessary.
Usually surgery is needed if the patient has
- Severe, continuous knee pain
- Chronic knee inflammation
- Knee deformity
- Rheumatoid arthritis
- Post-traumatic arthritis
- Knee injury
Knee Joint Replacement Procedure
During the surgery, the orthopedic surgeon makes an incision over the knee, removes the damaged knee joint and replaces it with the artificial joint. The three bones involved in the procedure include patella, femur and tibia. These bones are prepared by cutting them for the prosthesis, which is made of metal and plastic parts. The bones are fastened with bone cement. The procedure lasts around two hours and it is performed under general anesthesia. The patient is discharged in a few days and after proper rehabilitation, he or she can resume the routine activities.
After surgery, the patient needs to follow proper rehabilitation program, which is designed by the physiotherapist to meet your needs. The therapist assists and instructs the patient about the exercises that help him regain the strength and flexibility of the knee. The therapists can also use a continuous passive motion machine, which is attached to the operated leg. This machine moves the knee to different degrees of range of motion and helps improve the flexibility and blood circulation. The patient is also encouraged to walk using crutches in order to not put stress on the knee.
For knee joint replacement surgery in Plano, TX, contact Dr. Kouyoumjian. to schedule an appointment with the surgeon, call (972) 985 -1072.
23. February 2015 12:12
Frozen Shoulder, also known as Adhesive Capsulitis, is a very common condition, characterized by stiffness, pain and limited range of motion in the shoulder. It occurs due to inflammation in the sac of ligaments surrounding the shoulder joint. The condition typically affects one shoulder but it can occur in both the shoulders too.
- Inability to use the shoulder normally because of pain, injury or chronic health condition.
- Diabetes & Stoke
- Cervical disk disease
- Surgery in the shoulder
- Thyroid Problems
- Activities which involve heavy rotation of the arm.
- Excessive weight lifting
- Old age
There are ample of reasons, which could cause stress on the shoulders leading to inflammation in the joints that causes Frozen Shoulder.
Signs & Symptoms
The common symptoms of frozen shoulder are pain and stiffness in the shoulder however the pain can be classified into three phases:
- Phase One (Painful Phase): This phase generally lasts for a period of 2-9 months. It is a painful phase in which the stiffness and limitation in the range of motion builds up gradually. The pain at this stage worsens during the night and when the patient lies on the affected side.
- Phase Two (Stiff / Adhesive Phase): At this phase the pain eases but the stiffness and limitation in movement gets worse. This lasts for a period of more than 9 months. Every movement of the shoulder affects the condition and rotation of the arms outwards affects it most severely.
- Phase Three ( Thawing / Recovering Phase): This phases lasts between one to three years and is characterized by reduction in the pain and stiffness which gradually gets back to normal or near normal.
The symptoms of frozen shoulder may also affect daily chores such as dressing, sleeping, driving, eating, cooking etc. If the condition remains untreated, it could last for a very long time.
It is important to get the condition diagnosed and treated by a specialized orthopedic doctor.
- Anti-Inflammatory: A doctor may recommend anti- inflammatory painkillers to reduce the swelling.
- Exercises: There are many shoulder exercises that may help in improving the range of motion.
- Physiotherapy: Many patients suffering from Frozen Shoulder are referred for Physiotherapy, which helps in relieving pain and increasing the range of motion.
- Surgery: In extreme cases surgery is performed to ease pain and offer relief to the patient.
For more information about the shoulder conditions and the treatment options available, contact Dr. Kouyoumjian. To schedule an appointment, you can call at (972) 985 – 1072 (Plano) or (214) 618 – 5502 (Frisco).