Shoulder Instability: Orthopedic Carrollton

by Craig W. Goodhart, MD 23. April 2016 10:37

The shoulder is one of the most mobile joints in the human body as it enables the movement of the arm in many directions. This extensive range of motion also makes it prone to dislocations and injuries. The shoulder joint comprises of the humerus (upper arm bone), scapula (shoulder blade) and the clavicle (collar bone). The humerus is rounded at the top and rests in a socket shaped cavity within the scapula.

Shoulder Instability or loose shoulder is a condition that occurs when the upper part of the humerus slips out of the socket in the shoulder joint. It is termed as partial dislocation or subluxation if the humerus is partially displaced and total displacement if it slips out completely. Patients with Shoulder Instability, are more likely to suffer from repeated injuries and joint dislocation.

Causes

  • Shallow or flattened socket
  • Muscle weakness
  • Stretching and consequent loosening of ligaments
  • Prolonged immobilization of the joint
  • Sudden trauma or injury to the shoulder or arm
  • Bankart Lesion- tearing of the cartilage that lines the socket
  • Repeated overhead movements such as in swimming or tennis
  • Inherent anatomical disorders
  • Impaired neuromuscular control
  • Lifting a heavy weight or an awkward position while moving the arm

Symptoms

  • Pain
  • Weakness and instability in the arm and shoulder
  • Numbness
  • Swelling
  • Repeated instances of the shoulder giving away
  • Tenderness in the shoulder when touched
  • Inability to lift things or move the arm away from the body
  • Discomfort while sleeping on the affected shoulder

Diagnosis

  • Evaluation of the patient’s medical history and daily activities
  • Physical examination of the Dislocated Shoulder
  • X-ray imaging
  • MRI scan may be done to evaluate the condition of muscles, ligaments, tendons and nerves

Treatment

  • Activities that may aggravate pain or discomfort should be avoided
  • Heat or ice packs may be used to reduce swelling and pain
  • Prescription of anti-inflammatory drugs and painkillers to provide relief from the symptoms
  • Torn or loose ligaments may be surgically stitched back to enhance stability
  • The shoulder and arm may be immobilized for a specific period of time post-surgery to aid healing
  • Range of motion exercises may be recommended by a physical therapist to regain strength and restore movement in the joint.

Dr. Goodhart, a leading orthopedic surgeon in Carrolton, TX, provides effective treatment for Shoulder Instability and other medical conditions. To schedule an appointment, you can call at (972) 492 – 1334.

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Osgood-Schlatter Disease: Causes, Symptoms And Treatment

by Craig W. Goodhart, MD 23. November 2015 13:16

Osgood-Schlatter Disease involves inflammation of the lower front of knee, where the patellar tendon attaches to the shinbone. The medical condition often occurs during growth spurts when the bones, tendons, cartilages are developing rapidly. People who participate in activities that involve a lot of running, jumping and swift changes in direction are more susceptible suffering from this condition. Boys have more probability of being affected by Osgood-Schlatter Disease as they actively participate in sports.

Causes:

Quadriceps muscle is used in contraction and relaxation of the knee muscles. Overusing these muscles puts strain on the patellar ligament which is attached to the shin bone. This results in pulling of the tibia (shin bone) and formation of a bony bump, leading to Osgood-Schlatter Disease. It may also be caused by trauma or injury to the knee.

Symptoms:

  • Knee pain
  • Tenderness
  • Tight muscles in the front or back of the thigh
  • Swelling

Diagnosis:

An orthopedic doctor may physically examine the knee for the symptoms and inquire the patient about his medical history. He may apply pressure to the tibial tubercle and check for tenderness. He may also ask the patient to move the knee to see if it causes pain. Imaging tests such as X-rays, MRI or CT scan may be conducted to determine severity of the knee injury. Ultrasound may also need to be conducted in some conditions.

