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Can Arthritis Affect You?

Arthritis is the most common cause of disability in the United States. With over 100 types of arthritis, we tend to focus on the most common type, osteoarthritis, also called degenerative joint disease, and the other most common type, inflammatory arthritis. This ailment affects up to 80% of people during their lifetime.

Osteoarthritis is caused by destructive wear and tear of the articular cartilage which covers the end of joints. All joints have a cartilaginous end to the bone. This tissue is well organized and is very smooth with low friction; therefore it takes multiple years and multiple cycles for a joint to typically wear out.

There are multiple causes for this wear.  It can be due to simple aging changes, hereditary factors, malalignment of the joints, or excessive strain to the joints such as repetitive wear or excessive weight.

Patients who come to Alabama Orthopaedic Clinic for arthritis pain are often diagnosed by the history of the joint pain and stiffness, the physical signs of joint pain, stiffness, malalignment, increased warmth or swelling, and confirmed by other diagnostic tests such as x-rays. The diagnosis of inflammatory arthritis can be assisted with x-rays, but are more typically diagnosed by laboratory tests such as rheumatoid factor, a sedimentation rate and an antinuclear antibody test or screen.

Unfortunately, there is no known cure for arthritic conditions; however, great progress has been made over the recent years in trying to find disease-modifying agents that can potentially slow the process of the development of arthritis. The initial treatment for arthritic conditions is related to activity.  This may be in the form of exercise, stretching, physical therapy or occupational therapy.  Next, diet may be important.  Not only does weight loss help joint wear, it may reduce some of the strain on the joint and certain types of diets may reduce the actual causes of inflammation in the body.  Medications which are frequently used for this include categories such as nonsteroidal anti-inflammatories.

If you are having symptoms or problems occurring from arthritis, please call and schedule and appointment today, 251-410-3600 or visit alortho.com.

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The secret to happy feet

There is not a day in the office when someone does not discuss shoes.  Proper protection and comfort are critical for our feet, as they are continuously subjected to high stress and injury with normal daily use.  Shoe-wear issues are a constant balancing act between the need of protection and comfort versus style and social expression.

Women, particularly, can struggle with the shoe dilemma. While heeled, fashionable pumps, can seem to be a good fashion choice, the consequences of prolonged wear could make them less desirable. The constant use of heeled and pointed pumps will ultimately contribute heavily toward heel cord contracture, insertional spurs on the back of the heel, toe deformities including bunion and hammer toes; as well as forefoot nerve compression syndromes. Moreover, they can be unstable and subject the wearer to greater risk of ankle sprains and tendon injuries.

Flip-flops on the other hand are comfortable, but non-supportive. They leave the foot largely unprotected against injury. Walking barefoot carries the non-supportive risk to its ultimate, and is particularly dangerous in the diabetic patients with nerve sensibility issues.

Moderation is the key to life, and footwear is no exception.  Fashionable, heeled pumps and casual un-supportive flip flops are all appropriate and good in the right setting, but are not to be worn most of the time.

Remember, whatever the shoe you choose, first and foremost it must fit. Uncomfortable shoes by definition do not fit, and will reliably lead to structural and painful problems with the feet.

What You Need to Know About Knee Injuries

Many people involved in some kind of athletic activity know the wear and constant use of your knees and joints can sometimes result in injury or pain. There are several ways to injure your knees. Knee injuries are generally caused by direct trauma and/or repetitive overuse.

Some of these different knee injuries can include damage to the articular cartilage, meniscus cartilage, collateral cartilage or cruciate cartilage. Cartilage is a thin, elastic tissue that protects the bone and makes certain that the joint surfaces can slide easily over each other. Cartilage ensures supple knee movement.

Ways to prevent injury to your knees is through strength conditioning, work and sports safety as well as proper sports techniques. If you do happen to have a slight injury you could try some conservative treatments. Active rest, the RICE treatment, or Physical Therapy. However, if you think you have an injury be sure to seek an evaluation as soon as you can.

There are also surgical treatments of knee injuries to fix the areas of your knee. AOC can help you determine if you are in need of surgery or not.

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Sports Injury Analysis: Louisville Player Kevin Ware

 

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Did you see the Gruesome injury sustained by Kevin Ware? Pitino said “it was as bad as I’ve ever been.” Ware was taken to the Methodist Hospital, which is two miles away from the arena. He had surgery later Sunday night and will remain in Indianapolis for at least two days.

The open (compound) tibia fracture sustained by Ware is a serious injury with several possible short term and long term complications. Placing a rod into the bone to stabilize and realign it is the preferred method, if possible.  Infection is one of the main concerns given the fact that the bone broke through the skin. Open tibia fracture can potentially take months to heal. However, return to basketball is possible.

We will keep up with Kevin’s healing progress and we hope this young athlete has a full recovery and is quickly back on the court competing at a high level again soon.

