Lipogems

What are lipogems? Lipogems injections are a new generation of treatment for orthopaedic conditions, including joint pain, arthritis, rotator cuff injuries and more. Lipogems injections are a minimally-invasive treatment that can offer an alternative to surgery, if deemed appropriate for your condition and injury. Lipogems are able to give support and cushioning to body tissue by using the cells in our fat that can aid repair and reconstruction of injured tissues. The cells in our fat that can do this include stem cells, pericytes and adipocytes. Why are lipogems injections used? Lipogems injections can provide an alternative solution to invasive surgery for people suffering from the following: Rotator cuff injuries Joint pain Lower back pain Tennis elbow Plantar fasciitis Patellar tendon tears Arthritis of the knee, hip, ankle or shoulders What do lipogems injections involve? During a lipogems procedure, a small section of fat is removed, using minimally-invasive techniques. This section of fat is then processed using the lipogems device which breaks down the fat, taking out the blood and other unwanted structures, leaving behind the selected reparative cells which are called the lipogems. The lipogems are then injected into the injury site. No general anaesthesia is required, just a local anaesthetic injection. The procedure lasts just an hour. How do you prepare for lipogems? This is a day-case procedure with no general anaesthesia. Before the procedure you may be advised to avoid food and drink for a duration, as well as halting use of any medications. This should be discussed with your specialist. Aftercare: It is normal to expect some pain, swelling and soreness following lipogems injection. However, this should only be moderate and can be managed with rest and painkillers. More strenuous activities can be resumed 1-2 weeks following the procedure, and improvements should be seen from two to eight weeks following the procedure. Results will however depend on the original severity of the injury being treated. Improvements are also dependent on participation in physical therapy. Alternatives to this treatment: There are alternative treatments for joint pain, tendon injuries and arthritis, ranging from other minimally-invasive procedures, such as injections, to invasive surgeries like a total knee or hip replacement. The best treatment for you should be determined with a specialist orthopaedic surgeon. ...

Sports injuries

What are sports injuries? Competitive and non-competitive sports injuries are injuries that occur in athletic activities or whilst exercising. Whilst some of these happen by chance, others are facilitated by inadequate practice or poor execution in terms of technique, as well as by not using sports equipment correctly. Sports injuries mainly consist of muscle injuries or joint and ligament injuries: Dislocations; Muscle injuries (sprains, pulled muscle, cramps); Knee or ankle sprain; Back injuries Bone fractures; Tendon injuries. Prognosis: The outlook of a sports injury greatly depends on what caused it and its severity. Imaging tests (ultrasound, MRI scan) can rule out structural injuries and help to assess the severity of the injury itself. Furthermore, based on the results, the specialist can estimate how long it will take for you to recover and get back to sports, as well as your risk of getting injured again. What are the symptoms? The symptoms of a sports injury depend on how big and how severe the injury is. They usually are: Immediate onset of pain; Stiffness of the affected muscle; Swelling; Bruising; Increased sensitivity of the affected area; A feeling of heat emanating from the affected area; Decrease in range of motion. How are they diagnosed? Sports injuries, especially muscular ones, can be diagnosed with a physical examination. The following tests may be prescribed to get further insight on where the injury is and how severe it is: X-ray scan; Computed tomography (CT) scan; Magnetic resonance imaging (MRI) scan; Ultrasound scan; Bone density scans. What causes them? As an example, the main risk factors for a football injury are: Not having exercised enough; Muscle fatigue; Age; Cold or wet weather; Poorly maintained training field; Quicker execution and overall rhythm of the game; Doing a movement too fast; A different or new training technique; Stumbling upon another player; Playing too fast or too slowly, without having warmed up adequately; Inadequate training program; Poor execution; Eating an unhealthy diet; Not resting enough. How can they be prevented? The main preventive measures are: Ensure you warm-up adequately; Eat a healthy diet; Stay hydrated; Use proper equipment; Wear good sportswear and shoes. How are they treated? Treatment largely depends on how severe the injury is. It usually consists of physical therapy, surgery, applying ice packs, taking painkillers or anti-inflammatory medications and bed rest. Which doctor should I talk to? You should see a specialist in sports medicine, but you may also be treated by physiotherapists and orthopaedic surgeons, depending on your treatment plan and injury. ...

Achilles tendon

What is the Achilles tendon? The Achilles tendon, also known as the calcaneal tendon, is the tendon that connects the calf muscle on the back of the leg to the heel bone. It is a tough band of fibrous tissue that allows the calf muscle to move the foot and is essential for walking, running and jumping. It is the strongest and largest tendon in the body, allowing it to withstand the tension caused by movement and to bear the weight of the rest of the body. In spite of this strength, the constant high tensions it endures and its limited blood supply mean that it can suffer from several injuries and conditions. What conditions affect the Achilles tendon? Achilles tendinopathy – tendinopathy is a general term for diseases of a tendon. Achilles tendinopathy encompasses Achilles tendonitis and tendinosis. Achilles tendonitis – an inflammatory condition caused by gradual wear and tear of the Achilles tendon due to repetitive strain or sometimes by a sudden injury. It usually manifests as pain and/or stiffness at the back of the heel where the tendon connects to it. It can take weeks or even months to heal. The RICE technique (rest, ice, compression, elevation) may help to speed up recovery, but sometimes further treatment, such as physical therapy or even surgery in certain long-term cases may be required. Achilles tendinosis – a gradual thickening and stiffening of the Achilles tendon with no apparent inflammation. Although it becomes thicker, the tendon is actually left more vulnerable to injury due to micro-tears caused by repetitive action. Symptoms include long-term pain, similar to tendonitis. Tendinosis is degenerative. Achilles tendon rupture – a severe injury, the tendon actually snaps, causing excruciating pain and permanent disability if left untreated. Ruptures are uncommon, occurring more often in middle-aged and older people, as in younger people, the muscles tend to tear before the tendons do. Achilles tendon ruptures may result from direct trauma, landing awkwardly after a fall or jump, or strenuous physical activity if you are not physically conditioned for it. You may hear or feel a pop and will likely be unable to bear weight with the affected foot. You should head for the emergency room immediately if this occurs. Treatment may involve the RICE procedure, immobilising the foot for 4-8 weeks, or reattaching the tendon surgically. Achilles peritendonitis – similar to tendonitis, but the inflammation affects the tissue around the tendon a few inches above the heel, rather than the tendon itself. Achilles bursitis – the bursa is a sac of fluid that cushions the tendon where it meets the heel. This can be irritated, for example by low-riding shoes, which can cause pain. Medical tests to diagnose problems with the Achilles tendon There are several ways to test for Achilles tendon issues: Physical examination – most cases are diagnosed by the doctor physically examining the patient’s leg and heel, checking for pain, swelling, warmth, discolouration, thickening, or the presence of knots or lumps along the tendon. Thompson test – the patient lies on their stomach while the doctor squeezes their calf. The foot should move down in response if the tendon is attached. If not, it may indicate a rupture. MRI – magnetic resonance imaging scans can show detailed images of the condition of the tendon, and is useful for diagnosing ruptures. It may not be able to show tendinitis or tendinosis, however. Ultrasound – these scans use sound waves to create images and can often identify ruptures. CT scan – multiple X-rays are taken to scan the patient. However, MRIs are superior in identifying Achilles tendon problems, so CTs are used less frequently for this end. Which type of specialist treats the Achilles tendon? Orthopaedic surgeons, particularly those specialising in foot and ankle problems deal with all sorts of conditions affecting the Achilles tendon. ...

ACL reconstruction

What is ACL reconstruction? The anterior cruciate ligament (ACL) is a band of connective tissue within the knee which, when over-stretched can get damaged and tear. This can happen during exercise, or with a sudden turn or movement. The ACL helps to keep the knee stable, and when it is damaged you are unable to play sports or to walk properly. Although a damaged ACL can repair over time, if it is badly torn it will require reconstruction. ACL reconstruction surgery replaces the torn ligament with new tissue, and it is usually performed arthroscopically, using specialist tools that are inserted and guided by a camera through very small incisions. Why would you need ACL reconstruction? ACL reconstruction surgery will be recommended if the patient has badly torn the ligament, or if the patient is young, active and wishes to continue playing sports and being active. Older, less active patients will often be recommended non-surgical treatments. ACL reconstruction also prevents further, worse damage happening to the knee cartilage. What does ACL reconstruction involve? During ACL reconstruction, the torn ligament is removed and replaced with a graft of new tissue. This tissue is taken from the patient’s body, such as the hamstring tendon, or the kneecap tendon (patellar tendon). Sometimes a donated tendon can be used too. The surgeon will drill two holes, called ‘tunnels’ so that the new tendon can be anchored in place. One ‘tunnel’ will be placed above the knee, and the other below it. With time, a new ACL will grow as the knee heals. How to prepare for ACL reconstruction Before surgery, the knee is shaved if necessary, any jewellery is removed and a hospital gown is worn. Anaesthesia for ACL reconstruction can either be regional or general. Post-operative care After surgery, you will stay in a recovery room for a few hours, until the anaesthesia has worn off. Afterwards, you can return home and rest. You will be given crutches to help with mobility and to keep pressure off the knee. Depending on your job, it is possible to return after just one week post-surgery. For more physical jobs, sometimes one to four months rest can be required. Intensive exercise is only recommended 6-8 months after surgery. During recovery, physical therapy exercises will help to restore strength to the affected knee. ...

Anterior cruciate ligament

What is the anterior cruciate ligament? The anterior cruciate ligament (ACL) is a bundle of collagen fibres that extends obliquely between the femur and the tibia. It inserts into the knee joint and, although small in size, it has a very important function. The anterior cruciate ligament (front) and the posterior cruciate ligament (back) cross each other forming an "X". Function of the anterior cruciate ligament The anterior cruciate ligament and the posterior cruciate ligament form the central axis of the knee and allow the tibia to move over the femur. Its functions are to: Prevent the forward movement of the femur over the tibia Give stability to the knee when rotating. It is, therefore, the most important element in preventing anterior displacement of the tibia, by limiting tibia rotation and internal and external angulation of the knee when stretched. Pathologies of the cruciate ligament The cruciate ligament is the most frequently injured of all ligaments. Any sudden change in the direction of the knee, or sudden stops, can cause injury. As a result, it is a common sports injury. In fact, two-thirds of anterior cruciate ligament injuries are sports-related, with young people being the most affected. Some examples include: landing awkwardly on the leg after a jump or stopping abruptly when running. These injuries occur more frequently in women since their anatomical characteristics are different to those of men: women have greater joint laxity, a wider pelvis that influences the external rotation of the tibia and a smaller patellofemoral groove (where the anterior cruciate ligament is located in the knee). One of the more serious injuries is rupture of the anterior cruciate ligament, which can cause instability in the knee and give the sensation of it not being able to support your weight, swelling of the joint, difficulty in supporting the leg or limited bending and stretching of the leg. There may also be achronic anterior cruciate ligament deficiency as a result of a previous tear or elongation or stretching caused by a previous trauma to the knee. When these injuries occur, whether rupture or chronic deficiency, they allow abnormal rotation and translation of the tibia. As a result, running and walking can damage the meniscus and cartilage. Osteoarthritis will develop if the bones and cartilage rub together without protection, resulting in pain and an inability to walk. Treatments for anterior cruciate ligament pathologies An anterior cruciate ligament injury cannot heal on its own. The orthopaedic surgeon will decide whether or not surgery is necessary. Non-surgical treatment is usually recommended if: You are elderly and have a low level of physical activity You have a good knee stability and do not engage in much physical activity There are no other injuries that require further treatment, such as a torn meniscus, ligaments or cartilage. Non-surgical treatment involves prolonged rehabilitation in order to strengthen the muscles of the quadriceps and hamstrings. A knee brace will also be needed for some sports activities or for walking. You may also need to change the type of sports you do as well as the level and intensity of the sports activities. If these treatments are not suitable for you or your type of injury, then surgery will be recommended, which will enable the full recovery of the joint. Thus, people with a recent ligament tear and an active lifestyle, those with chronic ligament deficiency that destabilises the knee (damaging the meniscus and cartilage), and people with an anterior cruciate ligament tear who practice impact sports may be candidates for anterior cruciate ligament surgery. If they do not have surgery, they may be unable to return to their sporting activity due to the instability of the knee and possible associated injuries to the meniscus, ligaments or cartilage. Anterior cruciate ligament surgery is usually performed using arthroscopy. This allows the injury to be approached through two or three incisions of less than 1 cm. The damaged ligament is removed, so it needs to be replaced with a graft. This graft will come from your own body, from the injured knee. The graft is inserted through a tunnel made in the tibia and the femur. The graft will heal to the bone tunnel several weeks after implantation, so the graft must first be fixed to it. This can be done using titanium screws (at the ends of the graft) or bioabsorbable screws, among others. The specialist will immobilise the knee after the operation. The next day you will be able to move the joint gradually. You are then ready to start rehabilitation sessions with a physiotherapist in order to restore mobility. Which specialist treats anterior cruciate ligament pathologies? Orthopaedic surgeons treat anterior cruciate ligament injuries. ...

Arthritis

What is arthritis? Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types of arthritis, but the most common are: Osteoarthritis: the most common type of arthritis. It usually starts with age and affects the fingers, knees and hips. In some cases, it develops in areas where there was a previous hit or injury. Inflammatory arthritis: There are many types of inflammatory arthritis, the most common of which is rheumatoid arthritis, which occurs when the body's defenses do not work properly. It affects both joints and bones, often in the hands and feet. What are the symptoms of arthritis? The symptoms of arthritis can be: Joint pain Joint inflammation Redness and heat of the skin around the joint Decreased ability to move the joint Joint stiffness, especially in the morning What are the causes of arthritis? This pathology can be a consequence of: Bone fracture Autoimmune disease Infection by bacteria or viruses Joint wear Crystals (such as uric acid or calcium pyrophosphate dihydrate) Can arthritis be prevented? Joint damage can be prevented with timely and adequate diagnosis and treatment. Also, if someone has a family history it is important to talk with the doctor, even if s/he does not have any symptoms. It is also recommended to avoid repetitive and excessive movements to prevent osteoarthritis. What is the treatment for arthritis? The treatment aims to alleviate the symptoms and prevent the disease from getting worse. The treatment can be covered by several aspects: Lifestyle changes: this is the preferred treatment, since exercises help to reduce pain and fatigue, relieve stiffness and improve muscle and bone strength. The doctor can also recommend physiotherapy. Other measures may include sleeping 8-10 hours a day, not staying in the same position for a long time, eating a healthy diet, avoiding alcohol and tobacco, among others. Medicine: can be added to the changes in lifestyle. Surgery: is performed if the other treatment methods have not worked. The main intervention is arthroplasty, which consists of replacing the affected joint with an artificial one. ...

