Here are some answers to common questions about the procedure.

When do you potentially need a shoulder replacement?

• When your shoulder consistently gives you pain
• When movement has become too restrictive
• When it no longer responds to such treatments as physical therapy and medications, including pain-relieving injections

What are the causes of these shoulder conditions?

• Osteoarthritis
• Rheumatoid Arthritis
• Posttraumatic Arthritis
• Rotator Cuff Tear Arthropathy
• Avascular Necrosis
• Severe Injury

Who is a likely candidate for the surgery?

• General good health
• Appropriate weight (BMI <40)
• Non-smoker
• Arthritis that has failed to respond to conservative treatment

How common is shoulder surgery?

Shoulder joint replacement has become increasingly common, and is now as effective as knee and hip replacement surgery to help patients get back to their normal activities without pain. According to the Journal of Shoulder and Elbow Surgery, 175,000 to 350,000 procedures per year may be performed by 2025. Orthopedic Performance Institute surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, routinely perform shoulder replacement surgery.

How is it done?

Total shoulder replacement surgery, also known as shoulder arthroplasty, involves removing the damaged portions of the shoulder joint and replacing them with artificial components, collectively referred to as a prosthesis.

The surgeon begins by making an incision over the shoulder to access the joint. The damaged or arthritic cartilage and bone from the head of the humerus (the upper arm bone) and sometimes the socket of the scapula (the glenoid) are carefully removed. These surfaces are then reshaped to fit the prosthetic components.

The artificial joint is made from metal and plastic materials designed to mimic the natural anatomy and function of the shoulder. Cement or a press-fit technique may be used to secure the prosthesis, depending on bone quality and the specific implant design.

Replacement Options

There are different types of shoulder replacement procedures, depending on the extent of joint damage and the patient’s needs:

• Partial Shoulder Replacement (Hemiarthroplasty)
  In this procedure, only the head of the humerus (the “ball” of the joint) is replaced with a metal implant. The socket (glenoid) is left intact. This option is often chosen when the glenoid is healthy or when the damage is primarily limited to the humeral head, such as in some fractures.
• Total Shoulder Replacement (Anatomic Total Shoulder Arthroplasty)
  Both the ball (humeral head) and the socket (glenoid) are replaced. The humeral component is typically metal, while the glenoid component is made of medical-grade plastic (polyethylene). This is the most common type of shoulder replacement and is generally recommended for patients with osteoarthritis, rheumatoid arthritis, or severe joint damage.
• Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty)
  In cases where the rotator cuff is severely damaged or nonfunctional, a reverse shoulder replacement may be used. This procedure reverses the normal ball-and-socket configuration: a metal ball is attached to the scapula, and a plastic socket is placed on the top of the humerus. This design relies on the deltoid muscle rather than the rotator cuff to lift the arm, making it ideal for patients with rotator cuff arthropathy.

Your orthopedic surgeon will determine which course of action to take.

What evaluation processes are involved?

The Orthopedic Performance Institute’s Dr. Matthew Dwyer and Dr. Christopher Phelps will evaluate you in four key areas.

1. Medical history. You’ll be asked about your overall health, pain and ability to perform everyday activities.
2. Physical examination. This will assess your shoulder motion ad strength.
3. X-rays. These will allow the doctors to evaluate the damage and what needs to be replaced.
4. CT scans and MRIs. These procedures may be warranted to allow a closer examination of the bone and soft tissue.

How long is the surgery?

The procedure is typically performed under general anesthesia and may take about 1.5 to 3 hours, depending on the complexity. Afterwards, you will either be released home or be admitted to the hospital for further observation.

What is the recovery timetable?

Recovery from shoulder surgery is a gradual process that typically spans about a year. In the first 1–2 weeks, patients begin gentle home physical therapy focused on passive range of motion, while keeping the shoulder dry until the surgical dressing is removed during the two-week follow-up. Sling immobilization is crucial during the first six weeks. From weeks 2–6, outpatient physical therapy continues to focus on passive motion, still with sling use. Between weeks 6–10, patients can discontinue the sling and begin active range of motion exercises, avoiding any lifting. From weeks 10–14, therapy progresses to include strengthening exercises. By 3–6 months, most patients follow a home regimen to further improve motion and build strength. Full recovery is typically achieved around one year post-surgery.

