Orthopedic surgery can be applied in situations where non-surgical treatments have failed to provide relief from pain or address the underlying condition.

While every patient’s situation is unique, there are some common reasons that orthopedic surgery may be called for:

Severe Trauma or Injury

In cases of severe trauma or injury to the musculoskeletal system, orthopedic surgery may be necessary. These conditions include:

• Fractures that cannot be effectively treated with casting or immobilization alone
• Dislocations
• Severe ligament or tendon tears
• Complex joint injurie

Surgery is performed to realign bones, repair damaged tissues and restore stability and function.

Chronic Pain and Degenerative Conditions

Chronic pain that is caused by degenerative conditions like osteoarthritis, rheumatoid arthritis or spinal disc herniation may require orthopedic surgery after the gauntlet of non-surgical options have been exhausted.

Joint replacement surgeries such as hip or knee replacements can provide significant pain relief and improve mobility for individuals with severe joint damage.

Sports Injuries

Athletes who sustain sports injuries such as torn ligaments (ACL, MCL), meniscus tears or cartilage damage can benefit from orthopedic surgery. Depending on the severity and location of the injury, arthroscopic procedures or reconstructive surgeries may be utilized.

These surgeries intend to restore function, stability and range of motion, allowing athletes to get back in the game.

Congenital or Developmental Abnormalities

Orthopedic surgery may be in order for individuals who suffer from congenital or developmental abnormalities of the musculoskeletal system. These conditions can include scoliosis, hip dysplasia, or limb length discrepancies. Orthopedic surgery can:

• Correct deformities
• Improve function
• Prevent long-term complications

Such surgeries are typically performed on children or adolescents to optimize healthy growth and development.

Infection or Tumor

Orthopedic surgery may be necessary to treat infections or tumors that affect the musculoskeletal system.

Surgeries such as debridement (removal of infected tissues), bone grafting or tumor excision are ways to eliminate infections or remove cancerous or benign tumors. These procedures are essential for:

• Preventing the continuing spread of infection
• Preserving limb function
• Avoiding further potential malignancies

Considerations for Undergoing Surgery

The decision to undergo orthopedic surgery is made on a case-by-case basis, taking into consideration such factors such as the patient’s overall health, lifestyle, and goals.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, at the Orthopedic Performance Institute will work closely with you to assess your condition, explore more conservative treatment options, and determine whether surgery is the most appropriate course of action.

Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for more information or to schedule an examination.

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Anatomy of the knee 

The knee is a marvel of design. Special ligaments are designed to protect it from injury and to keep it stable.

The femur (thigh bone), tibia (shinbone) and patella (kneecap) all comprise the knee joint. They’re connected to each other by four main ligaments that hold them together to keep the knee stable. The main ligaments are:

Collateral ligaments. Found on the side of the knee, the medial collateral ligament (LCL) protects the knee from unusual motion.

Cruciate ligaments. Found on the inside of the knee joint, they consist of the anterior cruciate ligament (ACL) in the front and the posterior cruciate ligament (PCL) in the back. These ligaments cross over to form an “X” to control the front and back motion of the knee.

The ACL prevents the knee from sliding in front of the femur and keeps the knee stable. The PCL keeps the shinbone from sliding back too far. Stronger than the ACL, it is injured less frequently.

Injuries can still happen, however — and one of the most frequently occurring is damage to the ACL.

Who Is at risk for ACL injuries?

Those who participate in high-impact sports such as soccer, football and basketball are most likely to injure their ACL. Depending on the severity of the injury, surgery may be required to get restored to full function.

When an ACL injury happens, damage to other structures can also occur, including articular cartilage, meniscus and other ligaments. These injuries are measured on a scale of severity.

Grade 1 sprains. Here, the ligament is mildly damaged, but it is still able to keep the knee stable.

Grade 2 sprains. Here, the ligament is stretched to the point where it becomes loose and is partially torn. This can be accompanied by a feeling of instability.

Grade 3 sprains. The ligament is completely torn and/or pulled off the bone, and the knee joint is rendered unstable.

Most ACL injuries involve complete tearing of the anterior cruciate ligament. Partial tears are rare.

What causes ACL injury?

• A sudden change in direction
• Stopping abruptly
• Decreasing speed while running
• Landing incorrectly (i.e., from a jump)
• Collision with another athlete (i.e., during a football tackle)

It has been reported that ACL injuries occur more frequently in female athletes than in males, possibly because of differences in physical condition and muscular strength.

