Orthopedic Treatment For Knee Pain

by Craig W. Goodhart, MD 20. May 2015 05:30

Knee is the largest joint in the human body and is susceptible to pain due to injuries, wear and tear or overuse. Knee pain is a common problem that can be a result of injury to any of the structures comprising the knee joint, the kneecap or the ligaments and cartilage of the knee. Knee pain can range from mild pain to severe discomfort and can occur at any age. It can be localized or diffused all over the knee and an orthopedic doctor should be consulted for proper diagnosis and treatment.

Causes:

  • Age
  • Sprains
  • Strains
  • Muscle Overuse
  • Excess Body Weight
  • Knee Fracture
  • Tear in the Meniscus
  • Ligament Tear such as ACL and MCL
  • Kneecap dislocation
  • Knee joint dislocation
  • Bursitis
  • Osteoarthritis
  • Tendinitis
  • Iliotibial Band Syndrome

Symptoms

  • Redness
  • Inflammation
  • Discomfort
  • Limping
  • Weakness
  • Instability
  • Swelling
  • Stiffness
  • Inability to straighten the knee

Diagnosis

The orthopedic surgeon may physically examine the knee to determine the extent of the injury and pain. He can recommend certain imaging tests like X-ray and MRI to rule out the possibility of a fracture. The doctor may also ask details about the nature of any injury and previous medical history. The orthopedic surgeon devises a treatment plan considering the level of injury and pain, age and activity level of the patient.

Prevention

There are certain measures that can help in the prevention of knee pain:

  • Maintain proper weight
  • Exercise regularly and stay active
  • Wear knee guards during sports
  • Maintain proper posture
  • Avoid over exertion of the knees

Treatment

  • Rest: Having proper rest assists in getting relief from knee pain.
  • Ice Packs: The orthopedic surgeon can recommend using ice packs or the R.I.C.E therapy.
  • Medication: The orthopedic doctor may prescribe anti-inflammatory medication to reduce pain and swelling.
  • Braces: The orthopedic surgeon may prescribe using braces to offer support to the knee.
  • Physical therapy: The orthopedic surgeon can recommend physiotherapy to promote flexibility and strength of the joint.
  • Assistance: If the pain is causing difficulty in movement the doctor may recommend using a cane or assistance while walking and performing basic daily activities.
  • Surgery: If non-surgical methods do not provide relief, the orthopedic surgeon can recommend surgery. This is followed by rehabilitation and post-surgical care, which must be followed as prescribed by the surgeon.

In case of knee pain you must visit an orthopedic surgeon for proper diagnosis and treatment of the condition.

For comprehensive diagnosis and treatment of knee pain, you can consult Dr. Goodhart in Flower Mound, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 899 – 4679.

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Knee Ligament Injury: Orthopedic Carrollton

by Craig W. Goodhart, MD 16. April 2015 10:40

Knee injuries are common among athletes and sports persons who put lot of pressure on the knees. Most of the sports related knee injuries occur due to tearing of Anterior Cruciate Ligament or ACL, which is a painful and debilitating situation.
Knee has a number of muscles, tendons, and ligaments to keep it together and working. Ligaments are tough bands of tissue, which connect the bones and are susceptible to injuries. Two major ligaments in the knee are more prone to injuries and these include Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). These ligaments connect the thighbone with the lower leg bone. Stretching and snapping of these ligaments due to huge pressure often leads to knee ligament injury.

Causes of Knee Ligament injuries

  • Landing on the bent knees while jumping or due to other reasons such as falling from height
  • Twisting of knee
  • Stopping suddenly while running
  • Getting hit on the knee
  • Extending the knee too far
  • Suddenly shifting weight from one leg to another

Symptoms

The most common symptoms of Knee Ligament injury include

  • Sudden and severe pain
  • Restricted movement of knee
  • Popping sound during injury
  • Feeling of looseness
  • Inability to put weight on the knee
  • Swelling
  • Knee giving out when you twist

Diagnosis

When you visit orthopedic doctor with the above-mentioned symptoms he may physically examine the knee and recommends some imaging tests to confirm a Knee Ligament injury. These tests can include X-ray, MRI, and CT Scan, etc.