Contact Us Today

Don’t let shoulder pain keep you from the activities you love. Contact the Orthopedic Performance Institute in San Antonio at (210) 545-7171 for a complete evaluation with Dr. Christopher Phelps or Dr. Matthew Dwyer.

The post Total Shoulder Replacement Surgery: Benefits, Risks, and What to Expect appeared first on Orthopedic Performance.

Who would benefit?

Who wouldn’t benefit? Athletes — runners, triathletes, or basketball, volleyball, and soccer players will benefit. This also includes adults who are thinking about jogging for exercise and want to prevent injury, or adults who are already running and continue to feel aches and pains. Beginner, intermediate or professional athletes — anyone can benefit from running technique improvement.

Running gait analysis includes inspecting:

Feet

• anatomy
• arch analysis
• shoe choice
• weight distribution

Knees

• Alignment

Hips

• anterior hip flexibility

Upper extremity

• alignment
• arm movement during stride

Overall

• flexibility
• training schedule
• diet
• breathing
• cadence
• posture

Why do I need a gait analysis?

The average runner takes 160-170 steps PER MINUTE of running. That’s approximately 10,000 steps an hour!

Gait analysis can lead to proper alignment and distribution of weight — which can prevent injuries to the muscles (think tendonitis), bones (stress fractures) and joints (meniscus injuries). In addition, analysis can make a runner more efficient — able to run longer distances using the same amount of energy.

What do I need to bring?

Running clothes, your running shoes, and you!

Dr. Alexandra Matthews, OPI’s Sports Medicine Specialist, will methodically perform your running gait analysis and provide you with the information you need to reach your peak performance. Contact us for an appointment today!

The post What Is Gait Analysis? appeared first on Orthopedic Performance.

Every step you take involves a remarkably intricate network of bones, muscles, tendons and ligaments. That complexity — combined with all the weight they carry — accounts for why feet can be so prone to problems, including bone fractures, arthritis and plantar fasciitis.

Potential Foot Problems

If left untreated, foot problems can worsen. Eventually, the pain can interfere with your ability to do even the most basic things, such as walking up stairs or down the street. If pain alters the way you walk, it can radiate to your knees, hips and back. These problems can multiply, limiting your activity and affecting your quality of life.

Several things can contribute to foot pain or numbness. Sports and physical activity can cause your feet to hurt or become numb. Going too far, too fast, or not warming up properly before exercise can increase your chances of painful or numbing injuries.

Excess weight puts extra stress on your feet. Poorly fitting shoes and other footwear are also common causes of foot problems.

Health disorders can also affect the feet. Lack of feeling in your feet could be a sign of a serious illness, such as diabetes, or a nerve disorder. See your doctor if you have unusual numbness in your feet or foot pain that is severe, comes on suddenly, or doesn’t improve with simple treatments such as rest or over-the-counter pain medications.

“Foot pain, even minor pain, can be nagging and effect every aspect of life, since you use your feet to walk!” says Dr. Alexandra Matthews, Sports Medicine Specialist with the Orthopedic Performance Institute. “There are some very conservative measures, like arch supports, correct toe spacing, correct show wear, to keep feet happy as and healthy, as well as more aggressive treatments that we use when appropriate.”

Keeping Your Feet Healthy

There are several ways to keep your feet healthy: Wear comfortable, well-fitting shoes. Wash your feet regularly (especially between your toes), wear clean socks, and try to rotate your shoes to give them time to air out.

The more you exercise your feet, the better the blood flow to them, which is essential for overall foot health. Walking is a great way to exercise your feet.

You can also try these foot exercises:

Sit down and rotate your ankles in one direction, then the other. In bare feet, sit in a chair and curl your toes, then spread them out. This helps stretch and strengthen your feet and maintain balance.

If you’re feeling any of the foot symptoms described here, an appointment with your doctor or an orthopedic specialist may be needed. The Orthopedic Performance Institute is here to help. We’re dedicated to helping you stay on your feet for life.

The post Facts About Your Feet appeared first on Orthopedic Performance.

Rheumatoid arthritis is a disease that affects your joints. It causes pain, swelling and stiffness. If joints on one side of your body have rheumatoid arthritis, usually the joints on the other side do too. It can affect any joint in the body. Rheumatoid arthritis can also make you feel sick and tired, and sometimes get fevers.

What’s the difference between rheumatoid arthritis and osteoarthritis (OA)?

RA is an autoimmune disorder that produces inflammatory joint symptoms throughout the body. OA is a degenerative condition that is the result of increased wear and tear on joints. OA may produce inflammatory symptoms as well, but it primarily destroys joint cartilage over time.