Arthroplasty

What is arthroplasty? The term “arthroplasty” refers to any surgical procedure to restore the function of a damaged joint, often by replacing them with artificial joints made of chromium, cobalt and titanium, along with high density plastics. The ultimate aim of arthroplasty is to correct deformities, reduce or eliminate pain in the affected areas, and restore mobility. Arthroplasty is commonly performed on the hip, knee, elbow, shoulder, and ankle, among others. Different types of arthroplasty include: Joint replacement – the damaged joint is removed and replaced with a prosthesis. Hip replacements and knee replacements are the most common. Interpositional arthroplasty – tissue, such as skin or muscle is interposed to keep inflammatory surfaces from rubbing together. Excisional arthroplasty – bone is removed from the surface of the joint to stop the bones making contact. Scar tissue is left to fill the gap. Resurfacing arthroplasty – the surfaces of the bones at the joint are replaced with a smooth, protective metal coating. Why is arthroplasty done? Arthroplasty is carried out to replace the damaged joint with a healthy one, allowing the patient to live a full and active life with adequate mobility. Arthoplasty may become necessary due to: Rheumatoid arthritis Osteoarthritis Osteoporosis Osteonecrosis Misaligned joints (often due to traumatic injury) What does arthroplasty consist of? Arthroplasty procedures are carried out under general anaesthetic. The patient’s heart rate, blood pressure, breathing, and blood oxygen are monitored, while the surgeon makes an incision and removes and/or repairs the damaged parts of the joint, before closing the incision with stitches. The process of placement of the prosthesis will be different depending on the type of joint replacement. Preparation for arthroplasty No special preparation is required for arthroplasty, other than notifying the specialist of the possibility of being pregnant and the medication the patient is taking, which may be strong in cases of rheumatic diseases and may need to be stopped or changed prior to the operation. Care after the intervention After the intervention, the patient may feel pain, which is normal in any intervention. In case of pain, the specialist will recommend the best treatment. During the hospitalisation, specialists will soon begin to move the joint, so that recovery is as effective as possible and the patient regains mobility as soon as possible. After being discharged from the hospital, the patient must go for rehabilitation for a few months to fully recover the mobility of the joint and also to check that make sure that the prosthesis is functioning properly. ...

Biological therapy

Biological therapy involves using living organisms, or substances derived from living organisms, in the treatment of diseases.

Bow legged

What is it? Genu varum, which is commonly known as bow leggedness, is the term used for a postural deformity in which the knees are separated when the ankles are touching. This results in the knees bending outwards. It is very common in children aged between 1 and 2 years old, especially if they have started walking early. It normally spontaneously resolves when they are around 3 years old (physiological genu varum). If this doesn’t happen, if there is a degree of bowing, or if there is a bone disease, corrective surgery should be carried out lo regain alignment. What does surgery do? Treatment for genu varum aims to: Lengthen distended ligaments and the inner leg muscle. Strengthen and build up the: gluteus maximus, gluteus medius, abductors, tensor fascia lata, femoral biceps, quadriceps external vastus, fibula, sural triceps, and the common toe extensor. Achieve adequate knee balance to reduce the menisci load. Achieve as much symmetry as possible. Prevent potential pelvic problems. Prevent spine deformities in the sagittal and frontal planes. Increase standing resistance. Avoid other injuries. Improve walking posture. What does it involve? Generally, the surgery performed to correct bow legs is an osteotomy. During this procedure, a bone is cut either to shorten or lengthen it, or to change its alingment entirely. Osteotomy is generally used to reshape the bones and it is a complex type of surgery. The surgeon makes a cut in the skin and uses wires to measure the bone, then take out or re-align the bone according to the desired length/position. In order to hold the bones in place, the surgeon may use tiny screws and a metal plate, which sometimes must stay in your body permanently, but sometimes can be removed after the bones have re-aligned. Post-treatment care After the operation, you may be in a wheelchair for 3 to 4 weeks. After this, crutches will need to be used until you are able to walk unaided. You may need to stay in hospital for a few days so the specialist can monitor your progress. For patients over 35 years old, rehabilitation takes at least 4 months. If there aren’t any complications, when the mobility aids are no longer used, the patient should not physically exert themselves for about two months. ...

Bursitis

What is bursitis? Bursitis is the inflammation or painful irritation of fluid-filled sacs called bursas, most commonly affecting the hips, shoulders, elbows, and knees. The function of these sacs is to help the normal movement of the joints and avoid direct friction between them. Bursitis can affect any of the joints in the body. There are two types of bursitis: acute and chronic. Acute bursitis causes pain, swelling, and warmth in the area of the bursae, and usually happens when the bursae are injured, stretched, or compressed. Chronic bursitis can re-occur and may last for several months, coming in bouts, which can last from a few days to weeks at a time. What are the symptoms? The characteristic symptoms of bursitis are pain and inability to carry out certain exercises or movements usual in daily life. The symptoms may appear suddenly or progressively, something that the patient feels through movement or by touch, as the skin surrounding the bursa is more sensitive than usual. The symptoms depend on the affected area, but the most common are: joint pain and sensitivity when pressing the area near the joint stiffness and pain when moving the injured joint redness, swelling and tenderness in the joint What causes bursitis? Bursitis may be caused by repetitive motion in the joint, or repeatedly putting the joint in certain positions which create pressure on the bursae, such as kneeling down for long periods of time (e.g while cleaning). Bursitis can also be caused by trauma or injury, and by other inflammatory conditions such as gout, or arthritis. Can it be prevented? Bursitis may be prevented by avoiding repetitive movements which put strain on the bursae. Another preventive measure is to strengthen the muscles that surround the joint or warm up the area with exercises before starting any physical activity. What is the treatment? In most cases the bursitis disappears without applying any specific treatment. The specialist will focus on reducing pain and inflammation to the patient by prescribing anti-inflammatories or corticosteroids. In case of acute bursitis without infection, the patient should avoid overexertion, limit certain movements and apply ice in the damaged area to reduce swelling. If chronic bursitis occurs, the treatment is similar, although due to the fact that rest is not effective, more aggressive and direct methods such as intensive physiotherapy or corticosteroid injections should be used. In case of infection, the accumulated fluid should be removed and a corticosteroid treatment be followed. ...

Cartilage repair

What is cartilage repair? Cartilage is the smooth, white tissue that covers the surface of joints. It reduces friction and acts as a shock absorber. Cartilage damage can occur as a result of a sudden injury, a sports injury or wear and tear (osteoarthritis). Cartilage damage can affect the hips, ankles and elbows, but is most common in the knees (articular cartilage). Minor injuries can heal on their own, but severe cartilage damage will require surgery. Cartilage repair is the repair, regeneration or replacement of damaged cartilage with surgical techniques if cartilage doesn’t heal on its own or with the use of physical therapy and medication. Why is cartilage repair carried out? Cartilage repair is carried out to restore damaged cartilage around joints, relieve pain and stiffness and restore joint function and mobility. It can also delay or prevent the onset of arthritis. What does cartilage repair involve? Before surgery is an option, some people heal well with rest, elevation of the damaged joint, physiotherapy and the use of NSAID’s. However, sometimes surgery is needed if the cartilage damage is too great. Most procedures to restore articular cartilage are done with arthroscopic surgery. The most common surgical procedures to restore cartilage are: Microfracture Microfracture stimulates the growth of new cartilage and can be done with an arthroscope(an endoscope placed into the joint through a small incision). A sharp tool (awl) is used to make a number of holes in the bone under the cartilage, called the subchondral bone. This allows a new blood supply to reach the joint, bringing new cells that will form new cartilage. Drilling Drilling stimulates the growth of new cartilage by making small holes in the bone below the cartilage, using a surgical drill. This procedure can also be carried out with an arthroscope. Abrasion Arthroplasty This procedure can be done with an arthroscope and is similar to drilling. Burrs are used to make incisions into the bone, the damaged cartilage is removed and new cartilage is generated in the healing process. Autologous Chondrocyte Implantation This procedure involves removing healthy cartilage tissue which contains healthy cartilage cells. These are then sent to a laboratory to be multiplied. This procedure is done with an arthroscope. Open surgery or an arthrotomy is then carried out to implant the new cells into the damaged cartilage. ACI is used more for younger patients and it can take a number of weeks. Osteochondral Autograft Transplant A graft of healthy cartilage tissue and bone is transferred from one part of the joint that doesn’t bear weight to the damaged part of the joint. This operation is good for small joint injuries and can be done with an arthroscope. Osteochondral Allograft Transplant This procedure requires a larger incision and is used for bigger injuries. The allograft is a block of cartilage and bone and unlike the autograft transplant, the cartilage is taken from a donor, rather than the patient themselves. Stem cells Although the application of stem cells to stimulate the growth of new cells and cartilage is still under investigation, current research is focused on this. Mesenchymal stem cells, from living human tissue, when placed in a certain environment can generate new cells. How can I prepare for cartilage repair? Your doctor will decide on the best surgical procedure for you, based on your age, medical history and degree of cartilage damage. There is no preparation for cartilage repair procedures, apart from resting the damaged joint and offloading any unnecessary weight before a procedure. What does post-operative care involve? Post-surgery, if the surgery was done on the knee, you may have to use crutches to offload any extra weight from the joint to allow it to heal. Physical therapy may be advised to reduce stiffness and increase mobility. Sometimes continuous passive motion therapy is used. Recovery from an arthroscopy is much quicker and less painful than open surgery. It is normal for a full recovery to take several months. ...

Chondrocalcinosis

Chondrocalcinosis is the excessive accumulation of calcium crystals in the bones. The condition affects mostly the knees, although it is also common in other joints and bones. Normally it does not cause any symptoms or discomfort in the patients, therefore it is discovered when the patient has an x-ray. The main evidence of chondrocalcinosis is the existence of a white line in the cavities at the ends of the bone....

Chondromalacia (runner's knee)

What is chondromalacia? Chondromalacia, also known as runner’s knee, refers to a condition where the surface of the cartilage on the undersurface of the kneecap (the patella) deteriorates over time. Runner’s knee is common among young adults, especially those who practice certain sports that have a great impact on the knees such as basketball, volleyball, football, cycling, tennis, ballet dancing and running. What are the symptoms? Runner’s knee typically presents through pain felt in the area around your knee. When bending or extending, you may also notice a grinding or cracking sensation in the knee. The pain may worsen during exercise or after much strain has been put on the legs (e.g after standing for long periods of time). Pain may also get worse after sitting for extended periods of time. What causes runner’s knee? The causes of runner’s knee vary but the condition can be the result of an injury to the patella, or a result of friction between the patella and the femoral joint when moving the knee. Abnormal rubbing can be caused by: Trauma to the kneecap Repeated movements or repeated stress being placed on the knee joints Weak hamstrings and quadriceps Certain congenital conditions which result in poor alignment of the joints Age, gender, and previous injury to the kneecap are all factors which increase the risk of developing runner’s knee. Women are much more likely than men to develop the condition, and young adults are also at a higher risk, thanks to rapid growth spurts which can cause muscle imbalances. Can it be prevented? The risk of developing runner’s knee can be lessened by taking certain measures such as wearing kneepads while playing sport to support the joints and muscles. If you have flat feet, shoe inserts can be used, which help to correct the arch in the feet and decrease the pressure placed on the knees. Being overweight may also be a risk factor, and maintaining a healthy body weight helps to reduce stress and pressure on the joints, thus decreasing the risk of runner’s knee and other stress-related conditions developing. What is the treatment? The choice of treatment will depend on the cause of the injury. Treatment is designed to reduce pressure on the kneecap and on the joint, and the damage caused may indeed repair itself with rest. Physical therapy may also be prescribed, which can help to improve muscle strength and restore balance. If there is pain and tenderness in and around the joint, your doctor may prescribe anti-inflammatories to help reduce the pain and swelling. Common treatment of runner’s knee makes use of the R.I.C.E method (rest, icing, compression, elevation) at first to deal with the initial symptoms, then moving on to other treatment options such as physical therapy, patellar braces, shoe inserts, or taping around the patellar if rest and therapeutic exercise does not resolve the problem. Most cases can be treated without surgery, but in very rare cases, it may be used to help restore the joint and re-align the knee. ...

Epicondylitis (tennis elbow)

What is lateral epicondylitis? Lateral epicondylitis, also known as tennis elbow, is an injury that causes pain on the outside of the elbow. It is due to repeated wrist extension and forearm supination movements. Repeated use of these muscles causes microinjuries to the tendon. If this persists over time, irritation and pain develops on the outside of the elbow. Although commonly known as tennis elbow, this condition is suffered not only by tennis players but also by anyone who performs work that involves repetitive stretching and flexing movements of the forearm and wrist; for example, professional painters, mechanics, labourers or those who work long hours in front of a computer using a mouse. Prognosis of the disease Lateral epicondylitis is not a very serious injury, though it can significantly affect your life. Most people improve with non-surgical treatments and the condition can even be cured. Symptoms often persist for several months before the condition is completely cured. Symptoms of lateral epicondylitis Lateral epicondylitis is characterised by the following symptoms: pain and movement difficulties when extending the wrist pain on the outside of the elbow pain with some basic movements, like lifting a cup of coffee This pain does not go away with rest or by applying local cold or taking anti-inflammatories. Medical tests for lateral epicondylitis Every trauma specialist should perform a thorough evaluation in order to diagnose lateral epicondylitis. Among other procedures, this will include: a visual exam to check the appearance of the skin, possible swelling of the area, and to make sure the joint is aligned properly using the hands to feel the area and evaluate pain a "chair test", which entails lifting a chair with the palm of the hand facing downwards and the elbow in extension. Pain usually prevents this action from being performed Pain assessment, by extending the fingers and wrist against resistance, and extending the middle finger against resistance with the elbow extended other assessments of pain and mobility such as the Mill’s manoeuvre Can it be prevented? Lateral epicondylitis can only be prevented with careful “postural hygiene”. Proper movements during sport and work will ensure that the tendons are not subjected to excessive stress. Resting your elbow well after a busy session can also help prevent epicondylitis. Stretching and preventive massages, as well as elbow pads, are helpful. Treatment for lateral epicondylitis Treatment for an injury of this nature should be gradual and depend on the severity of the injury. Initial recommendations include: nonsteroidal anti-inflammatory drugs, oral or topical. resting the elbow, reducing activities that cause pain and reducing the duration and intensity of exercise. physiotherapy and application of local heat, massages, shock waves, ultrasound, as well as exercises and techniques. If these measures are not effective, the following will be recommended: Local corticosteroid infiltrations or injections (with or without anaesthetic). These can improve pain for a period of time and stimulate healing when injected near the affected area. In some cases, three infiltrations are performed at 1-2-week intervals. However, infiltrations are usually limited to three, as there is a slight risk of rupture of the tendon and tendon insertion. At present, platelet-rich plasma infiltrations are also used. Limiting movements or activities that cause epicondylitis. In this respect, a study of your workplace should be carried out, which will be key to a successful cure. You should also reduce the practice or play intensity of racquet sports. If the above treatments also prove ineffective and you still suffer from the symptoms and pain of epicondylitis, surgery will be the next option. Surgery can be performed with an open incision, or using arthroscopy. Arthroscopy is currently the most commonly-used technique as it gives access to the lesion, with a miniature camera, through two or three small incisions. This technique is minimally-invasive, so recovery is faster and less painful. Which specialist treats it? Epicondylitis is treated by a trauma specialist, who usually has specific training in the treatment of elbow pathologies. Other professionals may be involved during recovery from an epicondylitis injury, such as physiotherapists, who will provide practical exercises to restore movement, and orthopaedic surgeons, to repair the tendons in the elbow when other treatment approaches have failed. ...

Femoro-acetabular impingement

What is femoroacetabular impingement? Femoroacetabular impingement (FAI) is a condition in which extra bone grows along one or both of the bones that form the hip joint, which leaves the bones in an irregular shape. As the bones are irregularly shaped and do not fit together, they rub against each other during movement. This can cause damage to the joint, creates pain and can limit activity. What are the different types of femoroacetabular impingement? There are three different types of FAI, which are known as: • Pincer – this occurs because extra bone extends over the normal rim of the acetabulum. This crushes the labrum under the prominent rim of the acetabulum. • Cam – In cam impingement the femoral head is not round and therefore cannot rotate smoothly inside the acetabulum. The edge of the femoral head grinds the cartilage inside the acetabulum. • Combined – this mean that both the pincer and cam types are present. What causes femoroacetabular impingement? It occurs because the hip bones do not form correctly during the childhood growing years. When the hip bones are shaped abnormally, there is little that can be done to prevent femoroacetabular impingement. What are the symptoms of femoroacetabular impingement? The symptoms of FAI include: • Pain • Stiffness • Limping How is femoroacetabular impingement diagnosed? During an examination with a specialist, the doctor will perform an impingement test. Your knee will be brought up towards the chest and rotate it inward towards the opposite shoulder. If this causes hip pain then it tests positive for impingement. Imaging tests such as an X-ray, CT and MRI scan will also help determine whether you have femoroacetabular impingement. What is the treatment for femoroacetabular impingement? Nonsurgical treatment may involve taking anti-inflammatory medications, changes to any activities that may cause symptoms and physical therapy. If symptoms are not relieved through nonsurgical treatment, surgery may be recommended using the arthroscopy procedure. Surgery can successfully reduce symptoms and correcting the impingement can prevent further damage to the hip joint. Not all of the damage can be completely fixed by surgery, especially if treatment has been delayed. ...

