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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Rotator Cuff Injury: Causes, Symptoms And Treatment

by Administrator 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
  • Swelling


  • 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
  • Ultrasound
  • 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.


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 Pain: Orthopedic Treatment In Plano, TX

by Administrator 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
  • Age
  • Excessive use
  • Arthritis
  • Fall
  • 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.

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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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Shoulder Joint Replacement: Plano, TX

by Administrator 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:

  • Osteoarthritis
  • Osteonecrosis
  • 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.

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Orthopedic Treatment For Shoulder Impingement

by Administrator 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
  • Tendonitis
  • Bursitis
  • Arthritis 
  • Osteoporosis
  • Injuries
  • Bone spurs under the acromion
  • Swelling or thickening of the rotator cuff tendon
  • Overuse
  • 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

Risk Factors

  • 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.