Both RA and OA are more prevalent in women than in men. RA can develop in patients aged 30 to 60 at any time. OA generally develops later in life. Courses of treatment can also vary.

What are the symptoms of rheumatoid arthritis?

Symptoms can range from mild to severe, including:

• Tender, warm and swollen joints
• Swollen joints on both sides of the body, such as your hands and wrists
• Swelling in other joints, including the neck, shoulders, elbows, hip, knees, ankles and feet
• A feeling of weariness and low energy
• Fever
• Pain and stillness lasting more than 30 minutes in the morning
• Symptoms that go on for years

What causes RA?

Doctors don’t know the exact cause, but they have identified several factors, The immune system normally attacks invaders to the body, such as a cold virus or bacteria, but with this type of arthritis, a person’s immune system attacks his or her own body tissues. Researchers are learning many things about why and how this happens.

Other causes of RA may include:

• Inherited genes
• Environmental factors
• Hormones

Is there a test for RA?

There is no single specific test. It can be difficult to diagnose because the symptoms are often the same as other kinds of joint disease and can take time to fully develop. Doctors use medical history, a physical exam, x-rays, imaging tests and lab tests to make a diagnosis.

How is RA treated?

Fortunately, physicians have many ways to treat the disease, including medications, surgery, regular check-ups and complementary therapies.

Most people with RA take medications to relieve pain, reduce swelling and to stop the disease from getting worse. What a doctor prescribes depends on:

• Your general healh
• How serious the disease is
• How serious it will become
• How long you will take the drug and how well it will work
• Possible side-effects

Depending upon the severity of the disease, surgery may be recommended. It can help to:

• Reduce pain
• Help your joint work more effectively
• Help you to resume your daily activities

Regular medical check-ups are essential in order for your doctor to:

• See if the disease is worsening
• Monitor the effectiveness of the medications
• Check for adverse side-effects
• Change treatment as necessary

Complementary therapies include special diets, vitamins and behavioral changes such as weight loss and joint care.

“Here are OPI we use a multi-disciplinary team approach to treating rheumatoid arthritis,” says Dr. Alexandra S. Matthews. “Often we work with rheumatologists, physical therapists and other health care providers to ensure maximal improvement in pain and quality of life.”

If you have any of the symptoms described above, contact Orthopedic Performance Institute today.

The post Rheumatoid Arthritis FAQ appeared first on Orthopedic Performance.

What’s the difference between sprains and strains?

A sprain is an injury to a ligament (tissue that connects two or more bones at a joint). When a sprain happens, one or more ligaments is stretched or torn.

A strain is an injury to a muscle or tendon (fibrous cords of tissue that connect muscle to bone). In a strain, a muscle or tendon is stretched or torn.

How do you get them?

Sprains occur most often in the ankle. However, if you fall and land on their hand, you can sprain your wrist. Skiing and other sports can make it more likely for you to sprain your thumb.

Strains are most common in your back and the hamstring muscle in the back of your thigh.

Certain sports can make it more likely for you to have a strain in your back or legs. Examples include:

• Soccer
• Football
• Hockey
• Wrestling
• Boxing

If you play sports that use your hands and arms a lot, you may be more likely to have a strain in your arm or hand. For example:

• Gymnastics
• Tennis
• Rowing
• Golf

What are the symptoms?

The symptoms of a sprain include:

• Pain
• Swelling
• Bruising
• Inability to use the joint

Strains

In addition to pain, symptoms of a strain include:

• Muscle spasms
• Swelling
• Cramping
• Difficulty moving

If you tear a muscle or tendon completely, it is very painful and hard to move.

What causes sprains and strains?

Sprains

Many things can cause a sprain. Falling, twisting, or getting hit can force your joint out of its normal position. This can cause ligaments around your joint to stretch or tear. Sprains usually happen when you:

• Fall and land on your arm
• Fall on the side of your foot
• Twist a knee

Strains

A strain happens when you twist or pull a muscle or tendon. Strains can happen suddenly or develop over days or weeks. A sudden or acute strain is caused by:

• A recent injury
• Lifting heavy objects incorrectly
• Overstressing your muscles

Chronic strains usually happen when you move the muscles and tendons the same way over and over (repetitive motion).

