• Telehealth from an Orthopaedic Surgeon’s Point of View

    Posted by Orthopaedic Specialists

    10 Things We Have Learned While Providing Telehealth Appointments

    telehealth

    1. Patients are so thankful that we are providing a way from them to have their orthopedic issues addressed.

    2. We have been graciously invited into their homes via FaceTime or other conference platforms.

    3. You can actually do a lot of an orthopedic exam without ever putting your hands on a patient. You have to be clever about helping the patient do the exam with you. For example: the patients palpate specific areas on their knee where you would normally palpate to look for a specific pathology.

    4. Most patients no matter their age are pretty handy with FaceTime.

    5. We’ve been able to review patients’ x-rays from various sources by them allowing us to look at their films from their phone or computer.

    6. Patients have allowed us to streamline this process, when they call to make an appointment we are gathering key data and giving them information on how to set up their phones, iPads, or laptops for the telehealth visit.

    7. Not everybody knows where the volume button is located on their smart device.

    8. We are learning the names and even getting to visit with some of their pets.

    9. Sometimes patients forget that we will need to examine the body part that is below the web cam level. There’s been a couple times when we had to go off camera so they could get appropriately dressed.

    10. The bottom line is patients are extremely appreciative of this service in these unprecedented times.

    Dr. Stacie Grossfeld is now providing virtual orthopedic and sports medicine consults to patients who don’t wish to make the trip into the office. Most types of insurance are accepted and set up is easy with the use of Zoom Video Conferencing and a smart device. To schedule an appointment, call our office at 502-212-2663!

    Everything You Ever Wanted to Know About a Frozen Shoulder (Adhesive Capsulitis)

    Posted by Orthopaedic Specialists

    1. It is not a shoulder that has frostbite…
    2. A frozen shoulder is also known as adhesive capsulitis. It is a condition that most commonly affects women (70 % of women vs 30% of men).
    3. Diabetics are also commonly affected. If you are a diabetic you have a 20-30% chance of developing a frozen shoulder. Diabetics also tend to have more severe cases of frozen shoulders than the general population.
    4. There is typically no injury that causes this condition.
    5. People will notice that they are slowly losing range of motion of the shoulder or the shoulder becomes more and more painful.
    6. Treatment starts with a cortisone injection in conjunction with physical therapy. The cortisone will help to reduce the inflammation and pain . The PT is to stretch out the tight structures in the shoulder joint.
    7. If PT and the cortisone shot fail then the next step is surgical intervention.
    8. A closed manipulation is typically the first surgical step. This is completed in a surgical center. A nerve block (this typically will last for 18 hours) is placed to reduce post-operative pain and light anesthesia is administrated. The surgeon places the shoulder through different planes of motion to break up the scar tissue and release the adhesions. After this procedure, the patient will see a physical therapist the day of in order to further manipulate the shoulder and arm while the nerve block is protecting against pain. I typically recommend PT 4-5 times for the first 3 weeks after this initial manipulation.
    9. If a closed manipulation fails then arthroscopic lysis of adhesions is needed. This is a true surgical procedure where we release the capsule around the shoulder joint and reset the areas of fibrosis (scar tissue).

    For more information on treating a frozen shoulder (aka Adhesive Capsulitis), contact Stacie Grossfeld and the Orthopaedic Specialists at 502-212-2663.

    5 Things to Know About Carpal Tunnel Syndrome Treatment From an Orthopedic Surgeon

    Posted by Orthopaedic Specialists

    Carpal Tunnel Syndrome (CT) is caused by median nerve compression in the wrist. It’s a painful, lingering injury that is very common. Some common symptoms from Carpal Tunnel are numbness and tingling involving the thumb and index finger, worsening numbness with wrist flexion, and shooting pain up the forearm. Fortunately, there are several ways to treat symptoms of CT. Here are 5 things you should know about carpal tunnel.