Ganglion or cyst

What is a ganglion cyst? A ganglion cyst is a benign but painful growth, usually on the hand or wrist. The pain often comes on at night, or after constant use of the hand. Ganglion cysts can vary in size, growing up to three centimetres wide. While the position of the cyst doesn’t tend to change, the size may fluctuate over time, and some go away entirely without treatment. Can a ganglion cyst be cured? As previously mentioned, ganglion cysts sometimes go away on their own. If the cyst persists, treatment may be recommended to reduce the size or attempt to remove it completely. Unfortunately if the cyst is removed there is still a chance that it will come back, and you may need further treatment. What are the symptoms? Cysts usually form a visible nodule, although in some cases if the cysts are small they may not be noticeable. Many of them have no symptoms, but if they do press on a nerve, it can cause pain, tingling and muscle weakness. How is a ganglion cyst diagnosed? Usually a ganglion cyst can be diagnosed by your GP with a physical examination. They may use a syringe to draw out fluid from the cyst. In some cases, they might refer you for an ultrasound or MRI to look at the inside of the lump and rule out other potential causes. What causes a ganglion cyst? The cause of ganglion cysts is unknown. They have been found to be more common in young people between the ages of 15 and 40 and to develop more in women. It is also more likely to be developed by people who use and overload the wrist. People who have arthritis may develop them more easily. Can ganglion cysts be prevented? At the moment it is not clear how to prevent ganglion cysts. The best thing to do is to see you doctor early on if you notice anything unusual. How are ganglion cysts treated? For many people, treatment will not be necessary especially if there is no associated pain. The main job of the GP will be to reassure you that the lump is not caused by anything more serious. However, if the cyst is causing you pain the GP may recommend treatment. The two main forms of treatment for ganglion cysts are: aspiration – this involves using a syringe to take fluid out of the cyst, then anti-inflammatory medication on the remaining bump. surgery – the normally recommended if the cyst is pressing on your nerves and causing pain, with the possibility of permanent nerve damage. Surgery is a more complex treatment and may involve putting your hand in a splint for several days afterwards. However, it tends to result in fewer recurrences of the cyst compared to aspiration. ...

Hip

What is the hip? The hip is the joint where the thigh bone (femur) and the pelvis meet. It has two main parts: The “ball” at the end of the femur. The “socket” cavity in the pelvis. The hip is a spheroidal or “ball-and-socket” joint in which the ball of the femur fits inside the socket of the pelvis. As a result, the hips are very stable and permit a wide range of movement. The hip has a complex structure, owing to the weight it must bear and the essential function it performs. It is composed of: An extensive set of bones Ligaments Vessels Muscles What is the function of the hip? The hip is the joint that unites the upper body with the lower body. Therefore, its correct functioning is fundamental in allowing our body to move correctly. The hip is designed for mobility as well as stability. It enables the lower limbs to move in three planes, and also provides an important shock-absorbing function for the lower limbs and the upper body. What diseases affect the hip? Some of the diseases and conditions that can affect the hips are: Osteoarthritis of the hip Arthritis of the hip Hip fracture Congenital hip dysplasia Epiphysiolysis of the femoral head Snapping hip syndrome Hip dislocation Trochanteric bursitis Hip joint distension Treatment of hip problems can include rest, medications, physiotherapy or surgery, including hip replacement surgery. ...

Hip prosthesis

Hip prosthesis is a major surgery technique that involves replacing the damaged hip with an artificial joint. The characteristics of the materials used in this type of prosthesis allow mobility similar to that of the human joint. The materials used in these implants include: various metals such as stainless steel, cobalt, chromium and titanium alloys; plastic, usually polyethylene, a very durable and friction wear-resistant material. Hip replacement is recommended in cases of osteoarthritis of the joint or rheumatoid arthritis. ...

Hoffa's syndrome

What is Hoffa’s syndrome? Hoffa’s syndrome, also known as infrapatellar fat pad syndrome, is a problem which affects one of three pads of fatty soft tissue that lies under the kneecap (patella) and leads to pain at the front of the knee. The Hoffa’s fat pad acts as a protective cushion, which separates the kneecap from the shin and thigh bones. If this becomes pinched, squashed or damaged, it becomes swollen, inflamed and sore. It increases in size after it has become swollen, and is more likely to get pinched again. This cycle can lead to a lot of pain the front of the knee that is hard to get rid of. What causes Hoffa’s syndrome? Hoffa’s syndrome can happen for a number of reasons. It could be caused by a sudden injury, such as a direct hit to the knee. It tends to gradually develop over time if the knee is repeatedly extended. This is when the knee is forced beyond its fully straightened normal position. The patient may have a history of being able to over-straight the knee, which is known as hyperextension. Other causes include tight quadriceps, forward tipping of the pelvis or a history of osteoarthritis in the knee. What are the symptoms? The symptoms of Hoffa’s syndrome include pain at the front and side of the knee. This is often hard to pinpoint and there has been no clear injury. Activities such as climbing the stairs, or even sitting with the knee bent are painful. In some cases there is a background ache and occasional jolts of sharp pain. Generally, there is swelling below and around the knee, pain in straightening the knee, or with prolonged walking. How is Hoffa’s syndrome diagnosed? A physiotherapist, orthopaedic specialist, or sports doctor will look for the symptoms mentioned above. They will perform a clinical examination called Hoffa’s test, which involves moving the kneecap after the patient contracts the quadriceps muscles. How is Hoffa’s syndrome treated? Hoffa’s syndrome is treated by firstly calming down the inflammation and secondly stopping the pinching and squashing. This can be achieved with rest and medicines. Further treatments include taping the knee and strengthening exercises. It may be advised to see a sports medicine professional, such as a physiotherapist or an orthopaedic surgeon. The specialist can apply a small anti-inflammatory injection to the fat pad, to calm the inflammation and to physically shrink the Hoffa’s fat pad. If the condition is severe then up to three injections are needed. Surgery is not usually a recommended treatment for Hoffa’s syndrome but in rare cases, a gentle minor surgery to trim out some of the inflamed fat pad can be performed. ...

Inflammatory arthritis

What is inflammatory arthritis? Inflammatory arthritis is one of the two major sub-categories of arthritis (the other being osteoarthritis), and, as its name suggests, it is characterised by the inflammation it causes in the joints and surrounding tissue. Most forms of inflammatory arthritis are thought to be autoimmune diseases. There are many different types of inflammatory arthritis, including the following: Rheumatoid arthritis – one of the most common types of arthritis, this autoimmune disease is thought to be caused by the body’s immune system attacking the joints. Psoriatic arthritis – a type of arthritis that may develop alongside the skin condition psoriasis. Ankylosing spondylitis – inflammatory arthritis primarily affecting the spine and back, AS can cause pain anywhere between the buttocks and the neck. The vertebrae may fuse together, robbing the spine of its flexibility. Juvenile idiopathic arthritis – the most common type of arthritis that affects children. Lupus can also have arthritic effects on the joints. What are the symptoms of inflammatory arthritis? The main symptoms of inflammatory arthritis are: Pain in the joints and surrounding tissue Swelling and tenderness Warmth in the affected areas Joint stiffness, particularly in the morning. These bouts of stiffness typically last longer than in osteoarthritis. Depending on the type of inflammatory arthritis, other parts of the body might be affected, causing additional symptoms, such as: Skin rashes Inflammation of the eyes Hair loss Fever Dry mouth What causes inflammatory arthritis? The causes of inflammatory arthritis are not fully understood, but most forms are thought to autoimmune. This means that the body’s own immune system mistakenly attacks healthy cells in the body’s tissues, wrongly identifying them as a threat. It is not understood why the immune system turns on the body it should be protecting in this way, but it is believed that genetics are a factor, along with other triggers, which may differ depending on the disease. What is the treatment for inflammatory arthritis? While the condition cannot be cured, inflammatory arthritis can be managed and its symptoms relieved. The aim is to improve physical function, reduce long-term complications, prevent further damage to the joints and organs, and send the pain and inflammation into remission. Inflammatory arthritis treatment depends greatly on the type, the severity, the symptoms that manifest, and the patient involved. Always consult your doctor to discuss the right treatment for your case. Some common treatments for the various forms of inflammatory arthritis include: NSAIDs (non-steroidal anti-inflammatory drugs) – these may be prescribed to relieve pain and inflammation, and have proven effective in managing the symptoms of rheumatoid and psoriatic arthritis. DMARDs (disease-modifying anti-rheumatic drugs) – medicines that work to change the course of the disease. One subset of these are biologic drugs, which work quickly, and may be prescribed to patients with rheumatoid arthritis. Another new variety of DMARDs are JAK inhibitors. Corticosteroids – these can quickly stop inflammation that threatens to cause significant damage to the joints or internal organs, but are used less commonly than other medications. Topical treatments – a variety of creams, gels, lotions, and shampoos are available to deal with the skin symptoms brought on by psoriatic arthritis. Surgery is an option for severe cases, when the patient’s daily activities, movement, and independence are threatened by their arthritis. Joint replacement can help to restore mobility in the joints and improve quality of life. ...

Injuries diagnosis

How are sports injuries diagnosed? Some sports injuries are more easily diagnosed than others. More simple cases such as dislocations, cuts and grazes are diagnosed through seeing or feeling the injury. Cases that are more difficult, such as soft tissue damage, fractures and overuse injuries require an examination. The specialist will examine these the complex ones using X-rays, CT or MRI scans. The doctor will also ask questions about the patient’s medical history to identify any underlying issues. The patient may be referred to a specialist for a correct diagnosis. What are the most common sports injuries? The most common sports injuries are: Ankle sprain Groin pull Hamstring strain Shin splints Knee injuries such as ACL tear and Patellofemoral syndrome Tennis elbow How are sports injuries tested? There are many different methods and tools used by sports medicine specialists to test for injuries. Shoulder (rotator cuff) injuries are best identified by observing and feeling the shoulder joint by using different movements. Injuries usually leave movement limited, therefore pain as a result of a range of movements can diagnose a specific type of injury. Strength tests can also identify any weakness in the joint. With cartilage tears in the knee, the doctor will apply pressure to see if there is any tenderness above or surrounding the cartilage. The knee may also be flexed and the doctor will listen out for a clicking or popping noise as the knee bends. This is known as the McMurray’s test and is performed when the patient is lying down. Ege’s test involves the patient squatting so that the specialist can check for a popping or clicking noise as the knee bends. There are several tests that are used to detect a ligament tear or strain in the knee. These include the Lachman test, the anterior draw test and the dial test. Most of these tests involve applying pressure to the knee joint and moving and bending the knee. The extent of the injury is usually determined by the movement or positioning of other parts of the legs and the location of the pain. What are the different types of diagnostic testing? Diagnostic testing helps doctors to understand specific sports injuries. These tests include X-rays, CT scans, ultrasound and MRI scans. ...

Joint preservation surgery

What is joint preservation surgery? Joint preservation surgery covers a number of treatments that are an alternative option to joint replacement surgery. The aim of joint preservation surgery is to restore functionality to a joint so that it does not have to be replaced, or to delay the need to replace a joint. Joint preservation can be achieved through osteotomies (cuts to the bone) to allow the realignment of the joint. Why would you need joint preservation surgery? Joint preservation is usually required to address the problems caused by osteoarthritis. Although joint preservation cannot cure arthritis, it can help to relieve pain and discomfort. This form of treatment would be offered to those where non-surgical options have failed. Joint preservation is also more successful in patients who only experience joint pain in certain areas of the joint and the joint as a whole. What does joint preservation surgery involve? During the osteotomy procedure, two small incisions are made, through which a camera is passed to allow the surgeon to assess the damage. An incision is made above the tibia so that the bone can be cut, to allow the realignment of the knee so that the patient’s weight is transferred to the healthier side of the knee joint. The procedure takes up to two hours. Post-operative care After joint preservation surgery, patients usually stay in hospital for 2-4 days. Afterwards, crutches are needed for up to 6 weeks. After two weeks, certain movements can be carried out to restore range of movement and muscle strength. Intense, physical activities can be resumed 4-6 months after surgery. ...

Joint replacement

What is joint replacement? Joint replacement refers to one of a number of surgical procedures in which damaged or diseased parts of a joint are removed and artificial replacements are fitted. Joint replacement surgery can be performed on a number of joints in the body, most commonly the hip and knee, but joints in the shoulders, elbows, fingers, and ankles can also be replaced. Why would you have a joint replacement? Joint replacement surgery may be necessary if one of the patient’s joints has become damaged due to arthritis, disease, or simply wear and tear from age, and this damage is causing the patient pain and affecting their quality of life. The doctor will probably suggest more conservative treatments, such as physical therapy or medications, before recommending surgery. Joint replacements can help to relieve pain and help the joint to regain some of its function, facilitating movement. However, the surface of the replacement can also wear away with time, and after 15-20 years another replacement may be necessary. What does joint replacement involve? The surgery is performed in a hospital or outpatient centre. The patient is anaesthetised so that they can’t feel pain during the operation. The surgeon will then remove damaged bone and cartilage from the joint and replace them with prosthetic parts, which may be made from metal, plastic, or ceramic. How to prepare for joint replacement In the weeks before the surgery, your doctor will run a series of tests, such as blood tests and a cardiogram to check your general health and plan the surgery. Your doctor will advise you on any preparation you will need to do for your particular operation. For many joint replacements, recovery can be a long process and may make movement difficult for a while – especially hip and knee replacements. For this reason, it is a good idea to plan ahead and make sure you have help and any assistive items, such as handrails or a shower bench after the surgery. Post-operative care Each patient and each operation is different, but in the vast majority of cases, physical rehabilitation is needed to aid recovery. Your doctor will usually advise you to start using the new joint soon after the surgery is complete, which should help to get your body used to it and speed up the recovery process. There is often some pain afterwards, which can last for a few months, as the tissues heal and the muscles become strong again. Exercise can be challenging, but it is crucial to recovery, and your doctor will advise you on how to exercise the muscles around the joint. In the long term, joint replacement generally improves motion, reduces the pain felt previously, and improves the patient’s quality of life. ...

Knee

The knee joins the thigh to the lower part of the leg, connected by two joints. One is the tibiofemoral joint, between the femur and tibia, while the other is the paletellofemoral joint, between the femur and patella. The knee is the largest of the joints in the human body, but it is also one of the most easily injured. What is the knee made up of? The knee is made up of bone, ligaments, tendons, and ligaments. They work together to allow the knee to move smoothly and support the body. The knee joint is complex, and therefore it can be injured in a manner of different ways. Common knee injuries Some of the more common knee injuries include: Fractures Ligament injuries (such as anterior or posterior cruciate ligament injuries) Tears in tendons or meniscus Dislocation Symptoms of a knee injury The knee can be injured in many ways, but some of the most common symptoms include pain, especially while walking or moving, a feeling of instability, and swelling in the knee or around it. If you are in severe pain, cannot move your knee, have significant swelling, or cannot walk without limping, you should seek immediate medical attention. Treatment of knee injuries Treatment of knee injuries depends on the type of injury and the part of the knee affected. Some knee injuries can be treated through methods like physiotherapy or medication. Some can be treated simply by immobilisation – meaning you cannot move your knee. Usually in these cases a cast or brace will be fitted to ensure protection and help it to heal. In some cases, surgery may be the best course of treatment. Most surgical procedures these days are minimally invasive, using very small instruments and making minimal incisions, which usually allows for a faster healing process. In some cases, some injuries may need to be treated with open surgery which requires a larger incision. ...

