Orthopaedic surgery is all about drilling, sewing, crocheting, and tying knots. The image above is me tying down a suture outside of the shoulder. I am using a tool called a knot pusher, which really looks like a crochet hook. I then push the knot into the shoulder joint to tie down the rotator cuff to the humerus.
The wrist is a super complicated part of your body. There are eight little bones that make up the wrist joint.
The medical term for growing pains in the knee is called Osgood-Schlatter Disease. Osgood-Schlatter Disease occurs in kids when they go through rapid vertical growth phases, typically sometime between 11 and 16 years of age. During this growth phase the bones grow faster than the tendons. The tendons tug on the growth plates were they are attached to the bone.
The most common site for growing pains is the front part of the knee. There is a growth plate in the front of your knee. If your shin bone grows very quickly where the tendon attaches to the growth plate or bone, the tendon can pull and elevated the growth plate off the major shaft of the tibia or shin bone. This will bother kids when they jump or run. The pain may occur until the growth plate completely closes which is typically age 14 for girls and age 16 in boys.
The treatment is supportive. Supportive means it’s OK to play through the pain. We recommend ice, anti-inflammatory medications as needed, and sometimes even a patellar tendon strap can help. Once the growth plate has closed the growing pains go away.
Image below is an x-ray of a patient with Osgood-Schlatter Disease. The red arrow points to the growth plate that is elevated off of the shaft of the bone. Typically the kids will complain of pain right in that area. Sometimes you may actually see some swelling from the localized inflammation.
Your biceps muscle turns into a thin tendon that attaches to your forearm. Rarely can the tendon tear off the bone, where it attaches in the forearm. When that happens the biceps muscle looks very flat and can migrate closer to your shoulder because the bicep muscles are no longer anchored at the end distally. The image with the blue arrow reveals how the patient for the biceps muscle has moved towards the shoulder and you can see some bruising where the tendon ruptured.
That image with the green circle and arrow is the end of the torn biceps tendon. The green arrow shows where the tendon should be attached in the forearm.
The purple arrow shows the tendon after I have placed sutures around it. I have already secured a metal suture anchor that is attached to the bone where the tendon is going to be attached. I’m now placing the sutures around the tendon and will pull the biceps tendon back into the form and attach it down to the bone in the forearm .
If you are a black diamond skier, warm up on some blue runs. If you were a blue level skier, warm up on some green runs.
While nothing is better than skiing with your air pods in your ears listening to your favorite Alpine ski playlist, listening to your surroundings is very important. When you’re on the chairlift for example, and the lady sitting next to you is nervously asking your husband how to get off the chairlift…that is a conversation you want to hear. Because when you’re getting off the chairlift, you want to make sure you are no where near her as you exit.
Check that your bindings are not too tight for your ski boots based on your ski ability. If you wipe out, you want to make sure your skis pop off your boots. A ski that does not detach can catch in the snow and tear your ACL.
When your legs are tired, you’re done for the day. I know everybody wants 10,000 vertical feet of skiing before 10 AM and 30,000 vertical feet of skiing before 3 PM, but if at 2 o’clock your legs are tired, end your day. It’s very important that you’re not skiing with tired legs.
Your hamstrings protect your ACL. So hit the hamstring curl machine prior to heading out west or jumping on that chairlift. Also, when you’re riding a bike, make sure you are clipping into your petals and pulling back during the up stroke of your pedal stroke on the bike because that will strengthen your hamstrings.
The top image is a normal ACL(a happy skier’s knee) and the bottom image is a torn ACL (a sad skier’s knee).
As spring approaches so too does running season here in the Ville! Saturday the 23rd is the Anthem 5K Fitness Classic, followed by the Rodes City Run 10K on March 9th, the Papa Johns 10 Miler March 23rd and the Mini Marathon and Marathon run of April 27th.
Whether you’re gearing up for the Louisville Triple Crown of Running or the Kentucky Derby Festival Marathon, properly training will go a long way in helping you reach your goals and stay injury free no matter your level of ability. As Dr. Stacie Grossfeld has many years of experience treating common running injuries and helping runners continue to enjoy the sport they love, here are a few tips on preparing yourself for the long road ahead!
Wearing the right shoes for your foot can help prevent common running injuries such as shin splints, stress fractures and sprains. It is recommended that you are fitted with running shoes at a store that is familiar with runners so you can have a gait analysis performed.
If preparing for a long distance run you’ll need to log the appropriate amount of mileage well before race day. It is commonly encouraged that runners complete at least 1 long run a week during their training in order to build up their endurance.
While discipline and dedication are positive attributes in athletic training, it’s important not to over train. The number one reason for stress fractures is too much training too quickly. That being said, take 1 or 2 days off a week and if you must keep moving, consider a low impact exercise such as yoga, walking or swimming.
If you don’t push yourself to run a little faster every time, it’s likely you won’t be able to even complete the mileage. Doing so will help you keep a better pace come race day. Just be sure to leave at least 10% in the tank.
