Easy To Understand About Shoulder Problems

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“People may come in with shoulder pain when they really have a neck problem,” An aching shoulder may not signal a shoulder problem. And a sore neck may not indicate a neck problem. It is totally depends on symptoms what kind of problem you have in your shoulder.

Shoulder pain treatment in India

The shoulder joint is made up of bones held in place by muscles, tendons, and ligaments. Tendons are tough cords of tissue that hold the shoulder muscles to bones. They help the muscles move the shoulder. Ligaments hold the three shoulder bones to each other and help make the shoulder joint stable.

Shoulder pain is a common musculoskeletal complaint that may be due either to intrinsic disorders of the shoulder or referred pain. The former include injuries and acute or chronic inflammation of the shoulder joint, tendons, surrounding ligaments, or periarticular structures.

Who Gets Shoulder Problems?

Men, women, and children can have shoulder problems. They occur in people of all races and ethnic backgrounds.

What Causes Shoulder Problems?

Many shoulder problems are caused by the breakdown of soft tissues in the shoulder region. Using the shoulder too much can cause the soft tissue to break down faster as people get older. Doing manual labor and playing sports may cause shoulder problems.

Shoulder pain may be felt in one small spot, in a larger area, or down the arm.

Shoulder Dislocation Treatment in India

How Are Shoulder Problems Treated?

Shoulder problems are most often first treated with RICE (Rest, Ice, Compression, and Elevation):

Rest: Don’t use the shoulder for 48 hours.

Ice:  Put an ice pack on the injured area for 20 minutes, four to eight times per day. Use a cold pack, ice bag, or a plastic bag filled with crushed ice wrapped in a towel.

Compression:  Put even pressure (compression) on the painful area to help reduce the swelling. A wrap or bandage will help hold the shoulder in place.

Elevation:  Keep the injured area above the level of the heart. A pillow under the shoulder will help keep it up.

If pain and stiffness persist, see a doctor to diagnose and treat the problem.

What Are the Most Common Shoulder Problems?

The most common shoulder problems are:

• Dislocation
• Separation
• Rotator cuff disease
• Rotator cuff tear
• Frozen shoulder
• Fracture
• Arthritis

What Research Is Being Done on Shoulder Problems?

Scientists are studying shoulder problems to find ways to:

• Improve surgery.
• Improve function and reduce pain.
• Correct movement patterns that cause shoulder pain in some people with spinal cord damage.
• Develop new medicines that help muscles and tendons heal.
• Prevent and treat rotator cuff tears.

For More Information About Shoulder Problems and Other Related Conditions:

If you need more information about available resources,  please visit our website www.jointclinic.in or contact the at mailto:jointclinic0@gmail.com

Anterior Cruciate Ligament (ACL) Reconstruction Surgery

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What is Anterior Cruciate Ligament Surgery?

Anterior cruciate ligament reconstruction surgery is an arthroscopic surgical procedure done to repair a tear in ligament of the knee called the anterior cruciate ligament.

The thigh and leg bones (femur and tibia, respectively) that contribute to the knee are held together with bands of tissue called ligaments with surrounding capsule and muscles supporting them. Considering the amount of movement at the knee that takes place against gravity, these ligaments have to be very strong to withstand the stress that they are subjected to. A total of four ligaments support the knee joints. Two ligaments, the anterior cruciate ligament (ACL) and the posterior cruciate ligament are cross-shaped ligaments present within the knee joint. Two other ligaments, the medial and lateral collateral ligaments are located on either side of the knee.

The femur and tibia have two eminences at their surface of contact with each other. The eminences on the inner aspect of the knee are called the medial condyles, while those at the outer aspect are called lateral condyles. The part between the medial and lateral condyles is called the intercondylar region.

The anterior cruciate ligament is attached to the intercondylar region of the tibia, more towards the front of the joint. It extends upwards and is attached to the inner aspect of the lateral condyle of the femur, more towards the back of the joint. It consists of two bundles – the anteromedial and posterolateral bundles. A third bundle called intermediate bundle may also be present. When the knee is bent, the anteromedial bundle becomes tight while the posterolateral bundle relaxes. The opposite happens when the knee is straightened.

An injury to the anterior cruciate ligament may make the knee unstable and warrant surgery. A torn anterior cruciate ligament is usually a consequence of sports injuries. It may be noted some patients who are born with weak ligaments, like Ehlers-Danlos syndrome. Though not all patients require surgery, reconstruction of the ligament is particularly recommended for patients who are very active, especially athletes involved in contact sports. Surgery can make the knee close to normal, and permit them to return to professional sports.

When Should the Surgery be done?

Joint Clinic- Though the opinions vary among centers, surgery is often advised between 3 weeks and a year following the injury. If the surgery is carried out before 3 weeks, there is a chance that the patient may suffer from a condition called arthrofibrosis, where excess of fibrous tissue forms within the joint. If the surgery is delayed beyond a year, the patient may develop damage to other structures of the knee like menisci and ligaments, which can result in osteoarthritis.

What are the Tests Required before Knee Surgery?

Before an ACL reconstruction surgery is carried out, diagnosis of knee ligament injury is confirmed based on:

·         History obtained from the patient to find out the type of injury sustained.

·         Physical examination of the patient to look at the instability of the knee.

·         An MRI test, which can detect injuries to ligaments and other soft tissues. During an MRI procedure, the patient is placed inside a narrow tube, which can make them claustrophobic if they have a fear of enclosed spaces. Few centers do offer special more open MRI machines, but the drawback is that the pictures may not be as clear. The MRI machine makes a loud clicking noises and it is advisable to ask for earplugs to help block these noises out.

Knee Replacement in India

Other tests had done include routine tests necessary before any arthroscopic surgery. These include chest x-ray, ECG, blood tests to detect your hemoglobin level, presence of infection, blood group and urine tests.

Some hospitals may want to do test for hepatitis and HIV/ AIDS, however if the patient is not comfortable, they should discuss it with the doctor.

What is the Postoperative Care Required following ACL Repair?

Following ACL repair, the patient is observed for a few hours in the hospital, after which they are discharged. A knee brace may be used to support the knee, and the patient may be given crutches to avoid putting direct weight on the knee. Physiotherapy is started after a few days to strengthen the knee. Skin stitches are removed in around a week. Full recovery may take around 6 months, after which the patient may even be able to get back to competitive sports.

Possible complications of the procedure include:

·         Failure of graft or other devices like screws

·         Inflammation of the synovial tissue of the joint, called synovitis

·         Infection

·         Pain in the joint

·         Stiffness of the knee

·         Injury to a blood vessel or a nerve during the surgery

·         Complications associated with anesthesia

Knee Pain Treatment in India

What is the Role of Platelet-Rich Plasma in Healing of Ligament Injuries of Knee?

Platelet-rich plasma has been used to regenerate injured tissues. It contains a high concentration of growth factors, which help in tissue healing. It can be injected or placed as a gel in the knee joint following ACL reconstruction surgery. However, the results from various clinical studies indicate a variable response, and therefore its use currently cannot be definitely recommended.

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