Knee

What is the knee? The knee is the central joint of the legs. It is formed by the meeting of two important bones: the femur and the tibia, and it joins the thigh and the lower leg. Inside the knee is a small bone called the patella or kneecap, which articulates with the anterior and inferior part of the femur. The knee also houses two fibrocartilage discs, the menisci, and it is surrounded by a joint capsule and ligaments, which give it stability. The main ligaments are the external lateral ligament, the internal lateral ligament, the anterior cruciate ligament and the posterior cruciate ligament. Important muscles surround the knee to allow for flexibility and extension movements of the knee and leg. Knee function: The knee supports most of our body weight when standing. The main movement of the knee is flexion-extension, although it can also rotate slightly when flexed. Pathologies of the knee: The knee is vulnerable to serious injury from impact and trauma, usually the result of sports injuries. Osteoarthritis is common in older people and can be very disabling. The most frequent knee injuries are: Simple contusions : minor trauma without damage to the main structures of the joint (meniscus, bone or ligaments). These are considered benign, without complications, and are usually resolved in a short time using conservative measures such as anti-inflammatories, rest and ice applied to the joint. Ligament and meniscus injuries : these are common injuries in sport, as they cause tension in the joint. The most frequent injuries are torn menisci, lateral ligaments and cruciate ligaments. Tendon injuries : the tendons that suffer the most serious injuries are the quadriceps tendon, patellar tendon, goosefoot tendon, and the tendon of the popliteus muscle. Fractures : these can occur in the lower femur, upper tibia, or kneecap. They are generally complex fractures that can affect several bones, ligaments and the menisci and are usually caused by severe trauma. Dislocation : dislocation is considered to be any injury that causes a permanent loss of contact between the joint surfaces. Joint effusion : the joint space usually contains synovial fluid, which serves to nourish the cartilage and provide lubrication, thus reducing friction of the joint and consequent wear. An excess of this fluid leads to joint effusion, which causes pain and an inability to move the knee. Osteoarthritis of the knee: this condition affects more women than men and generally occurs from the age of 50 onwards. Arthritis Osgood-Schlatter disease : this affects the tibial cartilage, causing pain during exercise. It improves with rest. Chondromalacia patella : this is common in young people and sportspersons. It is the degeneration of the cartilage between the kneecap and the femur. Hoffa's disease : chronic inflammation of the area of fat behind the patellar tendon and under the kneecap. Baker's cyst : this is a lump that occurs on the back of the knee due to chronic inflammatory processes and increased production of synovial fluid. Bursitis: the knee has several fluid-filled sacs or bursae, which are particularly vulnerable to repeated trauma. They can cause chronic inflammation. Treatments for knee problems: Treatment for knee injuries will depend on the type and severity of the injury. First of all, you must follow the "PRICE" protocol: Protection, Rest, Ice, Compression and Elevation. To prevent further damage to the knee after injury you should not apply heat, not drink alcohol, not run or do any other exercise, and not massage the injured knee, as this can cause further swelling. Anti-inflammatory drugs may help with mild to moderate pain. If the pain becomes intense, a doctor may prescribe a stronger pain reliever. If the injury is severe, the specialist may recommend physiotherapy and will design a rehabilitation exercise programme that is appropriate for you and the type of injury. In some cases, the injury may require surgery; for example, if you have torn the external lateral ligament, if you have damaged the anterior cruciate ligament and do a lot of sport, or if you have torn the internal lateral ligament, which will require reconstructive surgery. Surgery is also indicated if the injury involves several ligaments or if you have torn a patellar tendon. Which specialist treats knee problems? Orthopaedic surgeons treat problems relating to the knee joints. ...

Knee arthroscopy

What is knee arthroscopy? Knee arthroscopy is a minimally invasive procedure that allows access to and treatment of injuries affecting the various structures of the knee joint. Two or three small incisions of less than a centimetre are made to allow access to the joint. Most knee surgeries that do not involve implant placement are performed using full or partial knee arthroscopy. This is the preferred technique for treating many injuries since it allows for greater visualisation of the joint. All the points of the knee can be accessed in a minimally aggressive way in order to clean the cartilage, make small holes in the bone that lacks cartilage (microfractures), stabilise the cartilage and administer substances or elements (platelet-rich plasma or stem cells) to promote cartilage regeneration. Knee arthroscopy is also used to complement open techniques, as it improves injury diagnosis and prognosis due to being less aggressive. The surgery can be performed under local, regional or general anaesthetic depending on the injury and the individual. The anaesthetist will decide the best method in each case to reduce discomfort as much as possible. Why is it performed? Knee arthroscopy is used to treat knee injuries. One of the most common pathologies is meniscus injury, and arthroscopy allows preservation of most of the meniscus since the resection is not complete but partial. Meniscal sutures and meniscus transplants through knee arthroscopy are common techniques for improving protection for the joint cartilage. Another serious sports injury is rupture of the anterior cruciate ligament. Injury to this ligament causes instability in the knee, making it impossible for the person to practice almost any sport. If instability continues, it can damage surrounding structures such as the meniscus and cartilage. The anterior cruciate ligament must therefore be reconstructed with grafts, using arthroscopy to access the joint. Another common problem is cartilage injury (chondropathy, osteoarthritis or osteochondritis). Preserving the cartilage will also preserve the joint, thus preventing wear of the knee. What does it involve? The orthopaedic surgeon will make small incisions in the knee to access the joint. They first fill the knee joint with a sterile solution and remove any cloudy fluid, which will allow them to see the joint clearly. The specialist will then insert the arthroscope (a thin device with a camera at the end) into the knee. This device sends images to the TV monitor so that the surgeon can see all the structures in detail. Through the other holes, the surgeon inserts the surgical material that will allow them to treat the injury and repair the damaged structures. The procedure rarely lasts more than an hour. After surgery, you will be transferred to a recovery room and will be able to leave the hospital within around two hours. Preparing for knee arthroscopy Prior to surgery, you will need to have a complete physical examination so that the specialist can evaluate your health and detect any possible abnormalities that may interfere with the arthroscopy. You should inform the surgeon of any medication you are taking, in case you need to stop taking some before the operation. Complementary preoperative tests will also be performed, such as an MRI scan, an electrocardiogram and blood tests. Post-operative care The recovery period after arthroscopy is shorter than after conventional open surgery. However, you must follow the specialist's instructions so that the knee can recover properly. It is normal to experience some swelling in the days following surgery, so you should elevate the leg during those first few days. Applying ice will relieve any pain and reduce inflammation. Keep the incisions clean and dry to aid healing. The specialist will tell you when it is okay for you to shower and change the dressing. Shortly after the intervention, you should begin rehabilitation exercises with a physiotherapist, who will prepare a programme appropriate for you and the type of injury. This will strengthen the knee muscles and help restore movement. Alternative treatments The alternative to knee arthroscopy is conventional open surgery, which is currently only used in more severe cases, in which an implant is required. Any other technique would involve greater invasion of the knee and a more difficult postoperative stage. ...

Knee cap replacement

What is knee cap replacement surgery? Knee cap replacement surgery, which is also known as patellofemoral replacement or patellofemoral arthroplasty, involves the damaged bone and cartilage to be resurfaced with plastic or metal components. This type of surgery is considered a partial knee replacement as only a section of the knee is resurfaced. Patellofemoral refers to the section of the knee that includes the patella (knee cap) and the groove in the thighbone which the patella rests in. Why would you need knee cap replacement surgery? Knee cap surgery is usually required in patients suffering from knee osteoarthritis which is when the cartilage protecting the knee bones is gradually worn away, exposing the bone. A lack of cartilage here results in painful movement. Patients would consider knee cap replacement if non-surgical treatments are no longer effective in providing relief. Patients whose knee bone and cartilage damage is limited to the kneecap (patella) and the groove in the thighbone that the kneecap rests in are candidates for this form of knee cap surgery. It is an alternative to total knee replacement surgery and involves a much smaller incision, and hence recovery can be swifter. What does knee cap replacement surgery involve? The surgeon makes an incision in the front of the knee, after which the damaged cartilage is fully inspected. Afterwards, the bone is prepared by having damaged cartilage and a small amount of bone removed from the patellofemoral section of the knee. Once the bone is prepared, the implants are positioned. A metal femoral implant resurfaces the groove in the thighbone, whilst a plastic patella resurfaces the underside of the patella. The implants are secured to the bone using a special cement. How do you prepare for knee cap replacement surgery? This surgery does involve anaesthesia and the choice is either general anaesthesia or spinal (you remain awake, however, the body is numb from the waist down). Post-operative care after having knee cap replacement surgery Once the operation is complete, you are monitored closely whilst the anaesthesia wears off. Sometimes this procedure is carried out on an outpatient basis, so discharge can be quick. Pain following surgery is expected which can be managed with prescribed painkillers. Putting weight on the knee after surgery is recommended, using a walking aid for a few days following the operation. A number of physiotherapy exercises will be given which help to restore strength and motion to the knee. As knee cap replacement is not a total knee replacement, sometimes down the line there is a need for further surgery. ...

Knee fracture

What is a knee fracture? A knee fracture is a break or rupture in a bone in the knee joint. These bones are usually injured by falls, traffic accidents, contact sports and physical exercise. Prognosis: Depending on the severity of the fracture, some knee fractures can heal without the need for surgery, and conservative measures will suffice. However, bigger fractures will need surgery and a more lengthy recovery period with attention needed to physical therapy. Symptoms of a knee fracture: Symptoms of a knee fracture include: Joint pain and tenderness Swelling and inflammation, with the possibility of bruising Limited range of motion An inability to walk and move properly or place pressure on the affected knee Medical tests for knee fractures: Firstly, a detailed physical examination will take place. Next, the following will be carried out to determine the severity and location of the fracture: X-ray CT scan MRI scan What causes a knee fracture? The causes of knee fractures can be very varied. As mentioned above, many result from sports and physical activities. They can also occur following a fall or accident. Osteoporosis can also increase the risk of knee fractures. Can knee fractures be prevented? A knee fracture is difficult to prevent, unless certain sports or physical activities are avoided entirely. However, this is not realistic, but it is important to play physical sports with care, avoid poorly lit areas to not trip over, organize your house to avoid accidents, and wear a seat belt to minimise the possibility of knee fractures resulting from car accidents. Treatments for knee fracture Treatment of a knee fracture depends on the fractured bone and the type of fracture. If the parts of the bones are well aligned, a brace or cast on the knee may be enough. If the kneecap is affected, surgery may be necessary. Therefore, recovery from the injury depends on the fractured bone, the type of fracture, the treatment, and its progression. Which specialist treats you? Orthopaedic surgeons treat knee fractures. ...

Knee Osteoarthritis

What is osteoarthritis of the knee? Osteoarthritis of the knee is a disease which mainly consists of a tearing of the articular cartilage, and it can be progressive. The disease is not exclusive to old age, however, the frequency of affliction increases with age. It is also more common in women than in men, and in people who are genetically predisposed to it. Although many of these factors are not preventable, it is possible to slow down its progression or to reduce the chances of it developing. There are two types of knee osteoarthritis: primary knee osteoarthritis, which is related to age, and secondary knee osteoarthritis, which occurs after a previous injury, such as a fracture and affects people with high levels of strenuous physical activity or those who are obese. Prognosis of knee osteoarthritis Although osteoarthritis is generally not a serious disease, it can gradually undermine the quality of life of those affected. Prognosis of the disease depends greatly on the pathology and its evolution. Early diagnosis and joint protection measures are key in helping to slow the progression and development of the disease. Pain and a lack of mobility are the main factors that have an impact on the person’s quality of life, causing it to decrease. The disease mainly affects people over the age of 50. It can make them more sedentary, which can result in obesity and the appearance of risk factors for conditions such as cholesterol, hypertension and diabetes, among others. Symptoms of knee osteoarthritis: The symptoms and manifestations of osteoarthritis are diverse, progressive and appear gradually over time. The most common symptom is joint pain with limited joint movement, accompanied by cracking sounds and sometimes knee joint effusion (also known as ‘water on the knee’). Some people may experience stiffness or joint deformity. The worst symptom is pain. In the early stage of the disease, pain occurs when you move or try to force the affected joint, and it subsides when you rest. As the disease progresses, pain can occur not only when you move the joint but also when it is being rested. However, joint pain is not constant, so you can go for long periods of time without any pain, although the disease continues to progress. How is knee osteoarthritis diagnosed? Osteoarthritis can be difficult to diagnose. Firstly, it should be noted that it cannot be diagnosed by X-ray, so a thorough medical history must be taken and a physical examination performed. If there is swelling in the knee, the specialist may decide to remove fluid from the joint to test it and to confirm the diagnosis. In addition to X-rays, a CT or MRI scan may also be used to diagnose knee osteoarthritis. What causes knee osteoarthritis? The cause of osteoarthritis is still unknown. However, there are a number of risk factors associated with its occurrence: Gender: osteoarthritis affects women between the ages of 50 and 55 in particular. Age: the risk of osteoarthritis increases after the age of 50 Genetics: it may be an inherited disease Strenuous physical activity: constant repetition of joint movements can lead to joint overload Menopause: decreased oestrogen levels are a risk factor for the development of the disease Obesity: this can aggravate osteoarthritis in joints such as the knees Trauma: fractures and injuries can trigger osteoarthritis. Can knee osteoarthritis be prevented? The main measures for preventing the onset of osteoarthritis are simple: eat a healthy, balanced diet and take regular, moderate physical exercise according to your age and physical condition. You should limit strenuous physical exertion, such as lifting or carrying heavy objects. Contact sports such as football and rugby are not recommended for people with osteoarthritis, as they can exacerbate the disease. Footballers are one of the groups most affected by this disease due to frequent meniscus injuries. Treatment for knee osteoarthritis The main objective of treatment for osteoarthritis is to improve pain and functional disability. The first step is awareness, as avoiding risk factors is essential for preventing or minimising the disabling effects of the disease. You will also have a personalised and adapted exercise regimen which you need to follow with the physiotherapist to help improve your condition. Anti-inflammatories: sometimes pain is severe due to inflammation of the area. In this case, anti-inflammatory drugs may be prescribed to reduce inflammation and relieve pain. Chondroprotective drugs: these are specifically indicated for the long-term treatment of osteoarthritis, as they act directly on the joint. They relieve pain and improve mobility, as well as attack the disease at the root by slowing its progression. Chondroprotectors include glucosamine and hyaluronic acid. Surgery: implant surgery will be recommended if the disease is very advanced; in this case, a partial or total knee implant. Which specialist treats knee osteoarthritis? There are several specialists that can treat knee osteoarthritis, including orthopaedic surgeons, rheumatologists and physiotherapists. ...

