Iliotibial Band Syndrome: Causes, Symptoms And Treatment

by Administrator 24. April 2017 11:07

Iliotibial Band Syndrome refers to a condition in which the Iliotibial band (a thick band of fibers responsible for knee’s flexion and extension movements) gets inflamed and leads to excruciating pain in the outside of the joint. The condition is generally caused by overuse of muscles and is commonly seen in runners.


  • Poor training habits
  • Alignment issues in the legs
  • Improper posture while riding a bike
  • Weight lifting
  • Excessive squatting
  • Abnormal pelvic tilt


  • Affliction on the lateral side of the knee
  • Sensation of stringing or needle like pricks at the affected area
  • Popping or snapping sound in the knee
  • Swelling
  • Pain radiating from knee to the hip


To diagnose the potential cause of lateral knee pain, the knee doctor may conduct a thorough physical examination of leg, knee, hip and ankle. He may also ask the patient to get some imaging tests like X-ray and MRI. These tests may help to visualize the damaged tissues, ligaments or bones and evaluate the actual cause of condition.


Non-Surgical Treatment –

  • Rest - The doctor may advise the patient to take rest for few days, so that the scar tissues can help damaged muscles to heal and reconnect.
  • Icing – In order to reduce inflammation from the affected area icing may be recommended. Applying ice after every 15 -20 minutes helps to improve blood circulation in the body. This leads to an increased blood flow to the damaged area and speeds up the recovery process.
  • Compression – Keeping the injured area wrapped in a bandage may be suggested to reduce swelling and inflammation.
  • Elevation – Patients may also be advised to keep the wounded leg elevated so that no interstitial fluid deposit takes place. It is also suggested to alleviate swelling from knee.
  • Exercises – Various stretching and strengthening exercises may be suggested for restoring the movement of the joint.
  • Medication – Painkillers and anti-inflammatory medicines may be suggested to reduce pain.
  • Training Modification- The doctor may recommend patients to make some changes in their training routine as well. This would include not running on the same side of the road for a prolonged time, no walking downhill and avoiding strenuous exercises for some time. 

Surgical Treatment

Arthroscopy - The orthopedic surgeon may insert a small camera into the affected area to have a clear picture of the injury. He may then make a resection and cut a triangular shaped tissue, this will make more room for the bone to glide and eliminate the symptoms.

For treatment of Iliotibial Band Syndrome and any other knee related injury, contact Dr. Kouyoumjian. To request an appointment with the orthopedic surgeon in Plano, TX, call at (972) 985 – 1072.

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Knee Osteoarthritis: Treatment In Plano, TX

by Administrator 27. March 2017 08:39

Osteoarthritis, also referred to as Degenerative Arthritis, is a chronic medical condition that usually affects knee, hip, neck, lower back, small joints of the fingers, bases of the thumb and big toe. Knee Osteoarthritis is condition in which the cartilage acting a cushion between bones (femur, tibia and patella) wears away, leading to pain and inflammation in the knee joint. As the disease progresses, bones start to break and form spurs (extra growth of bones). Production of cytokines in the body further damages the cartilage and worsens the condition. According to orthopedic surgeons, in its final stages the bones start to rub against each other, leading to excruciating pain and very limited range of motion of the knee.


  • Growing age - It decreases the healing ability of cartilage
  • Excess weight - It puts more pressure on the knees
  • Hereditary - If someone in the family is already affected
  • Women above the age of 55 are more prone to developing the condition
  • Occupations that require a lot of kneeling, squatting, or lifting heavy weights
  • Excessive running or jumping
  • Medical conditions such as excess of growth hormones, Rheumatoid Arthritis etc.


  • Pain while walking or standing
  • Swelling
  • Feeling of warmth in the joint
  • Stiffness, particularly in the morning
  • Difficulty while sitting or standing
  • Cracking sound while moving the knee


The orthopedic doctor may suggest non-conventional methods to alleviate symptoms and provide relief to the patients. He may prescribe anti-inflammatory and pain relieving medicines. Braces may also be suggested to immobilize the joint and speed up the healing process. Certain muscle strengthening exercises may help to restore functioning of the knee joint.