      1. Supplements and Drugs

    There are a few treatments that are often used in conjunction to treat mild to moderate CT. Vitamin B6 is often used as a first treatment for Carpal Tunnel symptoms. There is some mixed evidence that B6 might help reduce pain from CT. Another natural symptom-reliever is turmeric, which may reduce inflammation. You can add small doses to your diet or you can consume turmeric supplements. Similarly, oral NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen aspirin, and naproxen sodium can be taken to relieve symptoms and reduce swelling. However, you should consult a doctor before taking B6, turmeric, or NSAIDs to make sure you are not consuming quantities that are too high and might lead to adverse side effects.

    One other potential drug treatment for CT symptoms is cortisone injections. These injections typically have about a 45% success rate in providing short-term relief, and are a good option if other treatments have failed.

    2. Night Brace

    Wrist splints can help avoid further stress to a CT injury. Wearing a splint keeps the wrist in a neutral position. This is especially important at night because you are most likely to bend your wrist while sleeping.

    3. Modified Work Stations

    One important way you can prevent or mitigate CT is by modifying your workplace layout. If your job requires a lot of wrist positions that add stress to your wrists, you may be able to make some adjustments that can help. Ensuring keyboards are lower than desks, using a touch pad instead of a mouse, and taking regular breaks can all help.

    4. Physical Therapy and Stretches

    Some hand therapy treatments may also help alleviate symptoms of CT, in general and after surgery. When used in combination with other treatments, specific stretches and exercises can help reduce mild to moderate CT symptoms. Stretches may help reduce pressure in the median nerve of the carpal tunnel, and improve circulation.

    Check out our video showing you some stretches to help with Carpal Tunnel!

    5. Carpal Tunnel Surgery

    If none of the treatment options above have worked, an EMG/NCS (electromyogram and nerve conduction study) may be conducted. An EMG/NCS is a diagnostic test that helps doctors determine a patient’s nerve and muscle condition and informs treatment options like surgery.

    CT surgery is an outpatient procedure that usually only takes 5-10 minutes and typically uses local anesthetic. A surgeon cuts the transverse carpal ligament and enlarges the carpal tunnel in the wrist to relieve compression of the median nerve.

    After CT surgery, patients usually wear a splint for one or two weeks before a follow-up appointment to remove the splint. After splint removal, a physical therapy program can help improve wrist and hand mobility and movement. Full recovery takes around 6 weeks. Over the course of recovery and beyond, it’s normal for there to be some pain and numbness in the fingers and wrist. However, you should always consult with your surgeon to assess your recovery.

    If you have Carpal Tunnel or you have any questions about treating Carpal Tunnel, you may want to consult with a professional for advice and treatment. Call Dr. Grossfeld’s office at 502-212-2663 for more information and an expert opinion.

    Patient of the Month: Anne Shelburne

    Posted by Orthopaedic Specialists

    Meet our patient of the month Anne Shelburne!

    anne shelburne

    Anne and her husband, Tim, are both retired attorneys, who after meeting at the Brandeis School of Law, practiced law for 30 + years in Kentucky and North Carolina. Now the duo design, produce and sell decorative and functional art crafted from clay and wood out of their studio in Spencer County. Hobbies that once served as therapy during their careers as lawyers have now become their full time passion. Anne is a ceramicist, and Tim a woodworker. You can follow their work on Instagram at the handle @ridgeworksky or purchase it at the Edenside Gallery on Bardstown Road.

    Anne fondly refers to her female figurines (pictured below) as “Queens.” She strives to depict the beauty, strength and resilience of women in each figurine.

    Recently, while Anne was glazing one of her favorite Queens, it fell and the arm broke off at the right shoulder. Rather than discarding the broken Queen, Anne fired her and was pleased with the results, although she only has one arm. As fate would have it, just a few weeks later, Anne would suffer from a similar injury at the beach (fortunately she would get to keep her arm).

    During a trip to North Carolina for an art show, Anne lost her balance on the beach while photographing gulls, landing on her right shoulder. Though she initially thought she had dislocated it, Dr. Grossfeld would later diagnose it as a displaced acromion fracture, an extremely unusual injury.

    Luckily, with the right preventative measures, exercises and physical therapy, Anne has been able to avoid surgery and is recovering well. She’s even turned to her art as part of the healing process, beginning with a super imposed image of her one armed Queen onto the X-ray of her now healing fracture.