Treatment

You may not require any surgery if the Knee Ligament injury is mild. In such cases the orthopedic surgeon often refers the patients to physiotherapists who help in speeding the healing process. The Knee Ligament injury is often treated with R.I.C.E treatment, which includes rest, ice packs, compression, and elevation techniques. This helps in reducing swelling along with anti-inflammatory medications prescribed by the doctor. You may also need to keep your knees elevated and wear braces to promote healing and to avoid putting weight on the joint.

However, if the ligament tear is too severe, you may need surgery to attach the ligament. Repairing a completely damaged ligament involves reconstruction. The process involves taking tendons from other parts of the leg to replace the torn ligament. The surgeon reserves surgery for extreme cases when non-surgical techniques didn’t provide relief.

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Meniscus Tear: Causes, Symptoms And Treatment

by Craig W. Goodhart, MD 23. March 2015 12:32

Meniscus Tear is one of the most common forms of knee injuries and is often seen in athletes, particularly those who are involved in contact sports. The meniscus is a wedge shaped rubbery cartilage that provides a cushioning in the space between the thigh bone and shin bone. A forceful twisting or sudden movement of the knee can result in a tear in any of the two menisci in the knee. 

Causes

  • Squatting or slouching the knee
  • Sudden twist of the knee
  • Playing sports that require sudden and rapid stops, such as tennis
  • Sudden blow to the knee
  • Excessive weight
  • Lifting heavy weights
  • Injury to knee ligaments
  • Damaged cartilage
  • Age related wear and tear

Symptoms

  • Intense pain in the knee
  • Swelling and stiffness
  • Feeling that the knee may give out
  • Decreased range of motion
  • Popping sound at the time of injury
  • Difficulty bending of straightening the knee
  • Tenderness when the affected area is touched

Diagnosis

To diagnose a Meniscus Tear, the orthopedic surgeon will physically examine your knee to look for any visible signs of injury or tenderness around the meniscus points. He may also recommend you to undergo certain imaging tests, such as X-Rays or MRI scans, to rule out the presence of any other knee condition.

Treatment

The orthopedic doctor determines the treatment method after determining the cause and extent of the condition.

  • RICE Therapy: This involves taking appropriate rest, applying ice at the affected area, compressing with a bandage and keeping it elevated above heart level.
  • Anti-Inflammatory Medications: The orthopedic surgeon may also prescribe certain non-steroidal anti-inflammatory medications to provide relief from pain and inflammation.
  • Physical Therapy: Exercises involved in physical therapy can help to strengthen the knee muscles to provide better stability and support to the joint.
  • Shoe Inserts: Wearing arch supports, braces or other shoe inserts can also help in an even distribution of weight around your knee. This can help to decrease pressure on certain parts of the joint.
  • Surgery: If the symptoms do not subside with conventional modes of treatment, the patient may need to undergo surgery. During the procedure, the orthopedic surgeon makes tiny incisions into the knee. After which the damaged meniscus tissue is repaired or the torn cartilage pieces are stitched together. 

For comprehensive diagnosis and treatment of Meniscus Tear, you can consult Dr. Goodhart in Flower Mound, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 899 – 4679.

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"Tommy John" Surgery

by Craig W. Goodhart, MD 17. March 2015 14:43

“Tommy John” Surgery-How to prevent in your child

 

As any Texas Ranger fan will tell you the loss of Yu Darvish to elbow injury is likely a big blow to the team this season.  Anyone who knows the history of this injury realizes that it is a devastating injury to the athlete and surgical reconstruction, though often very successful, is difficult to recover from.  Now is the time of year that I see an increasing number of these injuries and felt it might be a good time to discuss this injury.

“Tommy John” surgery was made famous by Dr. Frank Jobe in the early 70’s.  Throwing athletes were noted to have damage to the Ulnar Collateral ligament (inside of elbow) and often times this was career ending.  By reconstructing the ligament Dr. Jobe was able to extend the career of Tommy John.  The incidence of UCL overuse injuries has increased greatly in recent years in all throwing athletes.  At least one study has showed that about 60% of professional pitchers had a precipitating minor injury to the UCL in youth baseball.  Most UCL injuries typically occur over time due to multiple repetitive injuries weakening the ligament and then one single event leads to the final injury.  It is generally the repetitive throwing that leads to this injury.

