Achilles Tendon Disorders

The Achilles tendon is the largest tendon in the body which stretches from the calf muscles to the bones of the heel. It can be easily felt at the back of ankle and above the heel. Besides being the largest tendon, it is prone to injuries which may occur in many forms including inflammation of the tendons and partial or complete rupture, or tear of the tendons. 

The most common disorders related to Achilles Tendons are: 

• Achilles Tendonitis: It is the inflammation of the tendon which usually occurs due to overexertion or overuse of the tendons such as during running, playing, dancing etc. The inflammation is short lived but can progress into deterioration of the tendons if proper treatment is not given on time. 
• Achilles Tendonosis:  It is the degeneration of the tendon and occurs if Achilles tendonitis is not treated properly. In this condition the tendon loses its structure and develops tiny tears which may also lead to rupture of the tendon, in severe cases.

Causes:

Achilles Tendon disorders, also known as “overuse” disorders, are generally caused by a sudden increase of a repetitive activity which puts pressure on the Achilles Tendons. Other causes may include:

• Increase in level of physical activity too quickly 
• Lack of proper stretching before exercise
• Wearing high- heels
• Feet conditions like flat feet
• Improper techniques used for exercise
• Tight muscles or tendons
• Bone Spur

Symptoms:

• Pain near the back of the feet, which is generally severe during morning or after rest
• Pain worsens with activity
• Stiffness and tenderness
• Disorganized tendons
• Tendon thickens

In case of severe pain and inflammation, the patient should seek immediate orthopedic care as the condition may deteriorate and lead to ruptured (torn) tendons.

Treatment: 

The treatment for Achilles Tendon depends upon the severity of the condition which is checked by the orthopedic doctor by performing X-Rays and MRI’s etc. The condition can be treated by both surgical and non-surgical treatments.

Non-surgical treatments:

• Immobilization: This is the first step towards reducing the pain. An orthopedic doctor may suggest the patient to take complete rest and avoid motion as physical activities may worsen the pain.
• Ice Packs: Ice is used to reduce the inflammation over the tendons. Ice compression can be helpful for the patient suffering from acute pain and inflammation. The ice should not be applied directly rather a towel should be used for applying ice to the infected area.
• Anti-Inflammatory medications:  An orthopedic surgeon may also suggest anti-inflammatory medications to reduce the pain and the swelling.
• Exercise: There are certain exercises which help in reducing the stress on the Achilles Tendon.

Surgical Treatment: 

The surgical treatment for the disorder may be considered only if the patient does not show any signs of improvement after the non-surgical treatment. The surgery depends on the amount of damage to the tendons and the location of the tendinitis.

Orthopedic Treatment For Diabetic Foot

Diabetic Foot is the condition where higher levels of glucose or blood sugar damage the nerves and blood vessels of the body. This leads to a decrease in the immunity of the body to fight infection in case of any injury. Most of the effects of diabetes are felt and seen on the foot which can quickly turn into serious illness. In most cases any minor foot injury turns into ulcers and infections, and may even lead to amputation of the feet. Therefore, one should be aware of the causes and symptoms of the condition in order to avoid any serious damage.

Causes

The condition usually develops in a person suffering from Diabetes. The risk factors which increase the chances of developing Diabetic Foot are:

• Poorly Fit Footwear: The most common cause is poorly fit shoes. They can cause red spots, blisters, corns, and calluses in the feet which can turn septic in people suffering from diabetes.
• Nerve Damage: Diabetes patients who have to be on foot for longer period and have poorly controlled diabetes are at a risk of having damage in the nerves. Such nerve damages can reduce the sensation in the feet due to which a person with diabetes may not be able to sense the minor injuries which can turn into infections.
• Other Infections: Infections like Athlete’s foot, Ingrown toenail may also lead to diabetic foot.
• Smoking:  Smoking can cause damage to the small blood vessels in the feet and legs. The damage can hamper the process of healing and can cause major infections. 

Symptoms

• Persistent pain at the site of injury
• Punctures
• Redness around the wound signifies infection
• Inflammation of the feet or legs
• Ulcers and blisters
• A sensation of warmth around the injured area
• Hard and shiny skin on the legs
• Interrupted growth of hairs
• Calluses and corns
• Seepage of pus from the bruise
• Fever
• Spreading of redness from the wound signifies worsened condition

Treatment
In case a diabetic patient suffers from an injury or wound, he must immediately seek the advice of an orthopedic doctor. If the above mentioned symptoms persist, there is an increased risk of the infection of the wound. Treatment for Diabetic Foot may include:

• Antibiotics: An orthopedic physician may prescribe an antibiotic depending on the severity of the condition. He may analyze the blood sugar levels before providing any medication. The patient should make sure to take the prescribed dosage of antibiotics to treat the condition completely.
• Surgery: In severe cases, surgery might be needed to heal the wound. The procedure may involve combination of treatments to give relief from the pain.