    You can find Anne and Tim most days working away in their studio with their studio cat, Critter.

     

     

     

    4 Things to Know About Recovering from an ACL Injury

    Posted by Orthopaedic Specialists

    ACL tear

    If you have injured your ACL (anterior cruciate ligament), you may be wondering about the recovery process. How long will it take? What does it involve? Can you return to the activities you enjoy? How will your body be effected long-term?

    There are many factors that determine the answers to these questions for you. Here are 4 things for you to know about recovering from an ACL injury.

    1. Degree of injury

    When you injure your ACL, you have likely torn the ligament to some extent. However, the degree of the tear influences how long it will take for you to recover.

    The severity of an ACL tear is often diagnosed by grade. A grade 1 ACL injury involves an ACL that has suffered mild damage and is not torn. Most of the time, this level of injury can be treated without surgery. A grade 2 injury is when an ACL is stretched and torn slightly, and a grade 3 injury is a complete tear. Surgery is often the best treatment for a torn ACL.

    2. Common Treatments

    There are a few common treatments for an ACL injury. One of the most common nonsurgical treatments is physical therapy. Importantly, this can help patients re-develop stability in their injured knee. Choosing to heal an ACL injury non-surgically may be the right option for patients who have less severe injuries, more sedentary lifestyles, or knees with open growth plates.

    Another common treatment involves surgery. In the procedure, doctors rebuild the torn ACL using a ligament or tendon from elsewhere in the body. Patients with grade 3 injuries and active lifestyles that would be hindered by knee instability should consider surgery. After surgery, physical therapy treatment can help improve knee stability.

    3. Recovery Timeline

    The amount of time required for recovery depends on the type of treatment and each patient’s unique situation. In general, you may be able to resume normal activities after 6-12 months.

    Recovery involves a significant amount of symptom management and rehabilitation. After surgery, addressing swelling and pain is crucial. You can do this by using ice, rest, pain relief drugs, and crutches in the first couple of weeks after surgery. Physical therapy also helps patients develop knee stability in the months following surgery.

    4. Risks After Rehabilitation

    There are some risks to be aware of after rehabilitation. Re-injury of the ACL occurs at the highest rate right after returning to activity. Some of the major risk factors for re-injury are young age (under 20), a family history of ACL injuries, returning to activities that strain the ACL, and returning to activity too soon. Additionally, around half of all people with an ACL injury have osteoarthritis later in life. Because of the risks after an ACL injury, doctors may discourage patients from returning to the full level of activity they had before their injury.

    If you have an ACL injury or you have any questions about recovering from an ACL injury, you may want to consult with a professional for advice and treatment. Call Dr. Grossfeld’s office at 502-212-2663 for more information and an expert opinion.

     

    3 Things You Need to Know About Running Injuries

    Posted by Orthopaedic Specialists

    Running injury

    Chronic injuries are incredibly common for runners. These injuries occur over time due to a complex web of factors. Here are 3 things you need to know about running injuries.

    1. Common Injuries

    There are a multitude of injuries you can experience as a runner, but just a handful comprise the vast majority of all injuries. Here is a brief overview of the most common running injuries.

    PFPS

    Runner’s knee, officially called Patellofemoral pain syndrome (PFPS), is an injury where knee pain recurs, particularly after extensive periods of sitting, altitude descent, and long runs.

    Achilles tendonitis

    Achilles tendonitis is an injury below the calf that occurs when the Achilles tendon becomes overstressed and irritated. Symptoms often include swelling or a dull pain above your heel that may recede after icing or rest.

    Hamstring problems

    Having tight, weak, or painful hamstrings is a common injury type that can slow down your pace and shorten your strides. Symptoms of hamstring problems often occur while running hills or running with higher speeds.

    Plantar Fasciitis

    Plantar Fasciitis is an injury in which the tendons and ligaments on the bottom of the foot running between heel and toes become inflamed. Pain from plantar fasciitis is typically worst before the ligaments and tendons are warmed up, like first thing in the morning or at the beginning of a run.

    Shinsplints

    Shinsplints is a term given to medial tibial stress syndrome, where muscles around the tibia experience small tears. Tender or aching pain often accompanies runs but may go away afterwards.