Treatment:

  • Medication: An orthopedic doctor may prescribe anti-inflammatory medications to reduce swelling and pain. 
  • Rest: Rest should be provided to the affected area to speed up the healing process. Avoiding strenuous activities such as running, jumping etc. may be suggested by the doctor.
  • Exercise: Exercises, as recommended by a physical therapist, may improve flexibility and strength of quadriceps as well as hamstring muscles.
  • Supportive devices: Wearing a cast or brace may be advised by the physician to provide support to the knee and reduce discomfort.
  • Ice pack: Ice pack can be applied below the kneecap to reduce pain and swelling. Heat therapy may also be beneficial in providing relaxation to the stiff muscles.

Surgery may be needed if there is no improvement from non-surgical methods.

Prevention:

  • Stretching exercises should be done before performing any strenuous activity in order to avoid stressing the joint.
  • Wearing protective equipment, such as knee pads, while playing football, basketball, baseball etc. can prevent injury.

For treatment of Osgood-Schlatter Disease and other knee conditions, visit Dr. Goodhart in Carrollton, TX. To schedule an appointment with the orthopedic sports surgeon, you can call at (972) 492 – 1334.

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Rotator Cuff Injury: Orthopedic Treatment In Carrollton

by Craig W. Goodhart, MD 26. October 2015 15:05

The rotator cuff comprises of four muscles: supraspinatus, infraspinatus, subscapularis and teres minor that surround the shoulder joint. These muscles help in stabilizing the shoulder joint. Damage to any or all of these muscles and the ligaments can limit the movement of the joint and can lead to rotator cuff injury. There may be a partial or a complete ligament tear depending on the severity of the condition.

Causes:

  • Major injury to the shoulder
  • Degeneration of the tendon tissue
  • Heavy lifting over a long period of time
  • Development of bone spurs in the bones around the shoulder
  • Playing sports that require repetitive arm movements such as baseball and tennis
  • Occupations such as house painting and carpentry
  • Genetic factors

Symptoms:

  • Dull ache that penetrates the shoulder
  • Limited shoulder movement
  • Inability to reach behind your back
  • Difficulty in combing hair
  • Pain when lying on the side of the affected shoulder

Diagnosis:

Physical examination is done to locate the exact areas of swelling and pain. X-Rays are conducted to see if there are any broken bones or if you suffer from Arthritis within the shoulder joint. Advanced imaging tests such as MRI scan, arthrography or ultrasonography may also be conducted depending on the severity of the condition.

Treatment:

Persistent pain in the shoulder cuff needs to be immediately examined by a shoulder specialist. Following treatment options could be utilized:

  • Application of ice packs may help in reducing swelling. Rest is recommended along with administration of anti-inflammatory medications as it may help in eliminating pain.
  • Physical therapy: Gradual rehabilitation is enhanced by exercises that help in strengthening the rotator cuff. These may also help in providing flexibility to the shoulder joint.
  • Injection: Cortisone injections are given in case a patient suffers constant pain and extremely limited shoulder motion.
  • Surgery: Surgical intervention is required in case of severe injuries. Open surgery and arthroscopy are two available options.

For diagnosis and treatment of rotator cuff injuries, consult Dr. Goodhart. To schedule an appointment with the orthopedic sports surgeon in Carrollton, TX, you can call at (972) 899-4679 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Knee Pain Prevention: Orthopedic Carrollton, TX

by Craig W. Goodhart, MD 19. August 2015 11:07

The knee is the largest and one of the most important joints in the body. It also consists of several ligaments and tendons that hold the bones together in place. Since the joint bears the entire body weight, it is quite prone to wear and tear. When any of the joint structures get affected due to an injury or medical condition, it may lead to knee pain. The condition can cause severe discomfort while walking, bending or running.

Here are some useful tips that can help to prevent knee pain:

  • Maintain Weight- With each step you take, two or four times your body weight is transmitted through the knee joint. Thus, the more you weigh, the harder is the impact on your knees. Keeping one’s weight under control can help avoid knee pain in the long run as there is less stress on the joint.
  • Wear Proper Footwear- Wearing proper fitted (and comfortable) shoes can help to maintain body balance and proper alignment of the legs. This will ultimately prevent knee pain.
  • Warm Up- Before starting any exercise, it is important to warm up properly. Stretching of the outer and inner thigh muscles will put less pressure on the knee joint while doing strenuous exercises like tread mill, cycling, skipping etc. Also, a sudden shift to a high impact exercise can cause trouble in the knee. Hence, one must gradually move towards intense workouts starting from low impact ones.
  • Exercise Properly And Regularly- Keeping yourself physically active can help to maintain the strength and endurance of the knee joint. Swimming, walking and climbing the stairs can help in this regard. Giving up on exercise may cause the joint to become weak and result in pain. You must avoid sedentary lifestyle and keep the knee joints moving.
  • Proper Diet- Dietary changes can also help in keeping muscles and ligaments fit as nutrition is important for healthy living. For instance, including Omega-3 rich food like fish, Green vegetables and proteins can help to strengthen muscles and improve the general well-being of musculoskeletal system.
  • Posture- Maintaining a correct posture is also essential in putting pressure off the knees. You should keep your back straight while walking, avoid sitting for long spells of time and keep your feet planted on the floor. You should also walk steady so that the weight is distributed evenly through the knee joint.

If you are suffering from knee pain, visit Dr. Goodhart for proper treatment. To schedule an appointment with the orthopedic surgeon in Carrollton, TX, you can call at (972) 492 – 1334.

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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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Orthopedic Treatment For SLAP Tears

by Craig W. Goodhart, MD 22. September 2014 11:16

Just like the hip, the shoulder is a ball-and-socket joint which is extremely shallow and unstable. Thus, to help it to be more stable, the socket is surrounded with a ring of strong tissues, known as labrum. A SLAP tear can be defined as an injury to the labrum of the shoulder.

The word SLAP stands for superior labrum from anterior to posterior). SLAP tear take place in the region where the bicep tendons attach to the labrum.

Causes

  • Fall with a stretched out arm
  • Fall against the shoulder
  • A motor vehicle accident
  • Recurrent actions that involve overhead movements such as throwing
  • Lifting heavy weights
  • Forceful or rapid movement of the arm
  • Dislocated shoulder

Symptoms

  • A feeling of grinding, catching, popping and locking of the shoulder
  • Pain while moving the shoulder or holding in certain positions
  • Reduced range of motion
  • Pain on lifting something, particularly above the head
  • A sensation that shoulder has come out of the joint
  • Instability or weakness in the shoulder

Diagnosis

There are many tests that can be done to diagnose the presence of SLAP tears. However, the condition is difficult to be detected as it is not a common condition and there are almost uncountable causes of shoulder pain. Thus, the best way to diagnose MRI is by through a contrast MRI, i.e., by injecting a special dye into the shoulder before performing the test.

Treatment

The treatment options for a SLAP tear may include:

Non-surgical treatment

  • Medication: Non-steroidal anti-inflammatory medicines may be prescribed by the orthopedic doctor to reduce swelling and pain.
  • Physical therapy: Exercises must be done to brace the shoulder and restore it normal movement. Physical therapy must be needed for anywhere between three to six months and should be done under the guidance of a professional.

Surgical treatment

  • Debridement: When the SLAP tear is damaged, the orthopedic surgeon may trim away the torn labrum to smoothen the edge. This procedure is effective only if the tear is minor.
  • Biceps Tenodesis: This procedure involves cutting down the biceps tendon from the point where it is joined with labrum. This reduces the pressure on the SLAP regions and the patient is relieved of the pain.
  • SLAP Repair: This is an arthroscopic technique that involves securing the torn labrum to the socket of the shoulder. This is the best option for the patients who want to be muscularly active.

For complete diagnosis and treatment of SLAP tears, visit Dr. Goodhart in Carrollton, TX. To schedule an appointment, please call at (972) 899 - 4679.

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Common Knee Injuries

by Craig W. Goodhart, MD 21. July 2014 12:06

The knee joint gives us most of the strength and stability that enables us to do everyday activities like standing and walking. It is one of the strongest and most stable joints of the body which has to bear a large percentage of our body weight at all times. The importance of healthy knee joints cannot be overstated and any problem affecting the knee has the potential to be seriously debilitating and inconvenient. The knee, due to the heavy use it sustains, can be particularly vulnerable to a number of different problems. Here are some of the causes and lines of treatment for knee injuries.