Knee replacement

What is knee replacement surgery? Knee replacement surgery is a procedure that involves removing and replacing a damaged or worn knee joint with an artificial implant. An implant is placed in the damaged structure and replaces its function, allowing you to move the joint again, eliminating any pain you might have had before. During the operation, the damaged bone and cartilage are removed. For this purpose, either a general or regional anaesthetic will be administered. The anaesthetist and orthopaedic surgeon will decide which to use in order to minimise discomfort as much as possible. Why is knee replacement surgery performed? The main reason for knee replacement surgery is because of osteoarthritis of the knee, which damages the joint. A knee prosthesis or implant may also be required in the case of fractures that have caused significant damage to the subchondral bone, or in the case of specific bone tumours. What does knee replacement surgery involve? Knee replacement surgery takes around two hours and involves removing the damaged cartilage and bone from the joint and replacing them with artificial implants. These implants can be placed in different parts of the knee: the lower end of the femur (metal piece), the upper end of the tibia (piece made of strong plastic and metal), or at the back of the kneecap (made of strong plastic). Once the anaesthetic has been administered, the orthopaedic surgeon will make an incision of around 20 cm long in the joint to open it. The procedure is as follows: The patella is removed and a cut is made in the end of the femur and tibia to accommodate the prosthesis in the joint space The lower part of the kneecap is also cut so that the new piece fits well The two parts of the prosthesis are fixed to the different bones, one to the femur and the other to the tibia, using cement or screws The tendons and muscles of the joint are repaired and the incision is closed. Depending on the injury and the amount of bone removed, the knee replacement may be: Total or tricompartmental: the joint and kneecap are completely replaced. This is carried out with rigid axis prostheses (rarely used because they only allow a single movement, flexion-extension), joint surface replacement prostheses (isolated resection of the damaged joint), prostheses with linked components (these provide good stability due to the link between the tibia and the femur, as well as flexion-extension and rotation movements, but they are no longer used) and self-supporting prostheses (these replace the damaged surface and their design provides stability and functionality. The most common type is the medial pivot prosthesis). Unicompartmental : used for limited joint injuries. The prostheses usually have a metal femoral component that is placed in the damaged femoral condyle, and a polyethylene component that is placed in the tibial part. Preparing for a knee replacement: The orthopaedic surgeon and anaesthetist will advise you on what you need to do before the procedure. You must tell them about any medication you are taking, so that it does not interfere with the outcome of the surgery. The specialist will perform a series of preoperative tests, such as an electrocardiogram, MRI scan, x-rays and other procedures that will make the surgery easier and allow them to access the joint with full knowledge of the injury. Post-operative care: After knee replacement surgery, you must strictly follow the advice of the surgeon and physiotherapist for a complete and successful recovery. The physiotherapist will design a series of personalised exercises for you, adapted to the type of injury. These exercises will increase in intensity as the mobility of the joint increases. The objective is to regain and increase muscle strength, correct any instability or deformity, relieve any pain you may have, eliminate any scar adhesions and improve your physical function. The rehabilitation process also includes a number of other recommendations: to alternate flexion and extension movements when sitting, wear comfortable and well-fitting footwear, avoid sudden changes in weight to avoid overloading the joint, remove any furniture that may cause you to stumble or fall, do exercises at home (as recommended by the specialist), apply ice to the area after rehabilitation exercises, follow the instructions of the specialist for sitting, walking and going down stairs and, above all, keep the wound clean and disinfected. Alternative treatments: There is no alternative to knee replacement surgery. It is only performed in extreme cases, when the joint is severely damaged and the injury cannot be resolved with other procedures or treatments. The specialist will study the injury and decide on the best treatment or alternative. ...

Knock knees

What is 'knock knees'? Genu valgum, which is commonly known as knock knees, is a condition in which the knees are misaligned and there is a large gap between the feet and ankles. It is sometimes referred to as X knees or scissor knees due to the knees being very close together and the ankles very far apart. There are some normal changes (physiological changes) during growth, and different things can affect limbs, changing their shape. This is due to the supporting joint structures still developing. At around 8 years old, the final lower limb alignment is reached and the genu valgum corrects itself. If there is an issue after this, surgery will be resorted to. What is the treatment? Treatment for valgus knee correction aims to: Employ ligamentous techniques in which limbs are lengthened or shortened. Strengthen or stretch affected muscles. Improve posture and meniscus loads. Improve aesthetics, symmetry, or the locomotor system. Prevent potential scoliosis or spinal deformities. Increase standing resistance. Lessen meniscus and joint loads. Minimise risk of injury. Help the patient to walk differently as well as other functional movements that the joints use while being treated. What does it involve? Treatment includes a variety of options, from lifestyle changes to anti-inflammatory medications, as well as exercise programmes, and physical therapy. In more complex cases, surgery may be resorted to. There is no consensus on what is the most appropriate treatment for genu valgum correction. Some surgeons prefer to focus on patella treatment, which focuses on arthroscopic technique or open realignment. If the valgus and limb misalignment are noticeable, a corrective osteotomy may be recommended. How to prepare for it There are no specific recommendations to follow before treating genu valgum. Post-treatment care The patient should stretch the joints treated during treatment to avoid muscle injuries or tears. ...

Lateral collateral ligament

What is the lateral collateral ligament? The lateral collateral ligament (LCL) is one of the four major ligaments that support the knee joint. Joining the femur with the tibia, it goes from the top of the tibia to the lower section of the femur. Its function is to allow lateral mobility of the knee joint and keep the outer side of the joint stable. The most frequent injuries (tear and sprain) occur because of pressure or an injury that pushes the knee joint from the inside, which causes tension on the outside. What are the symptoms of lateral collateral ligament problems? The symptoms of a lateral collateral ligament injury are: swelling of the knee blocking of the knee with movement pain or tenderness on the external face of the knee looseness in the knee it feels as if it would loosen when it is being used What are the causes of lateral collateral ligament problems? An injury to the lateral collateral ligament can occur in the following situations: a blow to the inside of the knee a blow to the shin when the knee is bent when placing the foot on the ground to push oneself What is the treatment for lateral collateral ligament problems? If your lateral collateral ligament is injured you should apply ice to the area, in addition to anti-inflammatory drugs, raising the knee and avoiding physical activity until the pain and swelling subside. The treatment for the injury depends on the damage caused and its severity: Moderate injury: physiotherapy is the usual treatment. It consists of completing a program of rehabilitation exercises to strengthen the knee and stretch the muscles. Sometimes a splint can be used to hold the knee during the exercises, especially if the injury has been severe. More severe injury: if the knee remains unstable after treatment with physiotherapy, if the patient does a lot of sport or if more than one tissue or ligament of the knee has been damaged, the recommended treatment is knee surgery. ...

Medial collateral ligament

What is the medial collateral ligament? The medial collateral ligament, also called the tibial collateral ligament, is one of the four most important ligaments of the knee. It extends from the inside of the lower thigh bone to the inside of the upper shin bone. Function of the medial collateral ligament: The medial collateral ligament provides stability to the knee and limits its movement from side to side. Injury to the ligament often results in a partial or complete tear or excessive stretching of the ligament. Pathologies of the medial collateral ligament: You may have damaged the medial collateral ligament if you have pain in the inner part of the knee, if the knee feels unstable and you think it might give way or become locked, or if you feel pain when bending or stretching the knee or when walking. Most injuries to the medial collateral ligament can occur if the lower leg is moved outward at the knee; if a blow is received to the lower outer thigh; or if you put one foot ahead of the other to increase momentum (in skiing, for example). This causes total or partial ligament distension due to the excessive stretching of the ligament by forcing the joint beyond its range of motion. This injury, which is very common in athletes, is known as a sprain or tear of the medial collateral ligament of the knee. It is common in football players but also in sports such as skiing, handball and rugby. There are different grades of injury: Grade I: There is moderate pain, little swelling, and you can move the joint. Grade II: You feel pain, accompanied by instability, inflammation and a loss of function. Grade III: Joint function is severely affected, with high instability, swelling, and pain. Treatments for pathologies of the medial collateral ligament: Treatment for a medial collateral ligament injury will depend on its stage. Thus, for grade I injuries, treatment will normally be conservative. This involves immobilising the joint and rehabilitation. For grade II and III injuries, the orthopaedic spealist should study the injury on an individual basis and decide whether definitive conservative treatment or a surgical procedure is most appropriate. Physiotherapy is essential for a complete recovery. The main objective is to reduce pain and inflammation so that you can walk correctly, and also do exercises with contrast hydrotherapy and electrotherapy without feeling pain. Hydrotherapy is also extremely helpful since it reduces stress during therapy and allows for painless movements against water resistance, which also strengthens the muscles. The physiotherapy exercise programme should aim at increasing knee flexion, recovering stability and gaining muscle. To this end, the exercises will be gradually increased. Also recommended is deep transverse friction massage of the muscle fibres, to promote the reorganisation of the ligament fibres and greater tissue regeneration, enabling nutrients to pass through more easily. Some specialists also recommend platelet-rich plasma therapy. These are proteins that are naturally made by your body and help repair and regenerate tissues after injury. Thus, after extracting a small amount of blood from your body, it is treated and platelet-rich plasma is obtained, which is then injected directly into the injury. Which specialist treats pathologies of the medial collateral ligament? Various specialists treat injuries to the medial collateral ligament. Thus, it is mainly orthopaedic surgeons specialising in knee problems who will assess the severity of the injury. However, depending on the injury grade, the physiotherapist may also be involved in treating pathologies of the medial collateral ligament. ...

Meniscus

What are the menisci (meniscus)? The menisci are two fibrocartilage structures located inside the knee. They improve joint function, acting like shock-absorbing cushions that help disperse the weight of the body and absorb forces exerted on the knee. They give the knee stability and play a key role in the proper functioning of the joint. The knee joints are among the most vulnerable joints of the body and can suffer serious injuries. They need to be able to withstand great pressure and to absorb and dissipate forces, which makes their role fundamental. Function of the menisci: The menisci have various functions: To absorb the shock waves generated when you walk or run. The menisci can absorb almost 20% of these shock waves. Force transmission: the fibres that make up the meniscus enable the transmission of compressive force by up to 50% when the knee is extended, and by up to 90% when the knee is bent. Joint stability: if the knee buckles, this may be due to laxity or tearing of the anterior cruciate ligament. Knee stability is influenced by the meniscus, the quadriceps and hamstring muscles. Proprioception: the menisci help to increase proprioception. Joint slippage: they contribute to the lubrication of the joint due to their shape and high water content. Pathologies of the menisci: Certain movements of the knee can cause injuries to the menisci, when they do not follow the movements of the femoral condyles over the tibial plateau. This happens if, for example, the knee is suddenly extended, which is very common in football players. In this case, there is no time for the meniscus to move forward, so it is trapped between the femoral condyle and the tibial plateau. Another type of injury is distortion of the knee joint, with external rotation and lateralisation, causing the meniscus to slide under the convexity of the internal condyle, resulting in a longitudinal tear of the meniscus. Moreover, a torn internal ligament can also lead to a torn meniscus. Meniscus tears are one of the most common injuries. Although common in athletes, anyone can suffer this injury. There can be different types of tears, but the most common tears are longitudinal, parrot beak, flap, bucket handle and mixed/complex. In the case of sports injuries, these are usually accompanied by ligament injuries. Treatments for meniscus pathologies: Conservative treatment is recommended for this type of injury, which is sometimes sufficient for meniscus tears, giving the knee time to heal itself. This process is known as RICE, which stands for rest, ice, compression and elevation. It may be supplemented with anti-inflammatory medication to reduce pain and inflammation. However, surgery may sometimes be necessary if symptoms do not abate. In this case, the orthopaedic surgeon will usually recommend knee arthroscopy. During arthroscopy, a mini camera is inserted into the knee through a small incision, allowing visualisation of the inside of the joint. The specialist will make two or three other small incisions to access the knee and repair the injury. After surgery, the specialist will immobilise the knee. When the wounds have healed somewhat, you should start rehabilitation exercises to restore joint mobility and strength. Which specialist treats meniscus pathologies? Orthopaedic surgeons treat problems relating to the knee and the menisci. ...

Muscle injuries

What are muscle injuries? Muscle injuries are usually painful and are caused by overstraining, either during sports or during your daily activities. A muscle is made up of the discrete muscle and the tendons, and it can be imagines as a rope and its fibres. Muscle injuries can affect all of the fibres or only a part of them, and they can be classified into: contractures: the muscle becomes tight after an involuntary contraction; pull: an over-stretch of the muscle fibre; strain: tearing of the muscle fibre. A strain can be divided into several categories, based on which muscle fibres are affected: First degree: a muscle injury limited to certain fibres; you only feel a mild pain when the muscles contract. It usually lasts a week and requires no treatment. Second degree: there may be a haematoma and the pain could progressively increase in the following days. You may need to get it checked out to determine the exact location of the injury and to estimate recovery times. Third degree: the most severe injury, as in this case all muscle fibres are torn. You may feel like you can’t move, as well as experiencing acute pain, and notice a haematoma. You’ll need to see your doctor for treatment. Prognosis The outlook depends on how severely you were injured and in the case of a second- or third- degree strain, how soon after the injury you seek medical support. What are the symptoms? Depending on how severe it is, a muscle injury can cause one or more of the following symptoms: swelling and a burning sensation bruising, swelling and redness feeling pain when you’re using the affected muscle feeling pain even when the affected muscle is at rest weakness mobility impairment (partial or total functional loss of the affected muscle) a depression of the affected area high temperature How is it diagnosed? At the very least you will have a physical examination to determine the extent of the swelling, haematoma, pain or depression. In some cases the doctor may refer you for an Ultrasound scan or MRI scan to get a complete picture of the muscle. What causes them? Muscle injuries can occur due to direct and indirect causes: Direct muscle injuries are caused by external factors, such as carrying heavy loads, repetitive movements, traumas, unhealed injuries, poor posture, environment and weather, playing on unsafe playing ground Indirect muscle injuries are caused by internal factors, such as a poor diet, skipping warm-up and cool-down and muscle fatigue. How can muscle injuries be prevented? Muscle injuries can be prevented in the following simple ways: make sure to warm-up adequately before exercise eat a healthy diet stay hydrated; use proper equipment wear good sportswear and well-fitting shoes How are muscle injuries treated? Treatment depends on the affected muscle, severity of the injury and where it is located. To avoid worsening the trauma, as soon as you feel some pain or discomfort you should stop exercising and put ice on the area. A lot of the people who don’t stop exercising, fuelled by competitiveness, end up making it much worse. In order to prevent bruising in the area, you should avoid any straining for 24-36 hours. Apply ice and compression (using elastic bandages), and elevate the injured area to prevent swelling. Treatment mainly involves giving the muscle adequate rest, and tackling inflammation. The doctor may recommend exercises for you to gradually build strength in the muscle again, or may refer you to a physiotherapist. In severe cases they may recommend the use a brace to keep the muscle still for the first few days after the injury. ...

Orthokine

What is Orthokine (Regenokine) therapy? Orthokine (or Regenokine in the USA) is a procedure in which a patient’s blood is extracted, manipulated and reintroduced into the body as an anti-inflammatory drug to reduce chronic pain and osteoarthritis. The therapy is used for meniscus tear treatment, as cell therapy for arthritis, a torn ACL and to treat MCL cartilage damage caused by sports injuries. It is a way of treating these injuries and chronic pain without drugs or foreign substances. The method is biological and makes use of the body’s own proteins and healing factors. What is the procedure for Orthokine therapy? Blood is drawn from the patient’s vein and processed under special conditions. The blood is incubated at 37 degrees to stimulate the production of the anti-inflammatory protein Interleukin-1-receptor (IL-1Ra). The protein is extracted in a laboratory and filed in ampoules, later available in injection form. The serum that has been obtained is re-injected into the area of pain on the patient, such as the joints. The injections are given one to two times a week and patients are advised to avoid strenuous exercise for 48 hours. What are the advantages of Orthokine therapy? The benefits of using Orthokine therapy include: very rare side effects anti-inflammatory regenerative reduces pain improves mobility long-term benefit How long do the effects of Orthokine therapy last? Every case depends on the individual patient and will last a different length of time. The severity of the injury will determine the length of the results. The healing process begins immediately upon delivery of cells to the body. The effectiveness of the treatment will depend on the patient’s ability to follow post treatment care, which involves extensive rehabilitation to strengthen areas that were affected. ...