What does an ACL injury feel like?

A popping noise, followed by a feeling that your knee is going to give out, is a most common symptom. Your knee will begin to swell within 24 hours. If you attempt to continue intense physical activity, you are in danger of making the injury even worse.

When is surgery required?

Your physician will be able to make the determination, but young athletes who regularly participate in intense sports are the most likely. Surgery may not be required for older athletes who participate in fewer such activities.

What do I do when I’m injured?

See your physician. You’ll be asked about what you were doing when the injury occurred. X-rays and MRIs may be performed so your doctor can see the extent of the injury. You may be referred to an orthopedic surgeon for further treatment.

Fortunately, there are now several advancements in treatment available that offer surgical and non-surgical solutions to ACL injuries. OPI’s physicians will determine the best course of action for you.

Trust the professionals at OPI

At the Orthopedic Performance Institute, our physicians are experts in the diagnosis and treatment of ACLs. They will be able to diagnose the severity of the injury, and whether or not you need surgery.

Dr. Alexandra Matthews, OPI’s sports medicine specialist, says: “Don’t ignore the pain or try to fight through it. Have a professional examine the injury as soon as possible.”

Let the Orthopedic Performance Institute help you to get back in the game! Contact them in San Antonio or Boerne at (210) 545-7171.

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Rotator Cuff Tears

A rotator cuff tear occurs when the tendons that attach the muscles of the rotator cuff to the upper arm bone tear partially or completely. This condition is often caused by repetitive motions or sudden injuries. Treatment options for rotator cuff tears depend on the severity of the tear. Non-surgical treatments may include rest, physical therapy, and anti-inflammatory medications. However, in more severe cases, surgery may be required to repair the torn tendons.

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, also known as adhesive capsulitis, is characterized by pain and stiffness in the shoulder joint, limiting its range of motion. The condition typically develops over time and goes through three stages: freezing, frozen, and thawing. Treatment for frozen shoulder usually involves physical therapy, stretching exercises, and sometimes corticosteroid injections to reduce inflammation and improve mobility.

Shoulder Impingement Syndrome

Shoulder impingement occurs when the rotator cuff tendons become pinched between the bones of the shoulder. This often happens during overhead activities and can cause pain and weakness in the affected arm. Treatment for shoulder impingement may include rest, activity modification, physical therapy to strengthen the rotator cuff muscles, and anti-inflammatory medications. In some cases, a corticosteroid injection may be administered to reduce inflammation.

Bursitis

Bursitis is the inflammation of the bursa, small fluid-filled sacs that cushion and reduce friction between bones and soft tissues in the shoulder. Overuse or direct trauma can lead to bursitis. Treatment for shoulder bursitis includes rest, ice application, and anti-inflammatory medications. Physical therapy may also be recommended to strengthen the surrounding muscles and prevent further irritation.

Shoulder Osteoarthritis

Shoulder osteoarthritis is a degenerative joint disease that occurs when the cartilage that covers the bones in the shoulder joint wears down over time. As a result, movement becomes painful and limited. Treatment for shoulder osteoarthritis often involves a combination of pain management with medications, physical therapy to improve joint function and strength, and lifestyle modifications. In severe cases, surgery such as shoulder joint replacement may be considered.

Conclusion

Taking care of your shoulders is crucial to maintaining an active and pain-free lifestyle. If you experience persistent shoulder pain or limited mobility, it’s essential to consult an orthopedist, like Dr. Matthew Dwyer, Dr. Alexandra Matthews and Dr. Christopher Phelps, for an accurate diagnosis and appropriate treatment plan. Early intervention and proper management can significantly improve the outcome for various shoulder conditions. Remember, it’s always better to address shoulder issues promptly to prevent further complications and to get back to enjoying life to the fullest!

The post Understanding Common Shoulder Conditions and Their Treatments appeared first on Orthopedic Performance.

Causes

Bursitis is usually caused by overuse of a joint or trauma to a joint. For example, if you kneel or lean on your elbows on a hard surface for long periods, you may be at risk for bursitis. An infection, arthritis, gout, thyroid disease or diabetes can also cause bursitis.

If you perform activities that require repetitive motions or place stress on your joints — such as carpentry, gardening, playing a musical instrument, or playing a sport — you could be at a higher risk for bursitis.