Intense care should be provided to people suffering from Diabetic Foot in order to save them from the extremity of the condition. The condition should not be ignored and the patient must immediately refer to an orthopedic physician in case of an injury.

Shoulder Arthritis: Types, Symptoms & Treatment

Many people believe that shoulder has several joints, but in reality there are only two joints in the shoulder. One joint is ‘Acromioclavicular’ or AC joint, which is located where collarbone meets the tip of the shoulder bone. Another joint is the ‘Glenohumeral’ joint, which is located at the junction of the upper arm bone and the shoulder blade. Both these joints are susceptible to Shoulder Arthritis, and in order to get effective treatment, the doctor needs to determine which kind of arthritis one has.

Types

Orthopedic Treatment For Shoulder Arthritis

Following are the common types of Arthritis: 

• Osteoarthritis: This is also known as ‘wear and tear arthritis’ or ‘degenerative joint disease’. It occurs as a result of abrasion of protective surface that allows the joint to move smoothly.  Due to this, there is instability in the movement of the joint and results in pain and stiffness. 
• Rheumatoid Arthritis (RA): This is a chronic disease and affects same joints on both sides of the body. A lubricating lining called ‘synovium’, which facilitates easy movement of joints, swells because of this arthritis and causes pain and stiffness.
• Posttraumatic Arthritis: This is another form of osteoarthritis and usually develops after an injury like a fracture or dislocation of the shoulder.
• Rotator Cuff Tear Arthropathy: This type of arthritis occurs when there is some long standing rotator cuff tear. Due to damage in the surfaces of the joints, this condition can develop gradually.
• Avascular Necrosis: When the blood supply to head of humerus is disrupted, this arthritis is developed. It destroys the shoulder joints because of lack of blood and ultimately causes arthritis.

Symptoms:

• Shoulder Arthritis leads to pain in the joint, which becomes painful with any kind of activity in which the use of shoulder is there.
• The range of motion is limited and performing simple activities like combing hair, reaching out a shelf become difficult.
• It becomes difficult to sleep at night because of the pain.
• A feeling of grinding or catching is experienced within the joint.
• There is swelling and stiffness in the shoulder.
• The shoulder becomes tender.

Treatment:

Before moving on to surgical treatments for Shoulder Arthritis, all non-operative treatments must be fully exhausted. Pain killers and anti-inflammatory medicines can benefit those who are experiencing pain. For short term relief, steroid injections can be used but their use should be limited as they can further damage the joint. Ice can be rubbed on the affected shoulder to reduce the swelling. Physical therapy can be effective in reducing the pain and improving the range of motion of the shoulder. If the pain causes disability, then surgical treatments can be effective in providing relief. This treatment includes shoulder joint replacement in which damaged parts of the shoulder are removed and replaced. Anthroscopy includes use of incisions by inserting small camera into the shoulder joint.

Surgical treatments can help restore the motion of the shoulder.  Rehabilitation programs help in recovery and may take a few weeks to fully return to motion. Shoulder Arthritis is a treatable condition and one should consult a qualified doctor to begin treatment to recover from this condition.

Orthopedic Treatment For Turf Toe

Turf Toe is a condition in which pain is experienced at the base of the toe. The condition is caused due to a sprain in the big toe as a result of excessive running and jumping. Significant damage to the ligaments and the joint capsule adjacent to the toe joint causes its range of motion to be impaired. The toe becomes stiff and becomes painful due to swelling.  Commonly, this term is associated with players who play on artificial field like in football and basketball, but is also quite common in athletes involved in gymnastics, wrestling and dance. Turf Toe injury can be classified as:

Grade I: Minor swelling, some tenderness but no bruising
Grade II: Swelling ranges from mild to severe, with some bruising
Grade III: Moderate to severe bruising, with tenderness and swelling which is painful

Causes:

• The common causes of Turf Toe have been described below:
• When forefoot is fixed on the ground and heel is raised, some force pushes the toe into hyperextension.
• Artificial lawn surfaces are responsible for causing turf toe as they are hard and less shock absorbent.
• Shoes worn by athletes during sports activity provide flexibility but instability to the forefoot.
• A simple jamming or stubbing of the toe can also cause this condition
• Previous injuries to the toe and forefoot

Symptoms:

• Pain is experienced at the base of the toe
• Noticeable swelling both at the toe and the ball of the foot
• Popping sound at time of injury
• Bruising around the toe and ball of the foot
• Limited range of motion of the toe
• The toe becomes tender
• Mobility is reduced

Diagnosis:

Medical history and examinations can help orthopedic doctor determine the severity of injury to the toe. The doctor can check for signs of swelling, bruising and examine the range of motion of the joint. Imaging tests like X-Rays and MRI create clear pictures of bones and let the doctor detect the injured part. MRI creates better images of the soft tissues and help in determining the cartilage injuries.

