The human body makes thousands of movements a day. Think about the first few minutes you are awake each morning: you use your legs and back to get out of bed, you use your hands and arms to brush your teeth, you bend your knees to put on pants, bend your elbows to button a shirt and bend your back as you tie your shoes. Throughout the day, our bodies perform movements that we never even think about – until something goes wrong and we are suddenly unable to perform the simple tasks we once took for granted. Thankfully, there are medical specialists who are here to help when those situations arise: orthopedic surgeons and sports medicine physicians.
The field of orthopedic medicine involves the many facets of the human musculoskeletal system. That includes bones, ligaments, joints, tendons, muscles and nerves – all of the body parts that enable us to have mobility and the ability to perform a physical task: from the simple, such as going outside to check the mailbox; to the complex, such as play basketball or dance in a ballet.
Privia Medical Group North Texas includes physicians who specialize in many types of orthopedic conditions. Whether it’s treating the athlete who sustained an injury on the football field or the person who got hurt doing a normal household chore, Privia’s orthopedic and sports medicine physicians have you covered.
“The first thing to understand about the injuries we see is this: many of them are preventable,” says Dr. Donald Dolce, an orthopedic surgeon. “Whether it is an athletic injury or one that occurs in the workplace or around the house, it may have been preventable through better conditioning or training, or simply by taking better precautions.”
There are dozens of orthopedic conditions that physicians deal with. Here’s a look at some of the most common orthopedic injuries:
Carpal Tunnel Syndrome
The carpal tunnel is literally a tunnel that runs through our wrist. This tunnel is formed by the carpal bones on the bottom and sides, with the “roof” of the tunnel formed by the transverse carpal ligament, a very strong band of connective tissue. Because of the composition of the tunnel, it is very rigid.
The median nerve, which controls feeling in the thumb, middle, index and ring fingers, as well as the muscles near the base of the thumb, passes through the carpal tunnel from the forearm into the hand. The carpal tunnel also serves as the passageway for the flexor tendons, the nine tendons that allow us to bend our fingers and thumb.
Carpal tunnel syndrome occurs when the tunnel narrows, creating pressure on the median nerve – this can result in pain, numbness, tingling or weakness in the hand. Anyone can develop carpal tunnel syndrome, but women, seniors and those who engage in repetitive wrist and hand motions are more at risk.
Treatment can include use of a wrist brace to restrict movement, anti-inflammatory medicines, such as ibuprofen or cortisone injections. “In mild cases numbness will be intermittent, coming and going throughout the day. As long as you have normal feeling sometime during the day, anti-inflammatories and bracing are acceptable treatments,” says Dr. William Lowe, an orthopedic hand surgeon. If these treatments lose effectiveness over time or if the injury is more advanced, surgery may be recommended to relieve the pressure within the tunnel.
“Carpal tunnel symptoms can awaken you from your sleep in the middle of the night. Interruption of sleep is a primary reason patients elect to have surgery,” explains Dr. Lowe. “Newer techniques have turned carpal tunnel surgery into a minor procedure, with minimal downtime and recovery rarely longer that a few weeks,” he adds.
Shoulder injuries often result from activities involving repetitive and frequent overhead motion: swimming, tennis, pitching and weightlifting all fall in this category. But just as with other common injuries, mundane tasks such as lifting boxes up into the attic, painting a ceiling or trimming hedges can cause strain and injury to the shoulder.
One of the most common types of shoulder injury is to the rotator cuff, a group of muscles and tendons that holds the bones of the shoulder together. The rotator cuff is the part of the shoulder that enables us to lift our arms overhead.
“Identifying a shoulder problem early is key to preventing a larger problem from developing,” says Dr. Tom Carrell, an orthopedic surgeon specializing in shoulder, hip and knee surgery. “If you feel pain or stiffness in your shoulder or you are unable to perform your usual daily activities due to shoulder discomfort, you should rest your shoulder and see an orthopedic specialist as soon as possible.”
Sometimes, shoulder injuries can heal through rest, restricting movement of the shoulder and strengthening exercises. Other times, an injury may necessitate injections or surgery.
The knee is the largest joint in the body and is one of the most commonly injured, as well. Sometimes these injuries can be resolved by rest and restricted movement; others require surgery.
The patella – more commonly known as the kneecap – is the knee bone most likely to fracture. A patella fracture can make it impossible to bend or move the knee. It requires a cast to immobilize the knee until the fracture is healed and in the event of a more complex fracture, surgery may be required. These fractures are not uncommon if someone falls from a roof or a similar height, or is involved in a serious motor vehicle collision. These events can also trigger a knee dislocation, which inhibits the knee’s stability.
A sprain of the Anterior Cruciate Ligament (ACL) is one of the more common knee injuries and can occur when a person stops or changes direction suddenly, slows down when running or lands the wrong way after a jump. That’s why we often hear about ACL injuries in sports such as football, basketball and soccer.
The ACL is found on the inside of the knee and together with the Posterior Cruciate Ligament, controls the back and forth motion of the knee. An ACL injury is a sprain, of which there are three categories:
- Grade 1 sprain, in which the ligament is stretched but not torn
- Grade 2 sprain, in which the ligament is partially torn
- Grade 3 sprain, in which the ligament is completely torn in two.