In severe cases, a knee surgery may be recommended. There are three major type of surgical procedures that can help to relieve the symptoms –

  • Arthroscopy - A small camera is inserted into the knee joint by making a small incision. The surgeon may remove the damaged cartilage, clean the bone surface and repair the tissues with the help of metal screws or plates.
  • Osteotomy- The orthopedic surgeon improves knee’s alignment by changing shape of the bones.
  • Arthroplasty - Also known as joint replacement, this surgery may be recommended to aged people, whose joints have completely deteriorated. The procedure involves substituting the joints with artificial parts made from metals or plastic.

If you are looking for a knee surgeon in Frisco, TX, contact, Dr. Kouyoumjian. He is a board certified orthopedic sports surgeon and joint replacement specialist. To book an appointment, call at (972) 985 – 1072 or visit 4031 West Plano Parkway Suite 100, Plano, TX 75093.

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Lateral Collateral Ligament (LCL) Injury: Orthopedic Plano

by Administrator 25. October 2016 08:01

The knee joint is a major part of the body, vital for its movement and balance. The femur, tibia and the knee cap meet at this joint and these bones are connected to each other through ligaments. Lateral Collateral Ligament is a band of thick tissue that lies on the outer side of the knee joint. It connects the femur or the thigh bone to the fibula which is a small sized bone in the lower leg. This ligament along with the medial collateral ligament manages the sideways motion of the joint and prevents it from any stress. Injury to the LCL is most common among sportspersons. Ligament injuries are also referred to as sprains.


  • Direct fall onto the knee joint or the muscles during contraction can stress or tear the ligaments
  • Sudden change in directions or twisting of the knee may place undue pressure on the LCL
  • Hitting the knee from the back or sides can damage the LCL
  • Weakness in ligament structures due to internal problems
  • Sports that involve tackling or collisions
  • Improper use of technique during sports or exercise may stress the ligaments
  • Weakness of supporting thigh and leg muscles


  • Pain may be felt on the outer side of the joint
  • Unstable knees
  • Inability to bear body weight
  • Limited range of motion
  • Tenderness, swelling and bruising may also be seen
  • Stiffness


  • A thorough clinical check may be conducted by the orthopedic doctor to assess the extent of damage
  • The patient may be questioned about his/her medical history, symptoms, mode and time of injury 
  • The range of motion intact may be tested through some physical tests
  • X-ray imaging may be required in most cases to check the exact location of ligament and severity of damage
  • MRI or CT scan may be helpful in diagnosing damage to the surrounding soft tissue structures, grade of sprain and nerve injuries if any


  • Immobilization of the knee- a removable brace may be fixed to the joint to support it and prevent stress which aids in healing of the ligament
  • Medicines- pain relief drugs and anti inflammatory medicines may be prescribed by the doctor
  • Splinting of the injured knee may aid in recovery of low grade or minor sprains
  • Rest is important and any physical activity should be kept to the minimum
  • Ice packs may be applied for the first few days to reduce swelling
  • Physical therapy may be recommended in most cases to regain stability and movement
  • Surgery may be required in high grade or major injuries for the reconstruction of damaged ligament or the torn tissue may be stitched back and allowed to heal with time

Dr. Kouyoumjian in Plano, TX offers diagnosis and treatment for a wide range of knee injuries. To schedule an appointment with the orthopedic surgeon, you can call at (972) 985 – 1072.

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PCL Injury: Orthopedic Treatment In Plano

by Administrator 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


  • Pain
  • 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.

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Risk Factors For ACL Injury

by Administrator 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.

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Knee Injuries And Treatment

by Administrator 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.

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Knee Injury Prevention Tips: Orthopedic Plano

by Administrator 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.

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Knee Joint Replacement In Plano, TX

by Administrator 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
  • Stiffness
  • Chronic knee inflammation
  • Knee deformity
  • Osteoarthritis
  • 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.