Orthopaedic surgery

What is orthopaedic surgery? Orthopaedic surgery is the field of surgery responsible for diagnosing and treating a wide range of conditions of the musculoskeletal system, as well as for reducing the symptoms of any conditions affecting it. These conditions can affect the bones, cartilaginous structures or the joints. What conditions does orthopaedic surgery treat? Some of the conditions treated by orthopaedic surgery include: Foot injuries: metatarsalgia, bunions, cavus foot, flat foot, hammer toe; Hand injuries: scaphoid bone fracture, carpal tunnel syndrome, De Quervain syndrome, thumb arthrosis (trapeziometacarpal osteoarthritis), stenosing tenosynovitis (trigger finger); Knee, kneecap and ligaments injuries, as well as knee osteoarthritis; Shoulder injuries (shoulder impingement syndrome or swimmer's shoulder); Hip injuries (hip osteoarthritis). What are the sub-specialisations of orthopaedic surgery? Emergency or trauma surgery can be regarded as a sub-specialisation of orthopaedic surgery. This type of surgery treats people who’ve suffered a traumatic injury (thus, an acute trauma). A few examples of traumatic injuries include: Incision or laceration wounds; Gunshot wounds; Car accidents; Several types of domestic accidents; Work-related accidents. When do I need to see an orthopaedic surgeon? If you have one of the above-mentioned conditions, you should see an orthopaedic specialist, who will determine whether or not you need surgery. Should the orthopaedic specialist also be a surgeon, he or she will be the one performing the surgery (if needed). ...

Osteoarthritis

What is osteoarthritis? Osteoarthritis is a degenerative conditions that affects the joints, causing them to become stiff and causing pain. Any of the joints in the body can be affected, but it more commonly affects the hips, knees, and small joints in the hands. It affects women more commonly than it does men, and is the commonest form of arthritis in the UK. What are the symptoms of osteoarthritis? The most common symptoms of osteoarthritis are joint pain, difficulty in mobility, and stiffness or deformity in the joints. These symptoms vary depending on the patient and intensify in a progressive manner. Joint pain, the most common symptom, appears first with movement and ceases with rest, but as osteoarthritis progresses, the pain may also be present while resting. What are the causes of osteoarthritis? The causes of the onset of osteoarthritis are not currently known but there are a number of risk factors associated with it: Genetics: In more than 60% of cases, genetic inheritance influences the appearance of osteoarthritis. Physical activity: athletes and people who maintain high physical activity have a higher risk of suffering from osteoarthritis. Working day: those who perform repetitive joint movements in their working day can wear down the joints and overload them, which can trigger osteoarthritis. Menopause: osteoarthritis more commonly affects women who have reached menopause due to the decrease in oestrogen that occurs during this stage of life. Injuries: fractures and traumas in the joints can influence osteoarthritis. Obesity: although it does not directly cause the onset of osteoarthritis, obesity influences wear and tear of the joints and therefore the progression of the condition. Prevention of osteoarthritis To avoid risk factors and therefore prevent osteoarthritis, it is very important to eat a balanced diet, such as the Mediterranean diet, and perform regular moderate exercise, thus avoiding wear and tear of the joints. Avoiding obesity is important as carrying too much weight can be detrimental. Treatment of osteoarthritis The objective of the treatment is to avoid or reduce pain and improve mobility. To treat osteoarthritis, the medical specialist will recommend the patient a series of exercises to be performed which are adapted to their situation and abilities, often with the help of a physiotherapist. Pharmacological treatment: In most cases anti-inflammatories or analgesics are prescribed to reduce swelling and therefore pain. Chondroprotective medications may also be prescribed which may slow the progression of the disease. Surgical treatment: osteoarthritis in very advanced stages may require prosthetic surgery. ...

Osteoarthritis of the ankle

What is it? Ankle arthritis is a degenerative joint disease involving wear and tear of the cartilage that covers the bone. If these tissues wear, they won’t be able to cushion the weight that the ankle carries. Ankle arthritis is not a common disease, and usually appears due to a foot or leg fracture. The opposite is true for hip or knee arthritis, which are much more common. What are the symptoms? A patient with ankle arthritis will normally feel: foot pain a feeling of pressure that makes them feel more tired and walk with difficulty. Over time the ability to walk begins to decrease. In severe cases the person is unable to walk more than a few metres, if at all. Tests for ankle arthritis In order to correctly diagnose ankle arthritis the patients’ medical history must be taken into account, including any trauma that the ankle may have suffered. The doctor will then examine: any sore areas the external appearance of the ankle joint and any potential deformities the joint’s mobility the patient’s walking pattern (gait analysis). X-rays are normally taken, as they enable the doctor to look at the joints and bones in the foot. Sometimes further imaging tests are done, such as an MRI or CT scan. They allow a better view of the ankle and surrounding joints. What causes it? The main causes of arthritis in the ankle are: Traumatic arthritis: Occurs after a trauma or fracture of the ankle. It is the main cause of ankle arthritis. Alterations of the foot : Patients with flat foot or severe cavus foot may have ankle arthritis due to changes in joint movement. How can it be prevented? Some recommendations to prevent ankle arthritis include: avoid sports which could cause damage to your ankle, such as contact sports, and sports which involve jumping and spinning maintain strength and mobility in your legs with weight training, swimming pool exercises, and riding a bike maintain a healthy weight wear good-fitting shoes to protect your joints and feet How is ankle arthritis treated? Conservative treatment of ankle arthritis includes: steroid injections and anti-inflammatory drugs to reduce swelling and pain in the joints insoles to accommodate the foot better and reduce impact strength in the ankle when walking physiotherapy and advice on foot exercises to maintain the strength and mobility in your feet In severe cases where you are experiencing a lot of pain or the join is badly damaged, you might be offered surgery. Surgery can either involve fusion of the ankle bones, or an ankle replacement. Both kinds of surgery can now be carried out using minimally-invasive techniques, resulting in reduced postoperative pain and a faster recovery. What specialist should I see? If you have arthritis it is likely you will see a rheumatologist for conservative treatment. Ankle surgery involves referral to an orthopaedic surgeon. ...

Osteoarthritis of the hip

What is hip osteoarthritis? Hip osteoarthritis is a degenerative disease of the cartilage that covers the joint of the pelvic and femoral bones. This tissue facilitates movement between the bones and prevents them from rubbing against each other directly. When the cartilage decreases in thickness and texture, or is lost completely, the mechanism between the femur and the pelvis no longer functions correctly, resulting in hip osteoarthritis. Hip osteoarthritis can vary in severity, from mild to severe. Prognosis: Hip osteoarthritis is a chronic disease and usually progresses slowly over many years. It is one of the most common types of osteoarthritis. Symptoms of hip osteoarthritis: The main indicator of this condition is pain, which is primarily located in the groin area. Symptoms such as stiffness and impaired functionality (mobility) may also be present. The pain may sometimes radiate down the front of the thigh and also affect the knees, which might lead you to think that the problem is with the knee. Medical tests for hip osteoarthritis: In order to diagnose hip osteoarthritis, the specialist will: Ask questions about your symptoms and ask you to describe them. Examine the hip joint and its movements. This enables the specialist to assess the degree of osteoarthritis. X-ray the hip, to confirm the diagnosis. MRI scans may also be used. What causes hip osteoarthritis? The causes of hip osteoarthritis are numerous and results from a combination of genetic and environmental factors. Some of the secondary factors that cause hip osteoarthritis, either combined or in isolation, are: Obesity Older age Professional activity Excessive strain on the joint due to high-intensity sport Malformations Can hip osteoarthritis be prevented? One of the causes for the onset of hip osteoarthritis is ageing, making it impossible to avoid the disease. However, onset of the disease can be significantly delayed. The main actions you can take to try to prevent hip osteoarthritis are to: Lose weight Do physical exercise. This includes exercising the hip joints. Avoid movements that cause pain Use canes or crutches Follow a good diet. Treatments for hip osteoarthritis: There is currently no treatment that can cure osteoarthritis, but it can relieve symptoms, slow the progression of the disease and improve quality of life. There are several alternatives available: Weight control Correction of anatomical malformations or alterations Physical exercise Medication Surgery: replacement of the joint with an implant. This is usually performed for severe cases of the disease. Physical measures and medication can be considered conservative treatments, the aim of which is to minimise pain and immobilisation and to slow down the progression of the disease as much as possible. Which specialist treats hip osteoarthritis? Rheumatologists and orthopaedic surgeons would diagnose and treat hip osteoarthritis. ...

Osteotomy

What is an osteotomy? An osteotomy is a surgical procedure, carried out using general anaesthesia, that repairs damaged joints by cutting and reshaping the bones. An osteotomy can be performed on the following joints: Knee Hip Spine Jaw Chin Big toe Why is an osteotomy done? An osteotomy will fix problems experienced in different bones and joints. Knee – if the kneecap is misaligned or damaged from arthritis then a knee osteotomy cuts either the tibia or femur to take pressure of the damaged knee joint. Hip – the hip socket is reshaped so that the socket aligns better with the ball of the joint. Spine – a wedge of spinal bone can be removed to improve a hunched back. Jaw – in misaligned jaws, a lower jaw osteotomy can reposition the jaw. Chin – an osteotomy can narrow a very square chin. Most often this is performed by plastic surgeons. Big toes – a wedge of bone is removed to prevent the big toe obstructing your other toes. What does an osteotomy involve? Due to the complexity of an osteotomy, a hospital stay will be required. General anaesthesia is used, meaning you are asleep during the operation. The surgeons makes an incision over the area of bone that is being remodelled. Using a special surgical saw, a section of bone will be removed. The cut edges of bone are then secured together with metal hardware or special bone grafts. For a bone graft, a wedge of bone is usually taken from the pelvis, and it is secured with metal hardware. How do you prepare for an osteotomy? Before surgery you won’t be able to eat or drink and certain medications will have to be stopped. You will receive special instructions from your specialist. Aftercare following an osteotomy You can expect to stay in hospital for a couple of nights. Depending on the type of osteotomy performed, crutches are likely to be needed for a couple of months. Full rehabilitation can take up to 6 months. In most cases, physical therapy exercises will be needed to help restore strength, stability and movement to the bones. Alternatives to an osteotomy An osteotomy is often an alternative to larger surgical procedures, such as hip and knee replacements which are serious operations with very lengthy recovery times, and often revision surgeries too. Discussing your treatment options with your specialist is essential in making a treatment decision. ...

Ozone therapy

What is ozone therapy? Ozone therapy is form of alternative medicine which is based on the introduction of ‘ozone’ (e.g activated oxygen) into the body through various routes (such as the rectum, the vagina, intravenously, and subcutaneously). It has been suggested as a treatment or therapy for conditions such as AIDS, multiple sclerosis, and arthritis, along with disc problems such as herniated discs. Such claims lack significant evidence and research is limited. Why is it done? Ozone is said to enhance the circulation and cause ‘inactivation’ of bacteria, viruses, and yeast in the body. As an alternative therapy, it may be used to improve how the body takes in oxygen and how it uses the oxygen once inside the body. It is also said to help activate the immune system, and speed up the healing process. What does it involve? Ozone therapy can be applied in various ways, including through the vagina, through the rectum, under the skin (subcutaneously), through a vein (intravenously), and through a muscle (intramuscular application). Ozone can also be administered in other ways, such as through injections, a gas bath or sauna, or through ozonated water, drunk by the individual undergoing therapy. There is also a specific type of ozone therapy called autohaemotherapy, which involves withdrawing blood, mixing it with ozone, and putting it back into the patient’s bloodstream. Alternatives to this treatment Ozone therapy is an alternative therapy itself, and should only be done under medical supervision. If you are interested in receiving ozone therapy, talk to your doctor or visit a specialist who can advise you on the best method of treatment for your condition before alternative therapies are considered. ...

Partial knee replacement

Unicompartimetal patients suffering from osteoarthritis of the knee can be treated with different surgical methods. The most common are the tibial osteonomía young and total knee replacement in elderly. In unicompartmental knee replacement (also called "partial" knee replacement) only a portion of the knee is resurfaced with metal and plastic components. ...

Patellar luxation

What is it? Kneecap dislocation is a common injury in teenagers between 14 and 17, especially among the athletic population. The kneecap (patella) is displaced from its natural position within the patello-femural joint, being forced away from the midline. Kneecap dislocation often leads to ligaments and cartilage damage. It is important to make the distinction between kneecap dislocation and knee dislocation: a knee dislocation mainly affects the joints between the femur (thigh-bone) and tibia (shin-bone). Prognosis However painful and long-lasting it may be, if treated properly a kneecap dislocation can have no future consequences on your overall health. What are the symptoms? The main symptom is a sudden and acute pain in your knee, associated with a haematoma on the medial area of the joint, due to a blood backflow to your joint which will make it more evident. How is it diagnosed? If you have any of the above-mentioned symptoms, first of all you’ll need to have an X-ray scan. A CT scan and MRI scan can be helpful to rule out the possibility of ligament or meniscus damage, microfractures or loose segments of articular cartilage. What causes it? The main cause for dislocated kneecaps are trauma-related injuries or traumas due to a sudden movement of the joint. The most common one is where the quadriceps femoris muscle is contracted while the leg is still planted on the ground and the knee is partially flexed. It is also common for people to have an anatomical predisposition to these injuries, such as people with high knee. How can it be prevented? It is quite hard to prevent kneecap dislocation, especially if you have a structural predisposition to it or if you’re an athlete, due to very nature of the main cause of dislocated kneecaps. How is it treated? You should treat a dislocated kneecap as soon as possible after the injury. The treatment consists in reduction, that is, by manually pushing the kneecap towards the midline while straightening the knee. At first, your doctor will prescribe you to apply ice packs on the affected area and to take anti-inflammatory medication. You will only need to undergo arthroscopic surgery if there are microfractured segments of articular cartilage. Standard therapy consists in splinting the knee into a straight position with a cast for at least 15 days. In the following weeks, you will be gradually able to do more and more complex movements again. Once the cast is off, you’ll start doing physical therapy to rebuild the quadriceps muscle, which will be necessarily weakened by several weeks of bed rest. That will be helpful for the correct repositioning of the kneecap. Electrical stimulation, as well as using a dedicated splint for your knee, can be beneficial during recovery. You won’t be able to go back to sports again before eight to nine weeks, and you may have to wait longer if you underwent surgery. Which doctor should I talk to? If you have a dislocated kneecap, you should see an orthopaedic surgeon. ...

Patellar tendonitis (jumper's knee)

What is patellar tendonitis? The patellar tendon, which connects the kneecap to the tibia, works with the muscles in the front of the thigh to extend the knee and allow running, jumping, walking, etc. Patellar tendonitis (also known as jumper's knee) is when this tendon is injured or overloaded. This condition is more common in athletes whose sport involves frequent jumping, such as basketball and volleyball. However, non-athletes can also develop patellar tendonitis. Prognosis: Patellar tendonitis is not usually a serious injury, but it must be treated correctly so that it does not lead to anything else or long-term problems. Symptoms of patellar tendonitis: The main symptom of patellar tendonitis is pain, and may occur during physical activity or after intense training; it may worsen to the point of making it difficult to practice sports; or may make daily movements (such as climbing stairs) difficult. There may also be stiffness in the knee, pain when bending, or weakness in the leg. Medical tests for patellar tendonitis: The following tests are usually used to diagnose patellar tendonitis: MRI scan : a test that uses magnetic waves to make detailed pictures of the area which may show changes in the tendon Ultrasound: this uses sound waves to create a picture of the knee and show possible tears of the tendon. X-ray : to help exclude other bone problems related to the knee pain. What causes patellar tendonitis? Patellar tendonitis is usually caused by repeated stress on the patellar tendon. This causes tears in it that increase over time causing pain, inflammation and weakening of the tendon. Can patellar tendonitis be prevented? Different steps can be taken to try to prevent patellar tendonitis, such as: Strengthen muscles with exercise Improve your technique when playing sports Not exercising when suffering from pain Treatments for patellar tendonitis: Treatment usually begins with physical therapy to stretch and strengthen the muscles around the knee. A strap may also be applied to the patellar tendon that puts pressure on it and helps to distribute strength, relieving pain. Medications are also prescribed, corticosteroids and surgery is the last option. Which specialist treats you? An orthopaedic surgeon would treat cases of patellar tendonitis. ...