Diagnosis

To diagnose bursitis, your doctor will probably ask questions about your medical history and examine you. You will probably be asked to describe your joint pain and the circumstances in which it occurs. The location and onset of pain, whether your pain varies in severity throughout the day, and factors that relieve or aggravate your pain may all help your doctor determine a bursitis diagnosis.

Your doctor may also do manual examinations of the joint to see whether tendons, another part of your joints, are inflamed. They may also recommend x-rays, which do not show the bursae, but which may help rule out other problems. A magnetic resonance imaging (MRI) test can show whether the tendons or bursae are inflamed. Your doctor may also remove and test fluid from the inflamed area to rule out infection.

Treatment

Treating bursitis can reduce pain and inflammation and allow the injured bursa to heal. Some common treatments for bursitis include:

• Resting and elevating the injured area.
• Limiting your activity to reduce further injury.
• Taking anti-inflammatory medicines, such as aspirin, naproxen, or ibuprofen. Gentle stretching and strengthening exercises recommended by a doctor. Applying compression to the injured area.
• Putting a brace, splint or band on the injured joint.

If an infection is causing your bursitis, your doctor will probably prescribe antibiotics. Your doctor may also recommend ice for acute injuries, but most cases of bursitis are chronic and ice is not helpful.

If your bursitis does not improve, your doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa. Although these injections are common, they must be used with caution because they can lead to weakening or rupture of tendons. If your bursitis does not improve after 6 months to a year, your doctor may recommend surgery to repair damage and relieve pressure on your bursae.

Prevention

To help prevent inflammation or reduce the severity of its recurrence:

• Begin new activities or exercise regimens slowly.
• Gradually increase physical demands following several well-tolerated exercise sessions.
• Exercise regularly.
• Strengthen the muscles around the joint.
• Take frequent breaks from repetitive tasks.
• Stop the activities that cause pain.
• Cushion the affected joint. Use foam for kneeling or elbow pads. Increase the gripping surface of tools with gloves or padding. Apply grip tape or an oversized grip to golf clubs. Use two hands to hold heavy tools; use a two-handed backhand in tennis.
• Don’t sit still for long periods of time.
• Maintain good posture and position your body properly when going about your daily activities.

There’s no need to live with pain. If you are feeling this sort of discomfort, it’s a good idea to have yourself checked for bursitis. Contact Orthopedic Performance Institute in San Antonio or Boerne for an appointment today.

The post Facts About Bursitis appeared first on Orthopedic Performance.

Reasons to exercise

Just like muscle, bone is made of living tissue that responds to exercise by becoming stronger. Young women and men who exercise regularly generally achieve greater peak bone mass (maximum bone density and strength) than those who do not. For most people, bone mass peaks during the third decade of life. After that time, we can begin to lose bone.

Women and men over the age of 20 can help prevent bone loss with regular exercise. Exercising can also help maintain muscle strength, coordination and balance, which in turn helps to prevent falls and related fractures. This is key for older adults and people who have been diagnosed with osteoporosis.

The best bone-building exercises

Weight-bearing and resistance exercises are the best for your bones, as they force you to work against gravity. These include walking, hiking, jogging, climbing stairs, playing tennis and dancing. Resistance exercises such as lifting weights can also help to strengthen bones.

Exercise tips

If you have health conditions such as heart trouble, high blood pressure, diabetes or obesity — or if you are age 40 or older, check with your doctor before you begin a regular exercise program.

According to the Surgeon General, the optimal goal is at least 30 minutes of physical activity on most days, preferably daily.

“When you begin an exercise routine, it’s common to have some muscle soreness and discomfort at the beginning,” says the Orthopedic Performance Institute’s Dr. Alexandra Matthews. “But if it’s painful and lasts more than 48 hours, you maybe working too hard or doing it wrong.”

Definitely stop exercising if you feel any chest pain or discomfort, and see your doctor before you start again.

Exercising with osteoporosis

If you have osteoporosis, ask your doctor which activities are safe for you. If you have low bone mass, experts recommend that you protect your spine by avoiding exercises or activities that flex, bend or twist it. You should avoid high-impact exercise to lower the risk of breaking a bone.

You also might want to consult with an exercise specialist to learn the proper progression of activity, how to stretch and strengthen muscles safely, and how to correct poor posture habits. An exercise specialist should have a degree in exercise physiology, physical education, physical therapy or a similar specialty. Be sure to ask if he or she is familiar with the special needs of people with osteoporosis.