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ACL Injury Prevention Tips For Athletes

by Administrator 15. May 2014 05:35

ACL is a part of a complex group of four ligaments present inside the knee or more precisely the musculoskeletal part of the knee and is known as the Anterior Cruciate Ligament. The ACL is one of the most sensitive parts of the body and is very susceptible to injury. Most athletes who are involved in sports such as football, pro wrestling and ice skating, that demand high impact on the legs are at a risk of injuring their ACL. It should also be noted that female athletes are more prone to sustaining injury as well as athletes who are 25 years or under. Here are some techniques to prevent ACL injury.

Preventing ACL

  • A sudden rigorous movement to a body part has the potential to cause severe damage. Before each game athletes should carry out some warm out exercises. Stretching and warming up increases the body temperature and makes the body more flexible. A qualified coach or trainer can guide you with the best routine to follow. Without stretching or warming up the body remains cramped and is more prone to injury.
  • Training all year round is also very essential. Even during off season an athlete must train to keep the body in a good healthy shape. You must focus on proper landing techniques after a jump so that your knees absorb the force.
  • Strengthening hamstring and quadriceps muscles will also go a long way in preventing ACL. These muscles are at the back of the thigh and front and work together to make any movement in the leg. Strengthening them will avoid the knee getting injured.
  • Cooling down is another important criteria of any workout. Bringing the muscles back o a relaxed state with the right technique ensures no injury. Orthopaedic sports surgeon in Frisco emphasise on warming up and cooling down before and after every session.

It is important to consult an orthopaedic surgeon for a torn ACL. Having a torn ACL can heavily impact an athlete’s career and have long term impacts. Getting prompt and an expert advice will ensure proper treatment and healing from the injury. The surgeon can also suggest preventive measures and exercises to make legs stronger and avoid such an injury in the future.

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Patellar Tendon Tear: Causes, Symptoms & Treatment

by Administrator 17. December 2013 13:31

Patellar tendon tear, Jumper’s knee in layman terms, is a medical condition which occurs when the tissues around patellar tendon get inflamed. Patellar tendon is basically a ligament that connects the shinbone and kneecap. Any injury to this ligament may result in micro tears which further weaken the tendon and lead to patellar tendon tear. Although middle aged people associated with jumping sports are more prone to patellar tendon tear but according to knee doctors in Plano everyone is susceptible to this injury.

Patellar tendon tears can be classified into two types:

  • Partial patellar tendon tears: Some fibers of the soft tissue get torn but the tissue still remains intact.
  • Complete patellar tendon tears: The soft tissue gets disrupted into two parts.

Following are some common causes of patellar tendon tear:

  • Injury: Any injury that involves direct impact to the knee can cause inflammation in the tendon leading to patellar tendon tear.
  • Tendon Weakness: Weak tendons and muscle are more likely to cause patellar tendon tear. Overuse of the knee joint may also weaken the patella tendon causing it to tear away from the bone.
  • Health conditions: It is medically proven that people with chronic diseases like renal failure, hyper-betalipoproteinemia, rheumatoid arthritis, etc. are at greater risk for patellar tendon tear.
  • Surgery: Evidence shows that people who have had surgery around tendon are more likely to suffer from patellar tendon tear.

In addition, conditions like wide hips and knock knees may indicate a somewhat higher risk of patellar tendon tear

It is advisable to immediately consult an orthopedic doctor in Plano if any of the symptoms mentioned below are observed:

  • Bruising in knee
  • Popping sound when the tendon is moved
  • Tenderness around the kneecap
  • Swelling and cramping
  • Intense pain when touched
  • Inability to move thigh
  • Inability to strengthen knee


  • First of all, the doctors may suggest you to follow the RICE protocol i.e. rest your knee, apply ice, compress the area and elevate your knee on a pillow. They may also prescribe inflammatory drugs to ease the inflammation and pain.
  • The doctors may also refer you to a physical therapist to improve the flexibility and strength of your quadriceps muscles. The physical therapists often recommend a range of strengthening and motion exercises which include straight leg raise, seated leg press, knee extension etc.
  • If the symptoms still persist, the surgical repair may be considered by the orthopedic doctor to treat the condition.

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