Patellofemoral disorders

What are patellofemoral disorders? Patellofemoral disorders are a range of problems that affect the kneecap and the patellofemoral joint (where the femur meets the patella, the kneecap). These conditions can either be caused through injury, or long-term conditions such as arthritis. A healthy patellofemoral joint moves smoothly against each other when the joint is bent or extended. The main problems that can cause issues with the patellofemoral joint are pain, instability, and arthritis. Patellofemoral pain syndrome is one such condition in which pain is experienced within the kneecap joint due to overuse or injury. Pain is often noticed during exercise, or even daily movements such as going up and down stairs. This is also known as runner’s knee. The pain is caused by an uneven distribution of weight on the kneecap, which can be caused by an abnormally tilted patella. Patellofemoral subluxation and dislocation (kneecap instability) is another disorder of the kneecap. Subluxations can happen when the femur (thighbone) does not stay within the groove on the kneecap, but partially slips out. This is also happens when the kneecap becomes dislocated. Patella dislocations most commonly happen during sports and exercise, where the knee will usually buckle and cause the patient to fall over. In such instances, it is important to eliminate the possibility of an ACL tear as these are common knee injuries from sport as well. Patellofemoral arthritis is characterised by stiffness and pain in the front part of the knee which can worsen on uneven ground or when walking up or down stairs. Pain is experienced due to worn down cartilage between the kneecap and femur. Arthritis can occur due to trauma, repeated dislocations or subluxations, or by ‘wear and tear’. What is the treatment for patellofemoral disorders? Patellofemoral pain syndrome can at first be treated non-surgically by reducing the inflammation. This can be done by taking anti-inlfammatory medication, resting the knee and applying ice. Sports and physical activity should also be avoided. In some cases, a cortisone injection can be given to help reduce inflammation. Physical therapy will also help to restore strength and comfort to the joint. If these measures do not provide relief, then a surgical procedure called a ‘lateral release’ can be performed in which the tissue that surrounds the knee joint is released and realigned. Treating patellofemoral subluxation or dislocations differ depending on if the problems are occurring or not. Usually, for first time issues, treatment is non-surgical as the torn ligaments can heal on their own with rest. However, surgery will be needed if any bone or cartilage has been dislodged. Treating patellofemoral arthritis starts with non-surgical methods, including rest, avoiding physical activity, and doing physical therapy movements that strengthen the surrounding muscles. Anti-inflammatory drugs can also be taken to relieve pain. For mild arthritis, steroid injections can help reduce pain and inflammation. Weight loss in overweight patients can help ease pressure and pain as well. For patients who do not find relief in non-surgical treatments, partial knee replacement might be considered in which damaged cartilage is removed and replaced with a patella implant. ...

Plantar fasciitis

What is plantar fasciitis? Plantar fasciitis is the inflammation of the plantar fascia by overloading or stretching. The plantar fascia is a thick ligament in the sole of the foot which connects the heel with the toes. This inflammation causes pain as you walk about, usually first thing in the morning, which flares up when standing after sitting for a long period. Prognosis: Non-surgical treatments reduce pain in almost all cases. It may take several months before symptoms improve. Some people require surgery to reduce the pain. Symptoms of plantar fasciitis Generally, this condition causes pain and rigidity in the lower part of the heel. The pain is usually accompanied by the following symptoms in the lower part of the heel: Slight swelling Reddening Tenderness Tests for plantar fasciitis: To diagnose plantar fasciitis, the patient’sclinical history is evaluated and a physical examination is performed. The examination determines which stage the plantar fasciitis is at. Next, the specialist performs a gait analysis and evaluates whether the inflammation of the plantar fascia is related to the way the patient walks. An X-ray scan or MRI scan might be performed to rule out bone problems and potential pinched nerves. What are the causes of plantar fasciitis? The causes of plantar fasciitis is when the tension on the tissue becomes too great, causing inflammation. It is more likely to occur in people who: Do sports frequently Are obese Have a tight Achilles tendon Have foot arch problems Can plantar fasciitis be prevented? This can be difficult to prevent, however, maintaining a healthy weight can help reduce the chances of this developing. However, if you frequently do exercises such as running, dancing, or aerobics, plantar fasciitis can develop. In addition, checking that the ankle, Achilles tendon and calf muscles are flexible may help to prevent plantar fasciitis. It may also be helpful to stretch the plantar fascia in the morning before you get out of bed and to perform physical activities in moderation. Treatments for plantar fasciitis: There are different treatments for this condition but the first option considered is conservative treatments, including rest, applying ice to the painful area and stretching over several months. Massaging and stretching the fascia, can help to provide symptoms relief. Other, more novel techniques are infiltration of growth factors, intratissue percutaneous electrolysis (EPI) and shock waves, which have all been demonstrated to be highly effective treatments in the acute phase. Moreover, more and more tools are becoming available for the manufacturing of very precise individualised shoe insoles. One such technique uses a laser to obtain a virtual 3D mould of the patient’s foot. In very specific cases in which none of the above treatments have worked, plantar fascia surgery should be performed. During this surgery, the tendon is partially or totally released or, if a heal spur is present, the heel spur is reduced. Which specialist treats it? An orthopaedic specialist can help to treat plantar fasciitis. ...

Platelet-rich plasma

What is platelet-rich plasma? Platelet-rich plasma is a blood derivative that stimulates the production of collagen, elastin and epidermal tissue. It is used to achieve firmer, brighter and better-quality skin. Why is the treatment performed? Platelet-rich plasma is a cosmetic treatment aimed at rejuvenating the skin of the face, particularly the area between the eyebrows, the crow’s feet and between the nose and lips. Platelet biostimulation is also used for other treatments such as improving stretch marks, joint degeneration, burns, skin loss after surgery and wounds caused by ulcers. Since the patient’s own plasma is used, there is no risk of the substance being rejected, encouraging a better result. What does it involve? This treatment consists of taking a small amount of blood from the patient, extracting the plasma from it and then injecting it into the desired area to stimulate cell regeneration in the tissues and to combat the signs of ageing. Treatment with platelet-rich plasma helps the skin to recover its firmness and smoothness, whilst also reducing the expression lines of the face. The main advantages of this technique are safety and effectiveness. How to prepare for platelet-rich plasma treatment Bioestimulation with platelet-rich plasma is performed at the surgery. After cleaning and preparing the area for treatment, an anaesthetic cream is applied and blood is taken from the patient. Once the plasma has been extracted, it is then applied to the patient via multiple injections in the form of mesotherapy, using a very fine needle. Post-treatment care Following PRP treatment, the patient should apply arnica cream to prevent small papules appearing in the areas injected on the neck and neckline area, and to lightly massage with the fingertips the areas where the skin is more delicate. On the day of treatment, it is advised not to sunbathe or to apply creams to the skin. It is also not advisable to go to a sauna or gym directly after treatment. ...

Posterior cruciate ligament

What is the posterior cruciate ligament? The posterior cruciate ligament (PCL) is a ligament in the knee that connects the thigh bone (femur) to the shin bone (tibia). It is similar to the anterior cruciate ligament (ACL), but is bigger and stronger, however, it can be torn through injury, although injuries to the ACL are much more common. Symptoms of a posterior cruciate ligament injury: Pain and difficulty walking Swelling Instability (your knee may give way) Medical tests to diagnose a posterior cruciate ligament injury: A specialist will firstly ask for a history or account of what may have caused the injury and how it happened. A physical examination will also be conducted, in which you will lie on your back with your injured knee bent. The specialist will press against the upper shin, and any abnormal knee movements usually indicate a PCL injury. X-rays will also help diagnosing a PCL injury and can indicate if any bone fragments have come loose. An MRI scan can show the exact location of the teat in the PCL. What are the causes of a posterior cruciate ligament injury? PCL injuries usually result when the knee is bent and is commonly caused by either car accidents or when falling on a bent knee. Sports injuries will often cause PCL injuries, such as football and skiing. Can a posterior cruciate ligament injury be prevented? It is impossible to avoid unforeseen injuries, but generally contact sports are the biggest risk factor for PCL injuries. Therefore, taking care whilst participating in these sports will help avoid injury. Treatments for a posterior cruciate ligament injury: Depending on the severity of the PCL injury and whether the injury has just happened or not, treatment will differ. Often surgery is not required. Over-the-counter painkillers can help with pain and to reduce swelling. Using the RICE advice will help too: Rest – avoid putting weight on the injured knee. Ice – apply ice packs to the knee 3-4 times a day or a few days. Compression – an elastic bandage around the knee can help. Elevation – using a pillow to elevate the knee will reduce swelling. Physical therapy will give you exercises to strengthen the knee. A knee brace and crutches may also be needed. Surgery will be required if the injury is sever, or if other ligaments have torn or if bones have broken. Surgery will reconstruct the ligament. This can be performed either as open surgery, or arthroscopically, using an arthroscope. Which type of specialist treats a posterior cruciate ligament injury? An orthopaedic surgeon would treat posterior cruciate ligament (PCL) injuries. ...

Prolotherapy

What is prolotherapy? Prolotherapy is a regenerative injection therapy to treat chronic pain related to ligaments, tendons and joints. It is classified as alternative medicine or complementary medicine, in that its efficacy outside of the placebo effect has not been proven. Studies have generally yielded weak evidence that prolotherapy may have some effect in treating certain conditions, like tendonitis, while others have concluded that it is ineffective. That said, there is interest in its potential from the medical community, and more studies are being conducted. Why is prolotherapy done? The function of ligaments and tendons is to stabilise the joints and attach muscles to the bones. It is therefore essential that the ligaments and tendons remain healthy. Because ligaments and tendons are hypovascular tissues that receive little blood, the body's own ability to repair tissues may be limited. Repeated strain over a long period can result in conditions like tendonitis. Some of the problems where prolotherapy has been reported to help include: Tendinosis/tendonitis, e.g. Achilles tendonitis, epicondylosis/epicondylitis (tennis elbow), etc. Osteoarthritis of the knee Plantar fasciitis Low back pain What does it consist of? The procedures vary, as there is no standardised treatment, but prolotherapy in all its forms consists of injecting regenerative solutions into the tendons or ligaments causing pain. These substances are low volumes of irritatants, which cause local inflammation. This increases the blood flow in the area and, in theory, stimulates the body to heal itself, producing collagen fibres to repair the ligaments, tendons, and injected joints. After the injection, the patient may notice an increase in pain as a consequence of the inflammation generated in the injected area. It is normal and the pain will disappear after a few days. The substances used for prolotherapy are often natural sugars (most commonly hyperosmolar dextrose), although other substances are sometimes used. Care after the intervention As mentioned above, it is possible that after the intervention the patient will notice an increase in pain, due to the inflammation in the injected region. The pain is normal and usually disappears after a few days. ...

Regenerative medicine

Regenerative medicine is a form of medicine that aims to replace, or engineer tissues, cells, and organs rather than treating the symptoms of the condition, trauma, or disease. Regenerative medicine focuses on molecular biology, and stem cell research and artificial organs to stimulate the body’s repair systems to effectively heal tissue and organs that is not usually repairable. Different types of regenerative medicine Stem cells used for repair Stem cells are one way that the body repairs itself. Using stem cells harvested from the body, they can be injected into an area of diseased or damaged tissue. The tissue may then be able to reconstruct under the right circumstances. Further study and progress is being made in understanding how embryonic stem cells, which are able to transform into any kind of cell, can be used to help organs, nerve cells, muscle cells, tissue, blood, and other cells to regenerate and replace damaged or diseased cells. Regeneration already occurs in some animals, such as the zebrafish and the axolotl. Stem cell therapy Stem cells are found in the bone marrow, where they are traditionally harvested from, but new techniques allow the stem cells to be released into the blood using a blood hormone, allowing them to be collected from the blood. As explained in the previous point, these stem cells can be used to cure a wide range of diseases and genetic disorders, such as leukaemia, Parkinson’s disease, Alzheimer’s, multiple sclerosis, diabetes, arthritis, etc. by replacing the damaged cells. Organ growth and replacement In patients with failed organs, the usual procedure is to transplant a replacement organ from a donor patient. Regenerative medicine also includes the possibility of growing tissue or organs in a laboratory to be implanted into the patient. Cells can be taken from the patient to grow tissue and organ cells, and can solve the problem of a shortage of donor organs. Biomaterials and tissue engineering This field of regenerative medicine involves implanting biologically compatible scaffolds to allow new tissue to be formed. The scaffold attracts nearby cells to form on the scaffold, aiding the formation of tissue in the desired shape and structure. This is a relatively new field of study, with new developments being made all the time. ...

Revision knee replacement

What is revision knee replacement surgery? Although knee replacement implants are designed to last a long time, sometimes they can wear out and require additional surgery. Hence, revision knee replacement surgery revisits existing knee replacements, sometimes replacing previous implants. These implants, typically made out of plastic, inserted between the shin bone and the thigh bone. Why would you need revision knee replacement surgery? Revision surgery is sometimes needed because the implant can cause instability, possibly due to being placed incorrectly. This can cause the patient to feel wobbly whilst walking. Revision surgery is also needed when the implant is worn down, over time, and surgery swaps out the old implant for a new one. Surgery will also be needed if existing implants become detached from the bone. What does revision knee replacement surgery involve? Depending on the type of revision knee surgery being carried out, the procedure will differ. These procedures are carried out with regional or general anaesthetic. Post-operative care After surgery, patients will usually stay in hospital for 3 to 5 days. Crutches are usually needed for 2-3 weeks following surgery, after which a walking stick can be used for support. During recovery, physical therapy is recommended so that strength and movement is restored to the knee. Sufficient painkillers can be prescribed, along with blood-thinning medication to prevent blood clots forming. It is important to get moving as soon as possible after the revision knee surgery has been carried out. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals. ...

Shockwave therapy

Shockwaves have a therapeutic effect and cause the regeneration of injured or diseased tissues. Shockwaves are acoustic waves which have high power mechanical and biological effects. Such treatments are primarily used for treatment of diseases which require tissue regeneration. ...

Sport Medicine

Sports medicine is a specialty that evaluates the aptitude for sport.

Sport surgery

What is sports surgery? If a person sustains an injury during exercise, sports participation or any type of physical activity, depending on the severity of the injury, they may be advised by a sports medicine specialist to see an orthopaedic surgeon for treatment. Surgery is normally the last resort for amateur sportsmen and is more common amongst professional athletes. Surgery is likely if a person has sustained a serious injury or as a result of persistent symptoms that were not successful following the use of other treatments prior to the operation. What are the common sports injuries treated? Sports surgery can repair damaged soft tissue, realign bones and joints. However, not all injuries require surgery. A sports medicine doctor may treat the following injuries sustained through physical activity: Sprained ankles Hip Bursitis Fractures Knee and shoulder injuries Tendonitis Low back pain Pulled muscles Concussion Cartilage injuries The most common sports injuries are strains and sprains, which is when the ligaments have been stretched past their limits and have resulted in a tear. What are the different types of surgical procedures in sports surgery? Many sports injuries are treated using keyhole surgery. This involves the surgeon making a small incision and using a tiny camera to guide them during the procedure. This type of surgery is most common with knee injuries and is known as arthroscopy. How can sports injuries be prevented to avoid sports surgery? Even though it is recommended to exercise regularly as an important part of maintaining overall health, precautions should be taken to minimise the risk of injuries. Sports injuries occur from overtraining, lack of conditioning and poor technique. The following tips can be used as a preventative for sports injuries: Use the correct equipment Always warm-up before Wear the right protective gear Rest in between workouts to allow the body time to rest and repair Start exercising slowly and gradually increase strength, flexibility and endurance Listen to the body if it shows any signs of pain or distress What happens after a sports surgery procedure? Recovery from an operation for a sports injury depends on the severity and the individual case. Most injuries require a long rest period following surgery on an affected joint, muscle or soft tissue. Physiotherapy is used to rebuild strength and to increase the range of movement around the joint or muscle. It will also help to condition the injury to make it more resistant to any future complications. ...