Testing

Your doctor checks for a sprain or strain by:

• Asking how the injury occurred
• Examining the area
• Ordering an x-ray to make sure no bones are broken

Your doctor may order an MRI to look closely at the area of the injury or pain. An MRI is a test that uses magnetic energy to look inside the body.

How are they treated?

Treatments for sprains and strains are the same. To reduce swelling and pain in the first day or two, doctors usually say to:

• Rest the injured area. If the ankle or knee is hurt, your doctor may tell you to use crutches or a cane.
• Put ice on the injury for 20 minutes 4 to 8 times a day.
• Compress (squeeze) the injury using special bandages, casts, boots, or splints. Your doctor will tell you which one is best for you and how tight it should be.
• Put the injured ankle, knee, elbow, or wrist up on a pillow.
• Take medicines, such as aspirin or ibuprofen.

After treating pain and swelling, your doctor may tell you to exercise the injured area. This helps to prevent stiffness and increase strength. In addition, you may need physical therapy. Your doctor or physical therapist will tell you when you can start to do normal activities, including sports. If you begin too soon, you can injure the area again.

Managing sprains and strains

The goal is to get you back to your normal everyday activities, including sports if possible. You should work closely with your doctor or physical therapist to make sure you are ready. It is important that you have the following before returning to normal activity or sports:

• Normal motion
• Flexibility
• Strength

The amount of time you need to fully heal after a sprain or strain depends on the person and the type of injury.

Preventing sprains and strains

You can help prevent sprains and strains by:

• Avoiding exercise or playing sports when tired or in pain.
• Eating a well-balanced diet to keep muscles strong.
• Maintaining a healthy weight.
• Trying to avoid falling (for example, put sand or salt on icy spots on your front steps or sidewalks).
• Wearing shoes that fit well.
• Getting new shoes if the heel wears down on one side.
• Exercising every day.
• Staying in proper physical condition to play a sport.
• Warming up and stretching before playing a sport.
• Wearing protective equipment when playing.
• Running on flat surfaces.

“Strains and sprains are bound to happen for minimally active people all the way up to professional athletes”, says Dr. Alexandra Matthews, Sports Medicine physician with Orthopedic Performance Institute. “There are many treatment options, including simple RICE method (Rest, Ice, Compression, Elevation) to more aggressive braces or injections. We regularly see both injuries and would be happy to help heal you.”

The Orthopedic Performance Institute is a comprehensive medical practice specializing in adult and pediatric orthopedics and sports medicine, and has office locations in San Antonio, Boerne, or Bulverde.

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Is the Pressure to Excel Actually Hurting Your Child?

Young athletes are being increasingly driven to focus on a single sport in the hopes that they can join elite teams and earn college sports scholarships. The bad news is that early specialization has led to an increase in injuries, overtraining and burnout, according to recent studies.

What was once a free-play environment that children enjoy has become more demanding, adult-driven and structured. Training is more intense, and the pressure to succeed can be too much for young athletes, leading to burnout and injury. Coaches and parents alike can be responsible for encouraging this intense training and specialization.

In fact, research supports the positive effects of diversification in young athletes as opposed to specialization. Early diversification develops greater motor skills and athleticism that will serve young athletes well if they choose to specialize later.

Signs to Watch Out For

The warning signs of overtraining and burnout include:

• Change in mood
• Lack of enthusiasm
• Weight loss
• Increase in injuries
• Joint and muscle pain
• Exhaustion

If your child has been rigorously participating in a physically demanding team sport (i.e., tennis, football or basketball) and is exhibiting any of these symptoms, talk to them about it. When they feel that they’re in a safe and loving environment, they are more likely to open up about the pressure to succeed and any symptoms they may be experiencing.

Let them know that cutting back on these strenuous activities is nothing to be ashamed of. Have them examined by a pediatric sports specialist to check for any injuries that may have occurred and rehab if necessary.

On the topic, Dr. Alexandra Matthews, Orthopedic Performance Institute Sports Medicine specialist says, “Recent literature has shown an increase in physeal (growth plate) injuries, overtraining syndrome, and other pathologies as a result of specializing too early in sports. Adolescents who play multiple sports and specialize at a later age report more overall satisfaction in their athletic careers. In addition, they are more likely to exercise and participate in pick up games later in life.”

At Orthopedic Performance Institute, our dedicated physicians are experts at identifying and treating pediatric sports injuries. Contact us for an appointment today to ensure that your young athlete stays in top shape. Our offices are conveniently located in San Antonio and Boerne, Texas.

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