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The constant use of the lower extremities makes them an easy target for injury and pain, specifically in the knees. Walking, sitting and standing all put pressure on our knees, while most athletic activities rely on them as well. Knee pain is a common ailment that affects thousands of people in the US each year.

Anterior Cruciate Ligament Injury

The ACL (anterior cruciate ligament) is one of the most commonly injured ligaments in the knee. Running diagonally through the middle of the joint, the ACL works together with three other ligaments to connect the femur (upper leg bone) to the tibia (lower leg bone). ACL injuries occur most often in athletes as a result of a sudden deceleration, pivot and twist on the leg, direct contact, landing awkwardly after a fall, or playing recklessly. About half of ACL injuries are also accompanied by damage to the meniscus, cartilage, bone or other ligaments in the knee.

Signs that you may have injured your ACL include pain, swelling and instability immediately after the injury, followed hours later by greater swelling and pain, limited motion, tenderness and an inability to walk comfortably. While not all ACL injuries will require surgery, leaving the ligament torn or damaged puts the patient at risk for recurring episodes of knee instability. In many cases, patients will not be able to resume high-level athletic activity without surgery.

Your doctor will discuss with you whether or not surgery is recommended after a thorough evaluation of your condition, as well as consideration of your age, activity level, and overall health. The details, risks and benefits of surgery, as well as the different surgical options, will be discussed during a pre-surgical consultation.

Anterior Cruciate Repair

The ACL (anterior cruciate ligament) is one of the most commonly injured ligaments in the knee. Running diagonally through the middle of the joint, the ACL works together with three other ligaments to connect the femur (upper leg bone) to the tibia (lower leg bone). ACL injuries occur most often in athletes as a result of direct contact, landing awkwardly after a fall or playing recklessly. About half of ACL injuries are also accompanied by damage to the meniscus, cartilage, bone or other ligaments in the knee.

Signs that you may have injured your ACL include pain, swelling and instability immediately after the injury, followed hours later by greater swelling and pain, limited motion, tenderness and an inability to walk comfortably. While not all ACL injuries will require surgery, leaving the ligament torn or damaged puts the patient at risk for recurring episodes of knee instability. In many cases, patients will not be able to resume high-level athletic activity without surgery.

Your doctor will determine whether or not surgery is recommended for you after a thorough evaluation of your condition, as well as consideration of your age, activity level and overall health. The details, risks and benefits of surgery, as well as the different surgical options, will be discussed during a pre-surgical consultation.

Knee Arthroscopy

Arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the knee, allowing your doctor to examine the joint in great detail. For some patients, it is then possible to treat the problem using a few additional instruments inserted through small incisions around the joint. Sports injuries are often treatable with arthroscopy. Knee injuries that are frequently treated using arthroscopic techniques include meniscal tears, mild arthritis, loose bone or cartilage, ACL and PCL tears, synovitis (swelling of the joint lining) and patellar (knee cap) misalignment. Because it is minimally invasive, arthroscopy offers the patient many benefits over traditional surgery. These include:

  • No cutting of muscles or tendons
  • Less bleeding during surgery
  • Less scarring
  • Smaller incisions
  • Faster recovery and return to regular activities
  • Faster and more comfortable rehabilitation

Bursitis

Our joints contain small, slippery sacs called bursae that help muscles and tendons slide smoothly over our bones. Bursitis is the inflammation (swelling) of one of these sacs. Overuse or constant pressure on the knee causes the bursa to fill with fluid. It then becomes irritated, gritty and rough, and can create friction in other parts of the joint as it swells.

Two common sites for bursitis in the knee are the kneecap (prepatellar bursitis) and the pes anserine (“goosefoot”) bursa, located about two inches below the knee where the shinbone meets three tendons from the hamstrings. Pes anserine bursitis often afflicts runners and other athletes as well as people with osteoarthritis (“wear and tear” arthritis), tight hamstrings, obesity, or turned-out knees or lower legs. Symptoms include pain on the inside of the knee or at the top of the shinbone that gets worse with exercise or stair-climbing. Prepatellar bursitis tends to occur in people whose jobs involve long periods of kneeling, who play sports that frequently involve falling or being struck on the knee, who have been in a car accident, or who have rheumatoid arthritis or gout. Symptoms include pain after activity and swelling and tenderness on the kneecap.

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My Shoulders Are Letting Me Down

We rely on our shoulders for countless tasks. It can be problematic when they don’t function at our best and can make ordinary tasks a challenge. Finding a cause behind unstable shoulders can help bring pain relief and peace of mind. Here are some reasons behind your shoulder pain and what you can do to treat it.

What Causes Shoulder Instability?

Your shoulders play a pivotal role in how you go about your daily life. Unstable shoulders can frequently come out of place, making everyday activities difficult. 

One cause of shoulder instability is severe trauma to the shoulder. An injury such as a dislocation causes the head of your shoulder to dislocate from the socket. The initial shoulder dislocation can result in repeated dislocations and further instability.

Genetics may be another cause of shoulder instability. Some people are born with naturally loose shoulder ligaments. Excessively loose shoulder ligaments called Hyperlaxity can cause shoulder instability. This can occur without prior dislocations or a history of strains. Hyperlaxity can increase the chances of dislocating your shoulder or weakening the joint.

Symptoms of Shoulder Instability

Several symptoms characterize shoulder instability. Shoulder instability symptoms include

  • A loose feeling in the shoulder
  • The shoulder giving out
  • Repeated shoulder dislocations
  • Pain

How is Shoulder Instability Diagnosed?

Professional examination is how shoulder instability is diagnosed. 

If you’re having shoulder trouble, your doctor can order imaging tests to find the cause. One tool to find the cause of your shoulder pain is an x-ray. The x-ray helps doctors to take a thorough look at the bones around your shoulder joint and examine them for signs of injury. Your doctor may also order an MRI for further examination. An MRI provides a detailed image of the tissues around your shoulder and helps find damage to the ligaments and tendons in the joint.

How Are Unstable Shoulders Treated?

Your treatment plan depends on the nature and severity of your symptoms. First, you may need to avoid activities that worsen your symptoms. If you can’t stay away from pain-inducing activities, modifying your movements may help give you some relief. Also, anti-inflammatory pain medications and physical therapy can help.

If your shoulder problems need more aggressive treatment, our office can help. Schedule a consultation by calling (508) 363-6363.