In youth baseball it is fatigue that leads to this injury regardless of age or level of activity.  A pitcher that is fatigued is 36 times more likely of sustaining an elbow or shoulder injury.  The young players are often times playing ball for 10-12 months during the year.  Playing on multiple teams and throwing more than the developing body can handle.  They often times play on travel teams, school teams and have pitching lessons several times a week and this leads to overuse.  There is no question that the number of shoulder and elbow injuries is increasing and with this the number of surgeries performed.

The doctor can usually get a good idea of the diagnosis from a simple history of play and physical examination.  Radiographs are taken looking for other possible causes of injury.  MRI is really just a confirmatory test and may aid in determining the extent of injury and the chance of success without surgery.  Pitching more than 8 months a year increases risk of need for surgery by 500 percent, compared to normal players.  Throwing more than 80 pitches a game increases by 400% and throwing a fast ball over 85mph increases by 250%.

If elbow pain is addressed early then surgery may be avoided.  If your child has elbow pain take it seriously and the first thing that must be done is stop or decrease the amount of throwing and give the elbow a rest.  The longer the pain has been present the less likely surgery will be avoided.  The elbow should be rested for at least 8-10 weeks.  Following this work with a good physical therapist and pitching coach to normalize motion, improve strength and neuromuscular control and finally pitching mechanics will give the best chance to avoid surgery.  Working on CORE exercises and shoulder are also very important in the treatment of these injuries. 

 

The ligament probably has the ability to heal without surgery but only if the elbow injury is addressed early and appropriate care and rehabilitation is given.

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How to Prepare For Your Office Visit

by Craig W. Goodhart, MD 5. March 2015 15:41

How to Prepare For Your Office Visit

 

 

Going to the doctor can be a stressful and time consuming ordeal.  But it really should not be.  If you have a problem that bothers you enough to go to the doctor then you should be excited to get it diagnosed and treated.  I just finished with my doctor’s appointment and as usual re-learned some important lessons.   This is what I learned or in my case re-learned (I must be a slow learner).

1)       Fill out the paperwork on line or arrive early and have it prepared.

2)      Arrive early even if you have the paperwork filled out.  This keeps the doctors on time.

3)      Prepare for your visit.  Think about the problem.  Where is the pain?  How Long? What caused it? How does        it feel?  Sharp, dull, aching etc.  Does it go anyplace else?  What have you done for it?

4)      Make a list of all your questions.  Good advice is to have at least the top three ready. The internet can be        helpful to assist you with this.

5)      Ask questions?  Doctors like to feel smart and answer your questions.  We train hard daily for this.

6)      Make sure you understand and can explain in your terms the diagnosis.

7)      Understand the plan of treatment

8)      Know what to expect of the treatment outcome and when to be concerned.

9)      Use a “smart Phone” to take pictures (your x-rays, models, information etc.).

10)   Have fun.  We really do want you to learn, figure out your problem and have an enjoyable experience.

11)   Do not hesitate to contact the office if you have questions.  We may not be able to get right back to you but will        usually get your questions answered ASAP. 

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Patella Dislocation: Orthopedic Treatment In Flower Mound, TX

by Craig W. Goodhart, MD 25. February 2015 11:26

The dislocation of patella (kneecap) outside its normal position is a common problem among athletes, which needs to be treated immediately. The patella is a bone that lies securely in a triangle shaped groove in front of the knee. The patella moves up and down when the leg bends or straightens. Patella Dislocation can be treated surgically as well as non-surgically with the help of medicines and therapy.

Causes

Some of the common causes of Patella Dislocation include:

  • Sudden twisting motions
  • Fall or direct blow to the knee
  • Trauma
  • Abnormal movement of the knee

Certain conditions increase the risk of Patella Dislocation such as shallow v-shaped grooves, flat feet, inward roll of feet, weak thigh muscles, weakened and overstretched ligaments.

Symptoms

  • Severe Pain
  • Inflammation
  • Stiffness
  • Inability to walk
  • Abnormal bending of knee
  • A crack sound
  • Deformed knee

Diagnosis

If you experience pain in the knee you should seek immediate and professional medical treatment. The orthopedic doctor may ask about your medical history and physically examine the knee for tenderness and swelling to determine the condition. The doctor checks your symptoms and can also ask you to walk to determine the extent of the condition. You may be recommended imaging tests such as X-ray, CT Scan and MRI tests to see if there is any damage to other structures.