    ITBS

    The iliotibial (IT) band, which extends from the outer thigh to the outer knee, rubs along the femur during running. Iliotibial Band Syntrom (ITBS) occurs when irritation develops from this, and symptoms often occur a few minutes into a run but disappear after.

    Stress Fractures

    Stress fractures occur due to cumulative strain on a bone, commonly on the shins, heels, and feet. Pain often builds during a run and continues even when walking or being on your feet.

    2. Preventing Running Injuries

    Injury prevention is a key part of healthy and sustainable running. Here are a few aspects of running you can focus on to help prevent injuries.

    Cadence

    Many of the key ways to prevent chronic running injuries relate to running form. One important aspect of form is cadence. Cadence is a measurement of your strides per minute. An optimal cadence is generally thought to be 170 or higher, but can vary person to person. There is some evidence to suggest a higher cadence can improve overall running form and therefore reduce injury rate. A higher cadence tends to help the body become more biomechanically efficient.

    One part of that efficiency is having a shorter stride, which reduces the force of impact when the foot hits the ground. Additionally, when feet strike closer to the midfoot and are more centered, as opposed to heel striking or striking on the outer foot, injury rates are reduced and efficiency is increased.

    Periodization

    Another key to injury prevention over time is periodization. Periodization entails planning an exercise schedule in periods of time or cycles to reach a specific goal or set of goals. Workout frequencies, types, lengths, and intensities are varied according to the goals of a period. Not only does this allow optimal preparation for performance, it also can help prevent injury.

    For instance, when training for a race, a periodized plan might take place over 12-16 weeks and have gradual buildups, plateaus, dips, and descents in terms of mileage and intensity. Varied workout types like high intensity interval training, long runs, recovery runs, cross-training, strength training, and rest days might be spread throughout each week. After a race, a periodized plan might include several weeks of lower mileage and more frequent rest days, before adapting to meet another set of goals over several weeks or months..

    Periodized training can help structure gradual increases in mileage over several months, which is extremely important for injury prevention. Adding too many miles too quickly is a very common way to develop injuries. Generally, you should not increase your weekly mileage by more than 10% at a time, and you should include periods of slower increases, plateauing, and tapering.

    Overall, periodization is an important way to think about training to optimize performance and prevent overuse injuries.

    Cross-training

    Cross-training, or training with other forms of exercise, is another powerful tool for injury prevention. Cycling, swimming, core exercises, stretching, and strength training are key ingredients to a healthy running schedule. These activities can help you develop the stability and flexibility needed to sustain training in a healthy and optimized way.

    Listening to your body

    As simple as it may seem, being mindful of how your body feels during running and responding accordingly is a powerful way to prevent injuries from developing or worsening. By using pain as a guide to how and when you run, you can avoid chronic injuries. Have a flexible approach to training- your body will thank you for it!

    3. Recovering From Injuries

    If you do develop an injury, it is critical to assess the severity and treat your body accordingly. In general, rest, ice, and anti-inflammatory medications are a good start for dealing with symptoms in the short term. Additionally, it’s important to seek professional medical advice to develop a plan for healing. Physical therapists can help you with your healing process, and can help you develop more sustainable and healthy practices so you won’t become injured again in the future. Sometimes, surgery might be the best option to help you heal.

    For more information on running injury treatment and surgery, please contact Dr. Stacie Grossfeld and the Orthopaedic Specialists at 502-212-2663.

    Patient of the Month: Judy Morrison

    Posted by Orthopaedic Specialists

    Meet January’s patient of the month Judy Morrison!

    At 68, Judy enjoys the outdoors and being physically active. Originally from New Jersey, Judy moved to Louisville in 1980. She is a mom of two as well as an investment adviser.

    In May of 2019, Judy traveled with her daughter to hike the Camino de Santiago in Spain (also known as the Santiago de Compostela) a medieval pilgrimage that takes anywhere from 5-6 weeks to complete. The pilgrimage ultimately leads to the shrine of the apostle Saint James the Great in Spain.