ACL sprains can only be completely healed through surgery, although if the sprain is not too severe and the person is elderly and not very active, a non-surgical solution of restricting activity along with physical therapy may be an option.
In most cases, a torn ACL cannot simply be stitched back together. The surgeon must replace the damaged ligament with a graft – usually part of a tendon from another part of the body – that serves as the infrastructure for the ligament to regrow on. Because the ligament must be given time to completely regrow, recovery from ACL surgery generally takes six months.
The knee also has ligaments that run on the outside of the knee joint, known as collateral ligaments. These ligaments control the sideways motion of the knee and help to brace it. The Medial Collateral Ligament (MCL) can be torn when the knee is pushed sideways. Unlike the ACL, however, an MCL sprain rarely requires surgery and can be healed through a brace that restricts movement, as well as physical therapy.
Meniscus tears are another common knee injury. The meniscus refers to the cartilage in the knee between the thighbone and shin bone. Meniscus tears are a common sports injury and can sometimes occur at the same time as an ACL injury. Absent an ACL injury, a meniscus tear is characterized by pain and stiffness and swelling that comes on over a period of a few days. Depending upon the severity and location of the tear, sometimes a meniscus injury does not require surgery and can be treated through a combination of rest, ice packs, a compression bandage and elevation of the leg.
Ankle sprains are one of the most common injuries affecting athletes and non-athletes alike. According to the American Academy of Orthopedic Surgeons, 25,000 people a day suffer an ankle sprain. A sprain occurs when the ligaments in the ankle are stretched beyond their capability. As with the ligaments in the knee, some sprains are so severe they result in the ligament tearing.
Ankle sprains take place when the foot rolls or twists in an abnormal way. “To safeguard against ankle sprains, wear shoes that provide good support, pay attention when taking the stairs or stepping off a curb, and warm up before exercise,” advises Dr. Joseph Milne, an orthopedic surgeon.
One of the most common elbow ailments is known as Tennis Elbow, a condition that results from overuse of the elbow joint. As the name suggests, sports such as tennis and racquetball can lead to the onset of tennis elbow, but there are also several non-sports activities and professions that have been associated with the injury. In fact, most cases of Tennis Elbow are caused by everyday activities. People whose jobs require them to make frequent and repeated use of the forearm, such as plumbers, cooks, painters and carpenters have all been known to get tennis elbow.
Tennis elbow occurs when muscles in the forearm become weakened due to overuse, resulting in instability in the arm and small tears in the tendon that connects the forearm muscles. Pain, a burning sensation in the elbow and inability to grip objects are the resulting symptoms.
The hamstring is the group of three muscles found in the back of the thigh. A pulled hamstring is associated with a number of sports, as well as running and dancing. A hamstring pull is often characterized by a sudden pain in the thigh, followed by swelling and weakness in the muscle. Generally, hamstring injuries can be treated through rest, ice packs and use of crutches in order to keep weight off of the injured leg.
A pulled groin muscle—the muscle on the inside of the thigh – is another common injury. This is an injury often associated with baseball, football, soccer and hockey, as it can result from pushing off in a sideways motion. As with the hamstring, the best remedy is usually rest and ice packs.
A back injury can be painful, debilitating and limit a person’s mobility. Back injuries can just as easily be caused by a routine task or movement as they can by something that happened on the field or in the weight room.
For example, an athlete who is lifting weights in the gym knows that when doing a deadlift, he bends his knees, tightens his core muscles and lifts using the powerful leg muscles, not his back. And of course, if he’s training properly, he won’t try to lift more weight or complete more repetitions than his body can handle. A person who is lifting a heavy object at home or at work needs to take the same approach.
“Improper lifting can strain muscles, tear ligaments or damage the disks in the back, so lifting the right way is one of the most important things someone can do to prevent a back injury,” says Dr. James Brezina, an orthopedic spine surgeon. “Always life with your legs, not your back. And if it’s a large or especially heavy object, don’t try to lift it yourself: wait until you have a partner available to help you.”
A herniated disk is a common cause of pain in the back or neck. Disks are rubbery pads located in between the vertebrae, the bones of the back and neck. Over time, disks become more rigid and more susceptible to herniating, or rupturing. Improper lifting, repetitive motions that strain the back and smoking are all risk factors for a herniated disk.
Fortunately, most herniated disk cases can be treated with rest, medication and a combination of heat and cold therapy. Surgery for this condition is rare.
Listen to Your Body
“The most important thing we can all do to reduce our chance of a serious orthopedic injury is to pay attention to what our bodies are telling us,” says Dr. Mark Presley, an orthopedic surgeon. “While some orthopedic injuries occur suddenly and without warming – such as a kneecap fracture or an ACL tear – many are conditions that develop over time.”
“If you feel your back is sore on a recurring basis or your shoulder movement is more limited than it used to be, your body is telling you something isn’t right,” adds Dr. Presley. “That’s the time to stop any activity that is causing the discomfort and make an appointment with your physician to get checked out. Doing this could prevent a bigger problem later on.”
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