Click her for complete article, Louisville’s Kevin Ware suffers gruesome broken leg by Jeff Goodman

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TEAM USA COMEBACK ATHLETE SPOTLIGHT: Tyson Gay

During the countdown to the 2012 London Olympics AOC is going to spotlight some USA Team members who have came back from injury and fulfilled their dream of making the team. AOC loves when an athlete has a real COMEBACK RECOVERY and PERFORMANCE and is able to return to their passion.

 

Tyson Gay saw his Olympic dream shattered in 2008 by a hamstring injury and now the former world champion comes to the London Olympics after needing nearly a year to recover from right hip surgery.

In 2010, Gay delivered reigning Olympic champion Bolt’s first defeat in two years on his way to capturing the Diamond League 100m crown.

But in 2011, Gay underwent hip surgery to solve several chronic problems. There were times during the recovery when Gay doubted he might ever run again at a world-class level.

“It was a slower process with me,” Gay said. “I had a lot of doubts. I tried to tune them out. It was just everything I had to go through. I couldn’t even jog until March.”

Gay made his competitive comeback after being idled for 50 weeks on June 9 in a secondary race at the Diamond League meet in New York, winning in 10.00 seconds running into a 1.5m/sec headwind.

That was Gay’s only tuneup race for the US Olympic trials, where he finished second in the final to 2004 Olympic champion Justin Gatlin’s career-best 9.80, qualifying for London in 9.86.

Gay remains cautious about his health.
“The plan worked. It held up pretty well,” Gay said. “I’m just going to continue to take care of my body and stay healthy. That is the big thing.”

(via: www.indianexpress.com)

The men’s 100m dash is one of the most popular and most watched events of the Olympic Games, and this year is shaping up to be one of the best in Olympic history. The door is wide open; it’s anybody’s race. Tyson Gay, after his great COMEBACK PERFORMANCE, is hoping that he will be the one to cross the finish line and achieve his lifelong dream of Olympic gold.

(via: www.rantsports.com)

Keep up with Tyson Gay in this year’s London Olympics. You can follow him on twitter at @TysonLGay and we will keep you updated on our blog and Facebook page.

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Injury Analysis: University of Alabama RB Jalston Fowler

 

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The recent injury to the knee of University of Alabama RB Jalston Fowler reminds us of how debilitating such injuries can be. Although no official report of the exact structures that have been damaged has been released, the video shows hyperextension of his knee which can damage major ligaments such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), side ligaments (collateral ligaments) or cause fractures to occur.

Seventy percent of non-contact injuries that result in swelling within one hour are ACL injuries. Furthermore, the C-shaped cartilages, called the menisci, can be torn during sporting injuries.

Treatment of knee injuries during football or other sports is most often treated arthroscopically– meaning via small incisions using a small camera to assist in visualizing the injured structures. Over 400,000 ACL reconstructions alone are done in the United States yearly.

According to R. Kavner’s article on collegesportsblog.dallasnews.com, Alabama coach Nick Saban announced Monday that running back Jalston Fowler will have surgery on his injured knee and is most likely going to be out for the season. Regaining muscle tone, control and joint range of motion is important if returning to sports is desired. This can take many months of hard work and dedication. AOC hopes Jalston has a good recovery and can return to the sport as soon as he is able.

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TEAM USA COMEBACK ATHLETE SPOTLIGHT: Katie Bell

During the countdown to the 2012 London Olympics AOC is going to spotlight some USA Team members who were able to recover from an injury and fulfill their dreams of making the team. At AOC we applaud and love it when an athlete has a real COMEBACK RECOVERY and PERFORMANCE and is able to return to their passion.

The Olympics have been Katie Bell’s goal since she was younger, but injuries almost derailed that dream. At the Big Ten championships in Minnesota her freshman year, she mistimed a dive. She punctured a lung, separated chest cartilage and popped ribs out of place, though the full extent of the injury took two years to diagnose. Bell continued to battle injuries. She suffered a torn labrum in her shoulder two years ago, possibly because she was overcompensating from the previous injury.

“At that point, I didn’t even know if I was going to keep diving or not,” Bell said. “When I decided to keep diving, I set my mind on going to the Olympics. I worked so hard every year.”

To overcome her sports injury she saw many doctors, athletic trainers and a psychologist to heal her body and mind to get back to competitive diving. Last month after years of surgery, rehabilitation and hard work, Katie had a stellar COMEBACK PERFORMANCE and reached her dream of making the US Olympic Diving Team.

Keep up with Katie in this year’s London Olympics.

You can follow her on twitter at @HippieBell and we will keep you updated on our blog and Facebook page.

(info via www.dispatch.com)

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Why Your Orthopaedic Physician Cares About What You Eat

 

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Orthopaedic Surgeons do more than fix broken bones. We also help people decrease the aches and pains that are part of life.  We know that what you EAT has a big effect on how you feel.

