• 5 Ways You Can Prepare for Rotator Cuff Surgery

    Posted by Orthopaedic Specialists

    How to prepare for shoulder surgery rotator cuff

    If you’ve never had experience with surgery, your first time in the operating room might be daunting. That anxiety, combined with the fact that shoulder injuries are never fun, much less rotator cuff shoulder injuries that require surgery, might have you surprised to find out that you have a reason to be relieved.

    Now, we know you’re probably scratching your head and asking, “Relieved? How?” But, as tough as rotator cuff surgery can be, it does have one upside: you have the ability to prepare for it – sometimes even weeks to prepare – which is not an amenity some operations have.

    While each hospital might have variable guidelines and pre-operative guides, there are plenty of things you can do to prepare for the ‘after’ of rotator cuff surgery.

    How to Prepare for Rotator Cuff Surgery

    Rotator cuff surgery is one that requires roots of healing to become better. There is no band-aid method where the surgery is done and you become better without taking extra steps – it’s a high maintenance surgery. Full recovery can take up to a year, and you’ll be managing pain and juggling your everyday tasks one-handed for four to six weeks – it’s important to take your preparations seriously and do them thoroughly to mitigate discomfort and frustration during this time.

    Take a look at some of the top preparatory steps that doctors recommend for rotator cuff surgery.

    1. Establish Your Support System

    While rotator cuff surgery is usually considered an outpatient surgery – aka, you get to go home the same day – you’ll have been under general or regional anesthesia, which means you won’t be doing much for yourself afterwards until the medication wears off. You’ll need to have a companion with you – whether they are a trusted person in your life or hired help – following the surgery to drive you home, help you dress, shower, eat, and help with medications.

    Usually, people plan on having someone around for anywhere from a few days post-operation to a few weeks, especially if you have children or pets to take care of. If you take our second preparation tactic to heart, you might be able to regain most of your independence after a few days or so, but you should always have a contact to call should you need help, if only to mitigate re-injury. You should also make sure your place of employment is aware of the surgery, the recovery time, and the fact that your routine will need to be modified for an extended period of time.

    2. Practice Your Daily Tasks

    Now, this might sound like a silly preparation, but remember that four to six weeks of one-handed tasks can be a lot to handle if you’re not used to it – especially if you lose mobility of your dominant hand. Having someone on-hand is always recommended, but not always feasible. If you practice daily tasks beforehand, you’ll be ahead of the game.

    Suggested one-handed practice areas:

    • Morning routine (brushing teeth, applying makeup, taking medicine, dressing yourself, doing hair, etc.)
    • Cooking
    • Showering
    • Cleaning tasks (changing sheets, mopping spills, sweeping/vacuuming, etc.)
    • Caring for pets (it’s recommended you hire a caretaker to minimize risk of your pet accidentally re-injuring you)
    • Opening mail/packages

    Preparing your household to make this period of adjustment easier is a great way to ease the transition, and can be a part of practicing these modified tasks, since it’s a disturbance of normal routine.

    Suggested household preparations:

    • Lower anything on higher shelves that would require two hands to retrieve
    • Pre-cook and freeze meals/Meal-plan
    • Put shampoo/conditioner/body wash/hair products into containers that can be opened and scooped out instead of squeezed into your hand
    • Clean you house thoroughly before surgery so that you have time to recover before any tasks need to be addressed again
    • Shop for groceries that are easily handled/cooked with one hand

    3. Make a Plan With Your Physical Therapist

    Especially if you don’t already have a physical therapist, contacting and arranging a pre-operation appointment is a good way to be ready for what comes after the procedure. Get to know who will be leading you to recovery, and make a plan so that you know what comes next.

    The journey is long, but with the right physical therapist, can be much more enjoyable than having to select one on short notice. Since it plays such a critical role in recovery, your research should be extensive so that you get the best care possible. Physical therapy is the cornerstone to getting back into the swing of things, and will be there at every phase of the recovery process, so establish a relationship with them beforehand! It’s always helpful to both patient and physician to be familiar with each other and lay out expectations before addressing active pain.

    4. Double Check Your Hospital’s Procedures

    Some hospitals have very specific guidelines of the do’s and don’t of pre-operation. Most require that you use a special soap to prevent infection for an allotted amount of time, such as the night before, the morning of, and some time afterwards. And some having different prohibitions, like chewing gum for a day before the procedure, wearing makeup and jewelry, eating or drinking after a specified time – there’s no telling what instructions might pop up, but some may be serious enough to postpone your surgery if not followed. This is especially important to time-restrictive instructions, so make sure you pay attention and are well aware of what needs to be done on your end!