Treatment

The condition can be treated both non-surgically and surgically. In case the patella does not return to the triangular groove on its own, the physician will manipulate it back into the position. To make the knee immobile, the physician may use braces or casts to offer support and stability for a few weeks. You will also be required to limit physical activities to avoid any pressure on the knee. The doctor can prescribe medicines to offer relief from pain and swelling. The patient can also gain benefit from physiotherapy as it helps in maintaining the muscle strength and improves its range of motion.

Surgery

In case the condition does not improve with non-surgical methods, you may be recommended to undergo surgery. Surgery is usually arthroscopic, which involves removal of torn cartilage and reconstruction of the torn patella. Surgery is followed by physiotherapy and rehabilitation program to ensure proper recovery and help patients return to normal activity.

It is essential that you take precautions like using proper exercise techniques and keeping the knee strong to prevent Patella Dislocation.

For complete treatment of Patella Dislocation or any other knee condition, visit Dr. Goodhart, a renowned knee surgeon based in Flower Mound, TX. To schdule an appointment, visit 4951 Long Praire Rd, Ste 100, Flower Mound, Texas 75028 or call (972) 899-4679.

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Baker's Or Synovial Cyst

by Craig W. Goodhart, MD 20. February 2015 19:40

Baker cyst is a fluid-filled cavity that causes a bulge in the back of the knee. It is not a cancer. When painful, the intensity will get worse with bending and straightening of the knee. The cyst is usually caused by a problem in the knee such as arthritis or meniscal tears. The cyst may cause pain but treating the underlying problem will get rid of or reduce the size of the cyst. Pain and swelling in the knee other are the symptoms of a Baker’s cyst. Stiffness and cramping also may be present.

Baker’s cyst may leak or burst into the calf region leading to an increase in sharp pain, swelling and/or redness in the calf. These signs are similar to those of a blood clot and if they occur medical attention should be obtained immediately to rule out a blood clot.

What should you do for treatment?

If the cyst is causing pain or persistent stiffness the following may help:

  • Use of  ice or cold pack
  • Resting the leg
  • NSAIDs (Aleve or Advil)
  • Knee sleeve or brace for compression

What is the surgical treatment?

Many times no treatment is necessary and the cyst may disappear on its own Medications such, as a steroid injection often times is helpful for the pain and swelling. Episodic drainage of the fluid filled cysts may be helpful. Physical therapy may be helpful in some cases.

The surgical treatment for a synovial cyst occurs by treating the underlying problem such as arthritis or a meniscal tear. If either of these is present a knee arthroscopy may be helpful and should cause the cyst to be less painful. You and your doctor may decide that a Baker cyst removal is an option for a cyst if it is repeatedly refills after it has been drained several times.

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Little League Shoulder

by Craig W. Goodhart, MD 18. February 2015 21:02

TIME TO PLAY BALL!!

It’s that time of year again when baseball season is about to start. Every year I see many young athletes that are excited to begin the season and then disappointed when they begin to have problems with their elbow and shoulder.  So I am going to take a second and explain what “Little Leaguers Shoulder” is and how to prevent injury to the shoulder.

Little League shoulder is an overuse injury caused by rotational stresses generated during throwing.  This results in repetitive micro trauma to the growth plate and the equivalent of a stress fracture.  Pitchers and catchers are most often affected though any position can have this occur.  Usually there is several months of worsening shoulder pain with throwing.  There may be tenderness in the shoulder and usually the athlete becomes wilder with the throws and slower with the velocity of the pitch.  If this occurs then a thorough examination and radiographs are taken to confirm the diagnosis.

Management involves cessation of throwing for 3 months followed by a good throwing program that emphasizes good mechanics.  Compliance with the USA baseball pitch count recommendations make injury less likely.  USA baseball also recommends 3 months away from throwing each year and this has shown to limit injury to the shoulder. 

 

Age (years)

2006 USA Baseball Recommendations

Daily/Weekly Pitch Limit (Approx.)

2014 Little League Baseball

Mandatory Daily Pitch Limit

 17-18

 No recommended limit

 105*

 15-16

 No recommended limit

 95*

 13-14

 75 pitches (125 pitches per week)

 95*

 11-12

 75 pitches (100 pitches per week)

 85*

 9-10

 50 pitches (75 pitches per week)

 75*

 7-8

 No recommended limit

 50*

 

Read more: http://www.momsteam.com/sports/daily-pitch-limits-usa-baseball-little-league-rules-different#ixzz3S7zVWIex


 Age

  Pitches per game

 Pitches per week

 Pitches per season

  Pitches per year

 13-14

 75

 125

 1000

 3000

 11-12

 75

 100

 1000

 3000

 9 - 10

 50

 75

 1000

 2000

* Pitch count limits include only pitches thrown during games and don't include:


Read more: 
http://www.momsteam.com/sports/daily-pitch-limits-usa-baseball-little-league-rules-different#ixzz3S7zg9ul0

 

Good Luck and Have a great season. 