Overeating and obesity have the obvious effect of adding stress to joints resulting in arthritis and pain at an early age. The rate of obesity has more than doubled since 1980. Poor diets and obesity are also linked to Type II Diabetes. Diabetes results in damage to both nerves and blood vessels. This damage not only can be painful, but also hinders the body’s ability to heal and can even result in amputations or other painful disabilities.

Various foods have different effects on the body. Some help decrease inflammation and pain. Some can help us to metabolize fat and lose weight.

As Orthopaedic Surgeons, we see the problems that result from bad eating habits. We realize that most people don’t know enough about what makes up a healthy diet. We also know that this is not our area of expertise. That is why we are happy to partner with The Delicious Dietitian. Since 2011, they have offered a FREE Wellness program for our patients.

To see how proper nutrition can Take A Bite Out Of Arthritis, join us at our July 10th wellness program nutrition seminar.

At the Delicious Dietician, they teach people about healthy foods and portions. They can help with proper diets for individual health problems. They can also teach you how to buy the best foods on a budget.

Healthy eating is a choice that impacts how we feel for the rest of our lives.  At AOC, we know that healthy people are more productive. We encourage our employees to improve their health and happiness by working with The Delicious Dietician.

 

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Return to Sports After ACL Reconstruction

 

One question often asked by athletes before they undergo ACL reconstruction is “When and will I be able to return to sports?” This is an important question because returning to play (RTP) is just one of the factors taken into consideration as to the decision to undergo this invasive procedure. The answer to this question depends on many factors: level of activity before the injury, extent of the damage inside the knee, and level of competition.

Namdari et al in The Physician and Sportsmedicine in February 2011 reported on a study of 18 WNBA basketball players who underwent ACL reconstruction. They found reported that 78% returned to play in the WNBA. For those that did return, changes in performance were not statistically reduced compared to a comparison group.

Shah et al reported in The American Journal of Sports Medicine in November 2010 on a group of NFL athletes who had ACL reconstruction.  This study of 49 NFL players who underwent primary (first-time) ACL surgery found that 63% returned to NFL game play at an average of 10.8 months.  They found that the odds of returning to play were higher for those with more than four years of NFL experience.  Furthermore, Shah et al found that those drafted in the first four rounds of the NFL draft had higher odds of returning to play than those drafted later. They concluded that more experienced and established athletes are more likely to return to competition at the same level after ACL reconstruction than those with less experience.

Return to sports two to seven years after ACL reconstruction was studied by Ardern et al and reported in The American Journal of Sports Medicine in January 2012.  This medium-term analysis of 314 patients with the average age of 32.5 years used a self-reported questionnaire to ask questions regarding knee function and attempt to RTP.  Adern et al found that 45% of participants reported playing sports at their pre-injury level and 29% were playing competitive sports. However, younger patients were more likely to return to pre-injury levels of participation, and most patients reported good postoperative function of their knee.

In a separate study reported in The American Journal of Sports Medicine in March 2011, Adern et al reported on RTP 12 months after ACL reconstruction in Australian athletes. These athletes in competitive level Australian football, basketball, netball, or soccer had a return rate to competitive sport of 33% at twelve months. However, 47% indicated in this short term study that they planned on returning.  Ardern et al concluded that people may require a longer rehabilitation period to return to competitive sports than previously believed.

As you can see just from these few studies here, more research is needed to provide patients with the answer of returning to play after ACL reconstruction. Currently, there is a wide range of answers depending on age, athletic ability, and lifestyle that has to be factored into this important issue.

 

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ACL Injuries. What ESPN doesn’t tell you.

 

Knee injuries in sports are a common occurrence. One dreaded injury is a tear of the anterior cruciate ligament (ACL). Most ACL tears occur after a non-contact injury such as a wide receiver or soccer player making a sudden change in direction. The leg planted on the ground during the cutting move may experience enough force to tear the ACL. Seventy percent of acute hemarthosis (blood in the knee) after such injury is an ACL tear.

Non-surgical treatment for complete ACL tears in young, active patients has generally been met with less than satisfactory results. Loss of the ACL can result in instability or the feeling that the knee is loose. The knee wants to “give way” when a change in direction occurs.  This instability can result in further damage to the knee and the C-shaped cartilages called the meniscus. Rebuilding the ACL and restoring stability to the knee can protect the meniscus from further damage.

There are over 400,000 ACL reconstructions a year in the United States. Much research has occurred and is on-going into different techniques and choices of tissue to use to rebuild the damaged ACL. Two of the more common tissue (graft) choices are hamstrings and patellar tendon.  Both are usually taken (harvested) from the same knee and used in the reconstruction process. Other options include quadriceps tendon and tissue that has been donated to tissue banks (allografts). There are pros and cons to each graft choice, but analysis of multiple recent studies show little difference in long term outcomes between hamstring and patellar tendon autograft (tissue taken from the same patient.)

In part two of “ACL Injuries in Sports” we shall discuss current data on the return to sports after ACL reconstruction.

 

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