    Though her first reaction to the idea was to tell her daughter “you’re crazy,” Judy became inspired after watching the movie “The Way.” In the movie, actor Martin Sheen plays an American father who travels to France to retrieve the body of his estranged son (who died while attempting the pilgrimage.) Sheen ends up making the journey himself in an effort to understand.

    “After watching the film, I said to myself, ‘okay I’m doing this.'” Judy trained for 6 months to build her legs and upper body. She needed to be strong enough to be able to carry her backpack for the duration of their trip. The mother-daughter duo began their trek in France. They walked 5 days, at 15 miles a day, on a trail marked by yellow arrows and clamshells.

    However, during their travels Judy aggravated her back one day when she went to hoist up her backpack. After 6 months of medicine and worrying that she had torn her rotator cuff, she was referred to Dr. Grossfeld by her doctor for a cortisone shot.

    Judy is happy to report that she is feeling much better and was actually able to swim laps for the first time very recently. “The thought of not being able to do things would be devastating.”

    In May of 2020, Judy and her daughter plan to pick up where they left off. Although it was very challenging, I cannot recommend this hike enough. My favorite thing about the trip was the people that we met along the way and just the breathtaking scenery of the towns, country side and mountains that surrounded us.”

    An Overview of Tommy John’s Surgery

    Posted by Orthopaedic Specialists

    tommy john's surgery

    Athletes sustain injuries frequently, and some of these wounds can have life-long consequences. Many have to quit the field entirely because they suffered a career-ending injury. Fortunately, doctors and researchers work continuously to come up with effective treatments for such cases. Tommy John’s Surgery is a perfect example of this. Here’s a brief overview of this procedure:

    When do You Need Tommy John’s Surgery?

    Repetitive stress injuries are common in sports. Athletes that pitch or continuously throw fastballs often sustain Ulnar Collateral Ligament (UCL) damage. This damage occurs when the constant stress or exertion causes an ulnar ligament tear. You’ll hear or feel a popping sensation along with immediate numbness. Other symptoms include swelling in the inner part of an elbow, a weakened grip, elbow stiffness, inability to straighten the arm without significant discomfort, and a tingling sensation.

    History of This Surgery

    Tommy John’s Surgery is formally known as Ulnar Collateral Ligament Reconstruction. Its primary objective is to stabilize a patient’s elbow, eliminate pain, and restore range of motion. Most athletes return to the field in a year or so after undergoing this surgery.

    This reconstruction was first introduced by Frank Jobe, M.D., a well-known orthopedist who treated Major League Baseball pitcher Tommy John back in 1974. Until 1974, a ligament tear was considered permanent. Athletes with this injury had a ‘dead arm’ with long-term mobility issues. Dr. Jobe came up with an effective way to restore the UCL that lets athletes resume their careers after recovery. Around 85% of the athletes were able to continue playing with no compromise in skill.

    What Happens During Tommy John’s Surgery?

    UCL reconstruction is an outpatient procedure performed by a board certified orthopedic surgeon that takes around 60 to 90 minutes. Patients can return home after the surgery is done and complete their recovery. You’ll be given general anesthesia, so make sure someone accompanies you for the procedure.

    This procedure involves taking a tendon from some other part of your body or a donor and replacing a damaged UCL with it. Here’s a more detailed look at what happens:

    1. Harvesting a Graft

    The surgeon will first harvest a graft from some other part of your body like a palmaris longus tendon, big toe extensor tendon, or hamstring tendon. A doctor can harvest a ligament from any part of a patient’s body, but these three locations are ideal.

    1. Cleaning a Joint

    A surgeon will make a 3-4 inch incision outside the patient’s elbow to access the torn UCL. They will move all muscles and tissue aside and examine the damaged area carefully. The surgeon will then remove all the damaged tissue and only small sections of the original ligament if necessary. These fragments can help reinforce a new graft, making your elbow more stable.

    1. Adding the Graft

    There are several ways of adding a graft to an elbow joint. Many surgeons use a docking or figure 8 technique, both of which have high success rates. Here’s a look at this process:

    • The surgeon drills holes in the upper arm (humerus) and lower arm (ulna) bones.
    • They thread the graft tendon through these holes carefully, making sure not to cause any damage.
    • The surgeon secures the graft in place with screws, buttons, or sutures.