 

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Adhesive Capsulitis

by Craig W. Goodhart, MD 13. February 2015 16:14

One most painful conditions experienced in the shoulder is adhesive capsulitis.  This is defined as pain and loss of motion in the shoulder, which occurs for no reason. It usually is a result of inflammation and contracture of the shoulder resulting in pain. It is oftentimes associated with diabetes, thyroid disorders, previous surgery (long and rest), prolonged immobilization and extended hospitalization.

Symptoms of adhesive capsulitis are the slow onset of pain and stiffness. There is pain within the range of motion of the shoulder specifically with internal and external rotation.

A physician following a thorough physical examination and radiographs taken of the shoulder makes the diagnosis of adhesive capsulitis. An MRI is performed to rule out other possibilities causing the capsulitis.

The treatment for adhesive capsulitis is generally non-operative. It begins with a gentle structured program of physical therapy working towards a pain-free range of motion. NSAIDs, physical therapy, and intra-articular injections are oftentimes helpful in the early treatment of adhesive capsulitis. The majority of patients will improve over time though it may take many months before pain resolves and range of motion returns to normal.

The operative treatment for adhesive capsulitis occurs only after 3-6 months of supervised medical care. Various forms of treatment are available. Most commonly an arthroscopic surgical release is performed and in some cases a simple manipulation under anesthesia. All surgery has risks and as a result this should be the last option in the treatment of the shoulder pain.

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Runner's Knee: Orthopedic Treatment In Carrollton, TX

by Craig W. Goodhart, MD 19. January 2015 07:18

Runner’s knee causes pain in the knee, particularly around the kneecap, which is called Patella. The condition is common among runners due to the high activity.

Causes:

  • Repetitive bending of the knee
  • Injury to the knee caused by a fall or blow on the knee
  • Flat feet are also known to cause Runner’s Knee
  • Lack of physical activity that strengthen the legs, knees and thigh muscles
  • Lack of warm-up before exercising
  • Misalignment of kneecap
  • Arthritis
  • Excess of physical activity

Symptoms:

  • Pain while walking, kneeling, running, standing or bending your knees
  • Swelling, redness and itchiness on the knee
  • Pain that worsens when you are walking, running or climbing
  • Inability to stretch your leg
  • Feeling of tightness or imbalance in calf muscles or knee

Prevention:

Following a healthy lifestyle can prevent runner’s knee. You may need to lose weight in order to prevent any severe injury in the event of a fall. Wearing a proper running gear while running or performing sports will prevent injury to your knee.

Diagnosis:

The knee doctor will perform a physical examination in order to determine the severity of the condition. He can prescribe certain tests like X-ray or magnetic resonance imaging (MRI), blood samples or computed tomography (CT) to diagnose the runner’s knee. The doctor also questions the patient’s medical history to confirm the condition.

Treatment:

If Runner’s Knee is not severe, it can be treated with the help of non-surgical methods. However if it is causing an acute pain or is disrupting daily activities, the doctor may advise you surgery to get rid of any deformity.

Non-Surgical treatment:

  • Applying ice wrapped carefully in a towel at the affected area, several times a day, can offer relief.
  • Keeping your knee elevated by keeping a pillow below it and taking proper rest will reduce inflammation and reduce pain.
  • Avoid exercising and physically straining yourself.
  • You should take proper rest and should avoid exerting pressure on the knee.
  • The doctor may also prescribe anti-inflammatory medicines to reduce pain.
  • Follow an exercise program that your doctor prescribes you.
  • The doctor may also recommend putting an elastic bandage around your knee to prevent swelling.

Surgical treatment:

In case relief is not sought though non-surgical methods, the orthopedic doctor may advise you to undergo surgery in order to restructure the misalignment of the kneecap. During the surgery, the doctor will realign the kneecap or he may remove parts of damaged kneecap cartilage with the help of an incision.

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