Sports physical examination

What is a sports medical examination? Sports medical check-ups are all those tests concerning the state of health of the athletes, fundamental to play sports in a safe way. It is recommended to carry it out annually or whenever you want to start a new sport, to know if you are physically prepared to practice it. What happens during a sports medical examination? A sports medical examination may be composed of a series of tests: History: analysis of medical history and personal and family history. Gait analysis: revision of the pelvis, spine, ankles, knees, etc. Cardiovascular evaluation: checking blood pressure by listening to your pulse and heart beat Electrocardiogram: obtains a graph of the electrical activity of the heart. Respiratory assessment: this may involve listening to your breathing and spirometry (measures lung capacity and volume). Body composition: calculation of bone, muscle and fat weight. Evaluation of aerobic endurance test: consisting of running on treadmill or athletic track. Why is a sports medical examination carried out? The objective of a sports medical examination is to confirm that someone is ready for a certain sports activity, and to anticipate any difficulties the person may have. Anyone can benefit from an examination, whether they play sport to a professional level or would just like to take up a new sport as a hobby. Preparing for a sports medical examination Before submitting to the test, it is recommended to take the following measures: Wear loose, comfortable clothes Avoid heavy exercise for 24 hours before the exam Eat light food, do not smoke, do not drink coffee, alcohol or stimulants on the day Meaning of abnormal results of a sports medical examination A sports medical examination may reveal issues such as: Poor gait or posture that could result in injury Problems with breathing function that may require further investigation Inherited heart conditions which need managing for you to play sport safely After you are given the results of your exam you may be referred to another specialist, such as a cardiologist or physiotherapist, for further investigation and treatment. ...

Sports traumatology

What is sports medicine? Sports medicine is a branch of medicine that focuses on the prevention, diagnosis, and treatment of sports-related injuries. Sports injuries can happen suddenly, due to overtraining, not training properly, poor technique, wearing inappropriate clothing, and a lack of fitness, among other causes. The treatments used allow the person to go back to their normal training routine as soon as possible and in the best conditions. What’s the difference between traditional orthopaedics and sports traumatology? Sports traumatology focuses on athletes specifically and injuries arising in sport, considering the athlete's needs, whereas traditional traumatology treats general locomotive system injuries. This kind of specialist has in depth knowledge of different types of sports and understands the different situations that the athlete may have. They not only have physical, medical, physiological knowledge of the human body, but they are also able to treat different sports injuries (due to training, seasonal changes, competition expectations, among others), as well as other reasons for injuries. The most common injuries in sports medicine The most common injuries are: Sprained ankle. Muscle tears. Tendonitis and tendinopathies (tennis elbow, golfers elbow, Achilles tendon rupture). Knee injuries (meniscus fracture or damage to the anterior cruciate or posterior cruciate ligament) and cartilage injuries. Shoulder injuries (dislocation and tendinopathy), among others. Sports medicine treatments The right treatment in sports medicine will always be based on each player’s medical history, which should include family and personal history, injury history, surgical history, and orthopaedic issues. The information gathered in a sports admission exam will be included, this will assess postural information, the skeletal muscle, joints, ligaments, and physical fitness, risk factors will also be included for any potential injuries according to the sport. Some of the treatments within this speciality include: Ultrasound-guided galvanic electrolysis technique, commonly known as USGET, is an innovative medical and physiotherapy technique that enables accurate treatment of injured tendons, muscles, or ligaments, successfully treating sports injuries such as: Achilles tendonitis Patellar tendonitis Pubalgia Epicondylitis (tennis and golfers elbow) Rotator cuff tendonitis (supraspinatus) Plantar fasciitis Trochanteritis Iliotibial band syndrome Muscle tears (hamstrings, femoral biceps, calf, and soleus among others) Platelet Rich Plasma (PRP) is a highly effective treatment to stimulate scarring, regeneration, and healing damaged tissues, such as: Tendon ruptures Chronic tendinopathies Ligament injuries Muscle injuries Focal cartilage injury Osteoarthritis Hyaluronic acid: Hyaluronic acid injections can reduce pain and revive joint function thanks to the treatment’s lubricant, mechanical, and biochemical effect. The most common areas to treat are: Knees (joint that most often receives this treatment) Ankles Hips Shoulders Hands ...

Sprain

A sprain is a pull or twist of the ligaments, produced when overstretched or when a joint is in an unnatural position. The patient suffers muscle pain, swelling, discoloration of the skin and joint stiffness. ...

Stem Cells

What is it? Stem cells are cells that can differentiate, that is, they can transform into other tissues and organs cells. Stem cells can be found in any grown human body. Stem cells can divide into: Totipotent stem cells , which can become any kind of organic tissue; Pluripotent stem cells , a cell type that can transform into nearly all types of cells for tissues and organs; Unipotent stem cells , which can only produce one cell type; Multipotent stem cells , that is, cells which can only differentiate into a limited number of cells; Oligopotent stem cells , which can differentiate into only a few cell types. Stem cells can be found in the bone marrow, in the brain, in the dermis (skin) and in the dental pulp. In newborns, the umbilical cord and amniotic fluid are also rich in stem cells. What are stem cells for? Stem cell therapy is currently used in the UK as part of treatment for certain types of blood cancer. Stem cells enable significant blood transfusions after aggressive cancer treatment for conditions such as non-Hodgkin lymphoma . Because stem cells can regenerate old or damaged cells, there is significant interest in its use for a much wider range of conditions. Stem cell therapy is currently being researched for the treatment of conditions as varied as muscular dystrophy, jaw pain, Alzheimer’s disease. Treatment would consist in a procedure by which the damaged tissues or organs are healed by using stem cells. ...

Stromal vascular fraction

The stromal vascular fraction (FVS or SVF) is obtained by centrifuging and filtering adipose tissue, previously lipo-aspirated. The stromal vascular fraction is formed by different cells, including adult stem cells. The stromal vascular fraction favours the presence and disposition of blood and lymphatic vessels in tissues and organs, improving circulation and healing....

Tendinopathy

What is tendinopathy? Tendinopathy is an umbrella term for diseases of the tendons. Tendons are fibrous cords of tissue that hold muscles to bone, and in order to do their job, they must be strong and flexible. Despite this, they can be injured due to overuse. Tendinopathy broadly refers to three varieties of tendon injury, and is often confused with, or used synonymously with them. They are: Tendonitis/tendinitis – inflammation of a tendon, usually due to acute injury caused by overuse or repetitive strain. Tendinosis – chronic tendon injury with little or no inflammation, involving micro-tears in the affected tendon. Tendinosis causes long-term pain and is degenerative. Paratenonitis – inflammation of the outer sheath (paratenon) that surrounds certain tendons, such as the Achilles. There is some debate as to whether this should be considered separate from tendonitis. All of these conditions increase the risk of a more serious tendon tear, or rupture. What are the symptoms of tendinopathy? The common symptom of all types of tendinopathy is pain in or around the tendon, most commonly in the place where it attaches to the bone. Other symptoms depend on the type of tendinopathy – for example, tendonitis is characterised by inflammation, including heat, swelling and redness, while tendinosis is a chronic ache, pain or stiffness without much, if any inflammation. The pain is usually worse during and after activity, and the area around the joint can be stiffer the following day. There are tendons in many parts of our bodies, and tendinopathy can occur in any of them. It most commonly strikes in tendons such as those in the arms, shoulder, hands, and the Achilles tendon (in the heel). What causes tendinopathy? It is thought that the biggest factor in most tendinopathies is overuse, although there are many theories regarding other possible factors, such as thermal damage and load-induced ischemia. Both sudden bursts of exertion leading to injury and repetitive movements are thought to be the main causes of tendonitis, and obesity is thought to be a risk factor. In the case of calcific tendonitis, calcium deposits in the tendon are the cause of the inflammation, but why they build up in the first place is not fully understood. How can tendinopathy be prevented? While it is impossible to prevent with 100% certainty, the best way to prevent tendinopathy is to look after your muscles and tendons by not over-exerting yourself, but keeping them strong and flexible by doing exercise. Warming up before exercise and cooling down afterwards by stretching your muscles is also recommended. What is the treatment? The treatment may depend on the kind of tendinopathy, but in most mild cases the RICE therapy is advised: Rest until the injury improves Ice – apply cold Compress the injury with a bandage or brace Elevate – keep the injured tendon raised while at rest. Painkillers may be prescribed to deal with the pain – particularly NSAIDs if there is inflammation. In more severe cases, shockwave therapy or even surgery may be necessary. ...

Tendon injuries

What are tendon injuries? Tendon injuries, also known as tendinopathies, happen when there is an overload that causes small fibres to tear. When the affected muscles or joints are put under pressure, it causes tendon inflammation which reduces blood flow and can lead to nerve compression. When there is a mild inflammation it is referred to as tendonitis. It is called tendinosis if there is tendon degeneration. Tendon injuries are common in sports. Injury location will depend on the sport. Some common tendon injuries include: Achilles tendon: in the heel, it is common among professional athletes. It causes inflammation, pain, and swelling. Patellar tendon: in the knee, it is more common in women. Exercising is important to avoid discomfort. Supraspinatus tendon: in the shoulder, as it is a fragile area, and recovery tends to take longer. This is usually the tendon affected in rotator cuff injuries. Lateral epicondyle tendon: in the elbow, most commonly known as tennis elbow. It is common amongst tennis players, but can happen in other professions too. Prognosis: Tendon injuries do not tend to be a serious condition, providing adequate treatment is given. Tendon injuries may be: Acute: less than two weeks Subacute: between three to six weeks Chronic: more than six weeks What are the symptoms? The symptoms of tendon injuries vary according to their location. There are several common symptoms, including: Pain and tenderness when moving the tendon or joint Stiffness at night or upon waking Inflammation Heat and redness Hearing or feeling a crack when moving the tendon Thickening of the tendon (in some cases). Medical tests: A physical examination is normally enough to identify the affected tendon and the seriousness of the injury. However, in some cases the specialist may carry out other tests to have a closer look, these may be an ultrasound or an MRI scan. What causes tendon injuries? Some of the most common causes include: Not warming up before exercise Sports injuries Repetitive movements or overexertion Physical changes (such as postural dysfunction and many more) A bad movement, especially when exercising Inadequate training equipment Metabolic dysfunctions or poor hydration How can tendon injuries be prevented? There are different tips that can be followed to avoid this kind of injury. It is important to take care when lifting heavy loads to avoid pushing the tendon beyond its limit. A massage or stretching after lifting a heavy load is one way to prevent a tendon injury. Other things to bear in mind are: Improving sports techniques Lessening loads Using appropriate footwear What is the treatment for tendon injuries? Treatment tends to be conservative, and includes rest and anti-inflammatory measures, depending on the severity of the injury. This may include medications, nutritional supplements, dietary changes, using bandages and manual therapy. The methods used will depend on the injury location, severity, and how long it has affected the patient. Although there are many different treatments, the most common ones are: Rest Stretching Anti-inflammatories Physiotherapy When treatment doesn’t work, surgery may be resorted to instead. What specialist should I see? Tendon injuries are normally treated by a sports medicine specialist, an orthopaedic surgeon or a physiotherapist. ...

Tendonitis

What is tendonitis? Tendonitis (also spelled tendinitis) refers to inflammation of a tendon. It is one of the major sub-types of tendinopathy (tendon disease), along with tendinosis and paratenonitis. Tendons are thick, fibrous cords of tissue that attach muscles to bones. They are tough, yet flexible, and have evolved to withstand tension. However, they can become injured or strained due to overuse, leading to inflammation. Common types of tendonitis include: Achilles tendonitis – affects the Achilles tendon in the heel. Supraspinatus tendinitis – affects the tendon around the top of the shoulder joint. Tennis elbow – a.k.a. lateral epicondylitis. Causes pain on the outer elbow, which may radiate down towards the wrist. Golfer’s elbow – a.k.a. medial epicondylitis. Causes pain on the inner elbow, which may radiate down to the wrist. Tendonitis of the wrist – affects people who make repetitive motions with their wrists, such as badminton players and production line workers. Trigger finger – the affected digit becomes fixed in a bent position due to a thickened and inflamed tendon, and will usually click when forced to straighten. Calcific tendonitis – calcium deposits build up in the tendon, causing pain. This most commonly occurs in the shoulder, but can occur in any tendon. Tendonitis is related to, and often goes hand-in-hand with tenosynovitis (inflammation of the sheath around the tendon, such as De Quervain syndrome). What are the symptoms of tendonitis? Typical symptoms of tendonitis include: Pain – this may worsen during movement. Swelling, redness, and heat A grating or crackling feeling when the tendon is moving The tendon may develop a lump. Symptoms occur where the tendon connects to the bone. They may last anywhere between a few days and several months. Without proper treatment, the condition can develop into chronic tendinosis and leaves the patient more susceptible to ruptures in the tendon. What causes tendonitis? There are two main direct causes of tendonitis: Sudden injury Repetitive movements over time – these could be anything from movements made during activities like gardening, painting, or cleaning, to sports, such as tennis or golf. As we age, our tendons lose their elasticity, and become less flexible and easier to injure or tear. Other risk factors include jobs involving repetitive movements, sport (particularly “weekend warriors”, who are relatively inactive during the week, but push themselves hard at the weekend), and certain health conditions, like diabetes and rheumatoid arthritis, which seem to go hand in hand with a greater likelihood of developing tendonitis. Bad posture and not warming up properly before exercise can also lead to tendonitis. Calcific tendonitis is caused by a build-up of calcium deposits in the tendon. Exactly why this occurs is unknown. How can tendonitis be prevented? Exercise – to prevent tendonitis, it is important to keep your muscles and tendons as strong and flexible as possible. It is equally important not to push yourself too hard, as overloading the muscles with more than they can handle is a prime cause of tendonitis. Stretch before and after exercise to warm up and cool down. Avoid repetitive movement. What is the treatment for tendonitis? The first line of treatment for mild tendonitis is usually RICE therapy for 2-3 days: Rest – avoid exercise or activity with the tendon until the injury improves. Ice – apply cold to the tendon for 15-20 minutes. Compress – wrap a bandage around it. Elevate – keep the injured area raised on a pillow when lying down. It is recommended that you avoid heat, alcohol and massages for the first few days after injury. If the injury is severe or lasts longer than a few days, you should see a doctor, who may recommend different treatments, depending on the nature and severity of the tendonitis. Possible treatments include: Painkillers – NSAIDs, such as ibuprofen, are often the first line of treatment, offering pain relief and anti-inflammation. Steroid injections Shockwave therapy – may speed up healing, or may be used to break down calcium deposits in the case of calcific tendonitis Surgery – in very severe cases, the doctor may recommend removing damaged tissue or calcium deposits or repairing a rupture via surgery. ...

Traumatic injury

A traumatic injury is sudden and serious, for example, a car accident or gunshot wound. It requires immediate medical attentioan. It can be treatable or in some cases have lifelong implications, which vary from case to case. ...

Mr Gordon Shepard Orthopaedic surgeryBolton

Mr Gordon Shepard

Orthopaedic surgeon in Greater Manchester

MBChB FRCS (Tr&Orth) DIP Sports Science

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Mr Gordon Shepard
Orthopaedic surgery
Bolton

Orthopaedic surgeon in
Greater Manchester