    5. Make Sleep Accommodations

    One of the most common complaints of those who go through rotator cuff surgery is the inability to sleep. Pain makes sleep hard to come by, but it’s doubly-difficult when your normal sleeping position may not be feasible. It’s often suggested that you choose a comfortable recliner to claim as your bed for the weeks following surgery; propped up with your arm held close in a T-Rex position has been reported to have some success in establishing a consistent sleep routine. If you don’t have a recliner, collect a mass of pillows and heap them up on your bed to create a reclining surface there.

    This should be taken into account when practicing your daily tasks. You might benefit from conforming to this new sleep modification a couple of weeks before operation, so that you allow your body the proper time to rest and heal from your surgery when the time comes.

    Dr. Stacie Grossfeld, Your Louisville Orthopaedic Specialist

    In an effort to assist those who are coming out of post-operation, Dr. Grossfeld offers a series of helpful videos explaining a variety of different exercises that you can get help with by calling her number today.

    If you or someone you love has suffered a rotator cuff injury in the Louisville, Kentucky-area, board certified physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Pickled on the Court: Pickleball Injury Treatment

    Posted by Orthopaedic Specialists

    Pickleball Injuries and the importance of Physical Therapy before an injury

    Across the decades, different sports have come to be all the rage amongst particular age groups – perhaps you remember playing four-square and kickball in grade school, participating in the rage of football or basketball season in college, watched as the Spikeball national tournament earned a spot on one of ESPN’s networks.

    Sports have a funny way of appealing to different people at different stages of life, and one of which has become very popular with adults aged 55 and older is pickleball. We’ve mentioned pickleball a couple of times in our blogs, talking about the best places to play pickleball and the most common injuries that come from it. With 52% of pickleball players that participate 8 or more times a year falling in that 55+ range and 21% of those who play 8 or less times a year, it’s safe to say that this low-impact sport is a popular way to socialize and get moving, which is extremely important for people of any age.

    However, pickleball may not be as low-impact as previously thought – in fact, it may be this perception that’s contributing to the growth in pickleball injuries over the years.

    The Impact of Pickleball

    While pickleball may seem unassuming at first, no sport that requires regular, fast movement to play should be considered safe. Pickleball combines a lot of the movement of tennis or badminton in a smaller space, leading to quick stops and starts, sharp twists and lunges, and the greater temptation to overstretch the body to reach a ball. This, combined with the use of your shoulder and elbow joints, can lead to any injury you would expect in a ‘high-impact’ sport in comparison.

    Perhaps it’s no contact sport or long-distance run, but pickleball will work you up a sweat and leave you sore from working muscles you’re not used to when you start. Your joints, quads, calves, hamstrings, hips, and back will feel the workout – it’s one of the primary reasons pickleball is so popular. Using nearly all the muscle groups in a social sport, what better way to spend your evenings?

    Pickleball Injuries on the Court

    Unless proper protective and preventative measures are taken, your casual evening game of pickleball might just turn into quite a few evenings of bedrest or, in more serious cases, an evening in the hospital.

    Of the approximate 19,000 pickleball injuries every year (based off of a 2019 study) 90% of them affect players 50 and older, who are already at a higher risk of injury due to the natural degeneration of muscles, flexibility, cartilage, and bone density. This fact makes the emergency-room injuries identified in a 2021 study falling into a Slip/Trip/Fall/Dive category quite serious, yet extraordinarily common, since players over 60 accounted for 85% of those emergency room visits and equaled the number of ER visits for tennis of players in the same age group.

    The most common pickleball injuries include:

    • Slip/trip/fall/dive
    • Achilles strains/tears
    • Shoulder injuries
    • Rotator cuff injuries
    • Lower back injuries (especially disc-centric ones such as herniated or bulging discs)
    • Fractures
    • Epicondylitis (tennis elbow…or pickleball elbow)

    Should I Play Pickleball At All?

    Yes!

    The purpose of this blog isn’t to scare anybody off of playing the phenomenon known as pickleball – it’s just to inform you about the proper way to go about it so that you can keep on playing for years to come.