Exercise is only one aspect of a complete osteoporosis prevention or treatment program, along with a diet rich in calcium and vitamin D. But proper exercise and diet may not be enough to stop bone loss caused by medical conditions, menopause or lifestyle choices such as tobacco use and excessive alcohol consumption.

It is important to speak with your doctor about your bone health. Discuss whether you should take a bone mineral density test. If you are diagnosed with low bone mass, ask what medications might help keep your bones strong.

If you’re planning on starting an exercise regimen for bone health, make an appointment with Dr. Alexandra Matthews, Sports Medicine specialist for the Orthopedic Performance Institute.

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Here are some tips on how to limber up for cold weather exercise:

Safety First

Since stretching cold muscles can cause the types of injuries we seek to avoid, begin by briskly walking or jogging for a few minutes. This will get the blood flowing to your muscles and prepare them to be stretched.

Dynamic Stretching

Dr. Alexandra Matthews with the Orthopedic Performance Institute recommends a dynamic stretching routine in cold weather. This means that you should incorporate motions into your routine, (such as leg kicks and arm circles) rather than just stretching and holding the muscle without moving. Dynamic stretching benefits you in a couple of ways — it limbers up your muscles and gets your blood moving, which in turn keeps you warmed up and ready to work out.

Here are two dynamic stretches to add to your cold weather routine:

• Arm Circles. With your arms out straight and palms down, begin making small circles and gradually increase the movement. Keep your shoulders relaxed. When you’ve reached the maximum diameter that you can do, decrease the size of the circles until you’re back at the starting position.
• Forward Lunges. Place your feet together, put your hands on your hips and take a step forward with one leg. Bend the knee to a 90º angle while lowering your other knee toward the ground. Keeping your upper body straight, push back to a standing position and repeat three or four times before switching to the other leg.

Don’t Stop

If you’re going to be involved in a sport that leaves you standing still for periods of time, continue doing the dynamic stretches to keep muscles warm. You can even jog in place.

The Cooldown

Stretching is also good for cooling down after you work out or participate in a sport. This is when you will do some static stretching. It decreases your heart rate and makes your muscles feel better. However, never stretch a muscle to the point that you feel pain.

There’s no reason to curtail your outdoor activities in colder weather. Just remember to keep your muscles warm and limber — and dress appropriately!

The post The Importance of Stretching in Cold Weather 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.

• Baseline testing measures your brain function in a healthy state. This computerized test measures memory, attention span, and visual and verbal problem solving. Neurocognitive testing, like the ImPACT baseline test used by the Orthopedic Performance Institutem is the cornerstone of modern concussion management used by high schools, professional teams, universities, and clinical centers.
• While concussions aren’t preventable, baseline testing is a great way to be prepared if a concussion ever happens. If you have an injury, the Orthopedic Performance Institute, or other healthcare provider, can compare a post-injury test to the patient’s baseline test and determine the extent of concussion for treatment and evaluate a safe return to activity. Objective data will help evaluate reaction time, memory capacity, speed of mental processing, and executive functioning of the brain.
• As preventative medicine, an annual concussion baseline test is recommended to ensure an up-to-date record of a patient’s normal functioning.
• Baseline evaluations take about an hour in office and include the following:

1. Physical exam and review of personal history.
2. Vestibular/Ocular-Motor (VOMS) screening to indicate balance dysfunction.
3. ImPACT neurocognitive computerized test. This test is timed and takes about 20 minutes to complete.

• $50 is charged for each concussion baseline screening. They are not covered by insurance.

Post-Injury Concussion Treatment

Our concussion treatment plan is part of a multidisciplinary approach for balanced care and treatment, and includes:

• Physical exam and review of personal history.
• Vestibular/Ocular-Motor (VOMS) screening to indicate balance dysfunction and, if necessary, needed referral to specialist for more detailed assessment and management.
• ImPACT baseline computerized neurocognitive test to measure visual and verbal memory, reaction time, and processing speed. It takes 20 minutes and gives providers objective data to evaluate a patient’s post-injury condition and aids in tracking recovery.
• If the patient has already taken a baseline test elsewhere, then the post-injury test results will be compared to the baseline scores and or/normative data.

Fees for concussion treatment are usually covered by insurance without additional cost to the patient. Claims will be submitted to insurance by the Orthopedic Performance Institute.

When treatment for a concussion becomes necessary, call (210) 545-7171, ext. 404 for a STAT appointment with Dr. Alexandra Matthews.

The post Concussion Baseline Testing: Preventative Medicine for Athletes 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.

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