Treatment:

Turf Toe can be treated with RICE (Rest, Ice, Compression and Elevation) therapy when the injury is Grade I. Providing proper rest to the toe, icing several times a day, reducing the swelling with compression bandage and elevating the leg at a level higher than heart to reduce swelling can be effective in treating the injury when it occurs. Grade II injuries can be treated by prescribing a walking boot, with rest time varying from 3 to 14 days. Grade III injuries are treated by immobilizing the toe for several weeks. Walking boots or casts are used to keep the toe in a stable position. Physical therapy to help restore the strength of the toe is followed soon after. Surgery is performed in case the symptoms persist and athlete is not able to perform in sports. Grade III injuries may even require surgery if there is internal fracture and there is damage to the cartilage joint.

Turf Toe injuries heal fairly well. It may take a few weeks for pain to fully subside. It can be avoided by wearing comfortable shoes that provide support to the base of the foot. If possible, one should avoid playing on hard surfaces to prevent this condition.

Orthopedic Treatment For Scapholunate Ligament Tear

Scapholunate is the ligament connecting scaphoid and lunate, the two small carpal bones present in the center of the wrist. The ligament helps in ensuring that the wrist moves smoothly and the bones move together. When the Scapholunate Ligament tears, not only is the pain excruciating but the bearer loses his ability to grip objects firmly as well. Athletes mainly those who pertain to sports which involve gripping a racquet or a bat are quite susceptible to tearing their Scapholunate Ligament.
 

Symptoms: 

• Pain in the wrist
• Pain towards the thumb
• A popping sound in the wrist at the time of the injury
• Weakened grip
• Bruising or swelling of the wrist
• Difficulty while moving the wrist in a rotating motion

Causes:

• Taking a fall, wrist first
• Lifting excessive weight using the wrist
• Playing high impact shots in certain sports
• Any one of the above mentioned mishaps can lead to the separation of the scaphoid and lunate and ultimately cause a fracture.

Treatment:

• The following things are taken into consideration while treating this condition:
• The patient's age
• The extent of the damage
• Time passed between the injury and when you see a doctor
• Whether the patient is suffering from arthritis and its extent

An orthopedic surgeon will perform the necessary mobility tests to diagnose the condition up close and rule out any other possible damage. It is also essential to identify the precise point where you are feeling the pain. For this, apart from the said mobility tests, the doctor may also recommend X-rays and MRI scans. This will help rule out the possibility of fractures, tissue damage and cartilage damage.

Modes of treatment:
 

Non invasive methods such as a splint or a cast are generally used if the damage is not too much. To provide temporary respite to the patient, the doctor will likely recommend anti-inflammatory medicine and painkillers. In severe cases because of the extent of the damage, an arthroscopic surgery, using small incisions may be recommended. By removing the damaged ligament, the surgeon will create scope for a new healthy ligament to grow back in its place. In either case it is recommend to see a wrist doctor who can fully diagnose and prescribe the correct treatment.

Orthopedic Treatment For Intoeing

Intoeing is an unusual problem that is found in infants and young children. Intoeing or pigeon-toed refers to the condition when the feet turn inward while running or walking, rather than pointing straight. Often the problem eventually corrects itself as the child grows but in certain cases orthopedic treatment is required to rectify it.
 

Causes:
 

There can be skeletal and neurological causes of Intoeing. Skeletal reasons include Metatarsus Adductus, Tibia Torsion, and Femoral Anteversion. However the neurological reasons can be due to premature labor and the intoeing due to neurological reasons should be taken seriously as the situation may actually worsen with age.
 

If the child’s feet are curved inward from the middle of the toes, the condition is referred to as Metatarsus Adductus. This usually occurs before birth and it is understood that the feet eventually straighten as the child grows up.  Another cause is Tibia Torsion, which is a twist in the tibia, a bone between the ankle and the knee. The problem comes to notice when the child starts walking. Usually the twist straightens out itself; however, in some cases the twist does not straighten out sufficiently to make the feet straight and the child suffers from Intoeing.  An inward twist in the femur (thighbone) leads to Femoral Anteversion.
 

Usually children are born with somewhat twist in the thighbone but the cause of intoeing becomes clear when the child starts walking. As these problems occur from genetic and development reasons it is almost impossible to prevent them.
 

Symptoms:

•  Infant’s feet point inwards
• Outer sides of the child’s foot is curved
• clumsiness
• Stumbling
• Tripping while walking

 Treatment:

 
Whether the problem is neurological or skeletal, the condition can be clear only after proper foot examination. The parents must consult a specialist to know the exact cause of the problem and whether treatment is required or not, and if required, then what should be the line of treatment. Metatarsus Adductus can be treated by serial casting, which involves applying casts to foot and leg for gently straightening it. This can be done to younger children as it is not suitable for elders. For older children, orthopedic surgeons recommend corrective devices such as special shoes and splints. This helps in modifying the position of joints. Sometimes surgery may be required to reset the bones, if the problem does not resolve on its own. An orthopedic surgeon will suggest the correct line of treatment after proper diagnosis.