Fractures

The knee joint can face serious damage from heavy impact, resulting in fracture of the knee. Falls from great heights or vehicle accidents are most often the cause behind knee fracture which can cause major pain, loss of strength and stability of the affected leg. Most often, the bone patella gets fractured, but fractures might also occur at the end points of the femur or the tibia. To treat a knee fracture, prolonged rest and immobilization of the area might be prescribed, along with the use of pain medication and ice packs. For severe fractures, orthopedic doctors might prefer to go the surgical route.

Dislocations

A dislocation in the knee happens when the bones in the area fall out of alignment, due to impact damage or trauma. Mostly the tibia or the femur might fall out of their natural positions and sometimes even the patella can slip out of place. Dislocations are mostly caused due to impact damage but they can also affect people who already have structural abnormalities of the knee. Treatment usually consists of reduction, a process in which gentle pressure is put on the affected bone to snap it back into place. This is followed by a period of rest, gentle exercise and physical therapy to restore full functionality to the injured knee. Serious cases of dislocation may be treated with surgery.

Meniscus Tear

A very common knee injury is a meniscus tear. Any sudden abnormal motion of the knee like twisting, flexing or pivoting can cause the meniscus to tear and get damaged. Menisci also tend to get weaker with age related deterioration and due to conditions like arthritis, which makes them vulnerable to get damaged easily. Nonsurgical lines of treatment include rest, the use of ice packs, compression and elevation to reduce swelling. In serious cases, an orthopedic surgeon can go for a surgical procedure.

For complete treatment of knee injuries in Carrollton, visit Dr. Goodhart at 4780 North Josey Lane, Carrollton, Texas 75010. to schedule an appointment, call at (972) 492-1334.

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Torn ACL: Symptoms, Causes, Treatment

by Craig W. Goodhart, MD 20. November 2013 06:45

Torn ACL is a common musculoskeletal injury caused when the knee is twisted beyond its standard limits. Although this type of injury is most common among women athletes associated with contact sports such as football, basketball, etc. but according to orthopedic sports surgeons in Carrollton TX, everyone is susceptible to ACL tear.

Causes:

  • Most ACL tears are the result of trauma in sports and other physical activities.
  • Rapid change in direction can also lead to torn ACL.
  • Severe stress on the knee damages the ligament which further leads to torn ACL.
  • Improper landing after a jump may cause ACL to tear.
  • Sudden pressure on the leg especially when it is straight or slightly bent can also result in torn ACL.
  • Landing after a jump with a sudden slowing down, especially if the leg is straight or slightly bent is another cause of torn ACL.
  • Situations like missing a step on the staircase, falling off the ladder, stepping into a hole can also lead to torn ACL.
  • ACL tear can also be caused due to a motor vehicle accident.

Symptoms:
Early and late symptoms of torn ACL include:

  • Popping sound at the time of injury.
  • Sudden instability in the knee
  • Swelling and bruising around the knee.
  • Widespread tenderness and pain in the knee.
  • Limited movement of the joint of the knee
  • Inability to bear weight.

Treatment:

  • First of all, follow the RICE protocol, i.e. is rest the foot, apply Ice, compress and elevate.If the pain still persists, it is important to consult an orthopedic doctor. To rule out other medical conditions related to knee, your doctor may perform X-ray and MRI tests.
  • Certain anti- inflammatory drugs may be prescribed by the doctor to minimize the pain and inflammation.
  • The non-surgical treatment for torn ACL consists of a range of exercises which will help reinstate the motion and strength of the knee. Some of the exercises your doctor may recommend include straight leg raise, stair steps, squats etc.
  • In case of serious injury to the knee, surgery may be recommended by the doctor. The surgeries for rebuilding or replacing the ligament of knee include ACL reconstruction, knee replacement, or knee arthroplasty etc. Your doctor may also suggest wearing a knee cap for a few weeks after the surgery.

Prevention:
In order to prevent torn ACL one must wear shoes that offer protection and practice knee strengthening exercise. In addition, one can also attend ACL injuries protection programs which mainly emphasize techniques to deal with stress and avoid ACL injuries.

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