    Once the graft is placed, everything is stitched up once again. This procedure has a high success rate, but complications can happen. Some patients develop infections at the implant or harvest sites. The new graft can also tear or rupture, especially if it isn’t secured correctly. Patients can sustain blood vessel or nerve damage, which causes temporary or permanent numbness.

    Patients should not move their elbow for around 1-2 weeks after the surgery. When the site has healed, you can start on physical therapy for a complete recovery. For more information on elbow injuries, surgery, or other sports-related injuries, please contact Orthopaedic Specialists at 502-212-2663.

    6 Things You Should Know About Carpal Tunnel Syndrome

    Posted by Orthopaedic Specialists

     

    what is carpal tunnel syndrome

    Approximately one in 20 people develop carpal tunnel syndrome at least once in their lifetime, and 3-6% of people in the US suffer from it. It’s a fairly common injury, especially in modern times, and this painful condition can worsen with time, which is why you need to get treatment as quickly as possible. Here’s a look at some facts you should know about it:

    1. What is Carpal Tunnel Syndrome?

    Carpal tunnel syndrome is a compression of the median nerve in your wrist. It happens when a nerve or tendon swells or becomes inflamed. Compressed nerves and nerve trauma is relatively common, especially in women. While it is considered a modern ailment, earliest reports of CTS date back to the 1800s.

    1. Who Are Most Vulnerable to It?

    People with rheumatoid arthritis, patients with hypothyroidism, people with diabetes, and pregnant women are most vulnerable to it. Carpal tunnel syndrome usually disappears after pregnancy, but sometimes it can linger for several months. Don’t delay in getting treatment if that happens because there may be other underlying issues.

    1. What are the Symptoms?

    Early symptoms include a certain amount of stiffness that develops overnight. Patients feel the need to shake out their hands, hoping for some relief from discomfort. As the condition progresses, you may experience pain, numbness, and tingling. Patients usually feel these symptoms in their thumb and two fingers closest to it.

    Severe nerve compression also weakens a person’s grip. You may struggle with opening bottles, holding items, or applying any pressure. Symptoms can get worse if a patient continues using the ailing hand for extended periods.

    1. What Causes CTS?

    Repetitive stress is a common cause of CTS. If you engage in activities like typing or playing the piano, you may develop CTS. Sometimes, there’s no clear underlying cause. Here’s a look at some commonly known triggers:

    • Regular use of vibrating heavy machinery
    • Edema or fluid retention caused by pregnancy
    • Rheumatoid arthritis that causes inflammation or degeneration of nerves
    • Underactive thyroid
    • Injury to the wrist
    • Overactive pituitary gland
    • Lesions
    • Tumor or cyst in your wrist
    • Structural problems

    These are some common causes of CTS. Get a complete examination and prompt treatment to ensure there are no serious underlying issues.

    1. Testing for CTS

    Most doctors will ask questions about your symptoms and see if they are an indication of carpal tunnel syndrome. They will scrutinize a patient’s hand, looking for any sign of weakness around the thumb. Here’s a look at some tests they perform:

    • Tinel’s Test
    • Phalen’s test for wrist-flexion
    • Electromyography
    • Nerve conduction study
    • Imaging scans like x-ray or ultrasound (MRIs are ineffective)
    • Blood tests to look for underlying conditions like diabetes, hypothyroidism, or arthritis.

    Once a doctor has conducted some of these tests, they’ll come up with a treatment plan. In most cases, physical therapy is sufficient.

    1. Medical Treatment Options

    A doctor may prescribe anti-inflammatory medication or corticosteroid injections for treatment. Injections administered directly to the carpal tunnel are more effective than oral medication. If the symptoms last for more than six months despite various treatments, a doctor may recommend carpal tunnel release or decompression surgery. This outpatient procedure has a 90% success rate and provides long-term relief.

    Patients can also perform some at-home exercises and take preventive measures to address this problem. Resting your hands, icing the affected area, wrist splints, etc., can help.