If you start to have aches and pains in certain areas of your body and the pain is getting worse, do not try to run through them. This is a sign that something is wrong and you should consult a medical professional.
Hydrating during or after a run is key, but so is hydrating before. You’ll also want to make sure you’re maintaining enough caloric intake to keep up with your energy expenditure. If you are doing a lot of long distance running, you may want to keep a food log to make sure that you are taking in enough calories and nutrients to keep up. The second most common reason for stress fractures is lack of proper caloric intake.
If you have any medical conditions such as hypertension or coronary artery disease, you should check with your primary care physician for medical clearance before starting a running program of any kind.
If you or a loved one are experiencing an injury due to running, make an appointment with the Orthopaedic Specialists by calling us at 502-212-2663 or using the contact form online. Dr. Stacie Grossfeld is a trained orthopedic surgeon who is double board-certified in orthopedic surgery and sports medicine.
What does a ballerina’s foot look like on an X-ray when they are on their toes? The top image is you and me walking. The bottom left image is a ballerina en pointe. The most common injury among dancers are foot problems. I see metatarsal stress fractures, bunion deformities, flexor hallus longus tendinitis, and other foot related issues. Looking at this image can give you a reason why….
A meniscus is a structure located in your knee joint that functions as a shock absorber. You have two of them in each knee and they are prone to tearing. When the meniscus is torn, it produces a sharp stabbing pain and sometimes it will cause your knee to click or even lock. Many times swelling is associated with a meniscal tear.
The treatment for a meniscal tear is a knee arthroscopy. That is the procedure where I go in and remove the torn part of the meniscus. On occasion the meniscal tear can actually be repaired or sutured back together but that is only rare. The reason why the meniscal tears are typically not repaired is because the meniscus does not have a good blood supply. So if I place sutures in the meniscus it would just not heal. There is a part of the meniscus that is very vascular and has a good blood supply. If the tear occurs in that area then the meniscus can be repaired versus just removing the part that is torn.
The meniscus has shock absorbing qualities but once it is torn, the area where the tear is located no longer provides any shock absorbency. The only thing the torn meniscus provides is pain.
Often when a patient comes in with back pain, they ask the question, “Do I have scoliosis?”
Scoliosis is a curvature and a rotational deformity of the spine. By definition, the curvature of the spine should be at least 10°.
The standard case of scoliosis usually occurs during a growth spurt right before puberty. However, it is possible that the condition may not be caught until adulthood when the symptoms become more problematic. While the cause of adolescent onset scoliosis can be attributed to birth defects, a spinal injury, muscular dystrophy, or cerebral palsy, the cause of most pediatric cases is unknown. It has also been determined that scoliosis can be genetically related.
Treatment is based on the age of onset and the degree of the curve. This can range from simple observation and bracing, to complex invasive surgery. If caught early on, the issue can most likely be resolved. Uneven shoulders, hips or waist are signs of scoliosis.
Also known as degenerative scoliosis, this form of the condition typically affects those 50 or older. Adult onset scoliosis can slowly occur over time with age. In fact, it is normal to experience a form of degeneration when it comes to facet joints and intervertebral discs. As we age, this kind of deterioration is also known to cause osteoarthritis as well as degenerative disc disease.
According to a recent study, “at least 60% of the population over age 60 has at least mild degenerative scoliosis.” While adult onset scoliosis is fairly common, in some cases it may be accelerated, resulting in severe symptoms.
Symptoms include a dull back ache and sciatica like sharp shooting pains originating in the lower back or buttock, usually on one side. This can make it difficult to move or walk. Treatment options are often nonsurgical and involve physical therapy, medication, as well as avoiding overly strenuous activities.
If you or a loved one is experiencing back pain, make an appointment with the Orthopaedic Specialists by calling us at 502-212-2663 or using the contact form online. Dr. Stacie Grossfeld is a trained orthopedic surgeon who is double board-certified in orthopedic surgery and sports medicine.
The top left x-ray of the elbow is normal. The top right x-ray of the elbow has an occult fracture of the radial head. An occult fracture is when you cannot see the break on an x-ray. How did I know the radial head bone was broken if I couldn’t see the fracture line on the x-ray????
Answer: the bottom image has the positive “fat pad sign.” This anterior and posterior fat pad sign is circled in red. The soft tissue shadow located on the front and back of the elbow bone indicates that there is blood in the elbow joint. The fat pad which normally sits adjacent to the bone is not seen on a normal x-ray.
When there is bleeding in the joint it elevates the fat pad and it looks like a sail on a sail boat. The most common cause for a sail sign is an occult fracture of the radial head. This patient was also very tender to palpation over the radial head which matched the x-ray. Thanks Carina Curnow Burns ,M.D. and Becky Fuller Olds , N.P. for the great referral and the perfect textbook radiographic image!
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