    If you experience symptoms, contact your physician immediately for treatment. Prompt treatment is the only way of avoiding permanent consequences. It is also a good idea to look at underlying conditions like diabetes or obesity to prevent reoccurrence.  

    Board Certified Orthopedic Surgeon and Sports Medicine Physician, Dr. Stacie Grossfeld, has decades of experience helping patients in Louisville Kentucky with Carpal Tunnel Syndrome. For more information or to schedule an appointment, call Orthopaedic Specialists now at 502-212-2663.

     

    Answers to 5 Common Questions about Rotator Cuff Tears

    Posted by Orthopaedic Specialists

    rotator cuff tear

    Shoulder injuries are very common, especially among active individuals. These injuries are often a result of excessive strain or a sprain caused by activities like softball, swimming, tennis, baseball, golf, or weight training. People also develop problems because of rotator cuff degeneration, which manifests over time and is a symptom of age. One of the most common injuries to this region is called a ‘rotator cuff tear.’

    1. What is a Rotator Cuff Tear?

    Many rotator cuff injuries start with an inflammation caused by strain or sprain. This inflammation is called tendonitis, and it can heal gradually if your shoulder remains stable. Sometimes, injuries like tendonitis continue to worsen until the tendons become frayed or torn, and this is called a rotator cuff tear.

    A tear can be partial or full based on its depth. A partial-thickness tear penetrates a small portion of a tendon and can be quite shallow. A full-thickness tear penetrates to the bone, causing the tendon to separate from it.

    1. How Do I Know I Have Injured my Rotator Cuff?

    Pain is the most glaring symptom of an injury. Many patients also experience a great deal of stiffness or loss of mobility. Here’s a look at some common symptoms:

    • Pain while performing overhead activities.
    • Shoulder pain at night, which impacts the person’s sleep.
    • Weakness in the injured shoulder.
    • Problems with daily activities like bathing, dressing, reaching outward, etc.

    If you experience any of the signs mentioned above, visit a doctor immediately for treatment. Untreated rotator cuff tears can cause chronic pain, which compromises a patient’s quality of life.

    1. What Happens When I See the Doctor?

    If you have a shoulder injury, it is best to visit a specialist orthopedic surgeon. They will look at your medical history, past injuries, and conduct a thorough physical examination. A doctor will first take an x-ray to check for fractures or breaks before ordering an MRI for torn cuffs. Some doctors also request an ultrasound if the MRI isn’t an option.

    After they have conducted a thorough examination, the doctor will come up with a treatment plan to address the situation.

    1. What are the Treatment Options?

    A surgeon’s treatment approach depends on the extent of your injury. In most cases,  no invasive procedure is needed. A patient will heal with time and well-planned physical therapy. If you’re in too much pain, a doctor will prescribe anti-inflammatory medication, pain killers, or steroid injections to make things easier.

    If your tear goes deeper than 50% of the tendon, you will require surgery. The doctor will repair all anatomical damage to aid in recovery. As a patient’s tear heals, they will regain their full range of motion.

    Physical therapy is an important aspect of this recovery process. Therapists will recommend exercises that strengthen muscle, improve flexibility, and expand the overall range of motion. Without therapy, you won’t be able to recover completely as the tendon will remain weak for years.

    1. What can I expect Post Surgery?

    Rotator cuff tear repair surgery is an outpatient treatment. You won’t be asked to stay in the hospital unless there are complications. Patients must wear a sling for several weeks after treatment, especially if they have undergone surgery. This sling keeps your shoulder immobile and provides support.

    Recovery depends on factors like the patient’s current health, chronic medical conditions like diabetes, patient’s age, bad habits like smoking, etc. Your surgeon and physical therapist will work together on a post-procedure treatment plan. They will track your recovery before providing permission for everyday activities.

    Dr. Stacie Grossfeld has decades of experience helping patients in Louisville Kentucky with rotator cuff pain. As a double board certified orthopedic surgeon and sports medicine physician, Dr. Grossfeld is able to diagnose and treat all types of shoulder injuries including rotator cuff tears. For more information, or to schedule an appointment, please call Orthopaedic Specialists at 502-212-2663.