    If the perception of risk isn’t lower, than the correct preventative measures can be taken to avoid any injuries. Stretching – which includes warming up and cooling down – is more important than ever as we age, and going straight into a sport that utilizes muscles as pickleball does invites sprains, strains, and pulled muscles like no other. If there’s a particular part of your body that’s bothering you, then it’s always a good idea to address the pain before it grows.

    One way to do this is to participate in healthy aging physical therapy. A common misconception is that physical therapy is only there as a reactionary profession – meaning that it’s only beneficial after an injury. But that’s not true – it helps sustain five key elements that keep us up, running, and on the pickleball court, which are:

    • Flexibility
    • Strength
    • Endurance
    • Posture
    • Balance

    Physical therapy is both a preventative and a reactionary profession – it’s up to you, though, which it may be. Pickleball is a fun, engaging, social sport that is easily enjoyed by all, but it’s risks shouldn’t be taken lightly.

    If you’ve been injured, getting back to full strength might take a little longer the older you get, and physical therapy can help get you there. If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    The 3 Stages of Frozen Shoulder

    Posted by Orthopaedic Specialists

    What are the 3 stages of frozen shoulder or adhesive capsulitis?

    As a particularly important joint of the body, the shoulder seems to be prone to more than its share of a myriad of different aches, pains, injuries, and conditions. But, considering how much we use it in everyday life, these infirmaries are only made that much more noticeable when we can’t easily go about our day without pain or discomfort. Frozen shoulder, however, is a particularly nasty condition to develop out of all the shoulder maladies out there due to the amount of time it affects the body – talk about a disruption of daily life.

    What is Frozen Shoulder?

    Frozen shoulder – or adhesive capsulitis, as it’s sometimes called – affects approximately 2% of the general population, which, at first, doesn’t seem all that common, but that’s 158 million people documented. It’s most common in women aged 40-70, and is often associated with pre-existing medical conditions, such as:

    • Diabetes
    • Hypothyroidism
    • Hyperthyroidism
    • Parkinson’s Disease
    • Cardiac Disease
    • Previous Injury
    • Prior Extended Periods of Shoulder Immobilization

    This condition is trademarked by stiffness and loss of mobility in the shoulder, even by external means, such as someone else attempting to gauge mobility. This loss of motion is caused by the thickening and tightening (contracture) of the connective tissue called the shoulder joint capsule, and unfortunately does not have a definitive cure or comprehensive treatment that makes the condition go away immediately.

    In fact, the best frozen shoulder treatment option available outside of short-term prescription pain medication is physical therapy, which can be either home sessions or professionally guided ones. Orthopaedic Specialists has a program for you, so contact us today at 502-212-2663 and let us help you in your management of this long-term condition or to prevent it after a shoulder injury.

    The 3 Stages of Frozen Shoulder

    One of the most unique facets about frozen shoulder, however, is that it comes in stages, and these stages each last for a time period that varies greatly between cases. Most cases present an increasing time period by order of stage, so that stage one is shorter than stage two, which is shorter than stage three.

    Stage 1: The Freezing Stage

    In this stage, the shoulder joint capsule is beginning to thicken and stiffen, causing increasing levels of pain and a decreasing range of motion. The time frame for this stage has been documented lasting anywhere from 6 weeks to 9 months, with most cases falling between the earlier 6-9 weeks period.

    Stage 2: The Frozen Stage

    In the stage after freezing, the frozen stage plateaus the thickening and stiffening of the capsule, leaving the shoulder with very little motion, but less pain. This loss of motion, however, makes daily activities extremely difficult, and physical therapy is of great importance at this stage to make sure you can manage your condition and minimize the effect it has on your life. This stage lasts approximately 4-9 months, with most cases thankfully clocking in again at the earlier periods, between 4-6 months.

    Stage 3: The Thawing Stage

    In the final stage of frozen shoulder, there comes the ‘thaw.’ This is where there is a return to previous strength and motion – either to a complete degree or one close to it. Physical therapy is perhaps most important in this stage, when motion is returning where muscle was lost, and the joint is both susceptible to injury and healing. This stage has been documented over a range of 5 months to 3 years, but most cases are contained to a 6 month-2 year scope.

    Frozen shoulder, or adhesive capsulitis, can be a very scary thing to deal with, especially following an injury if you thought you were in the clear. Physical therapy can help shorten the time frame your stages last and get you returned to your prior status with healthy, resilient shoulders. Call us here at Orthopaedic Specialists today!

    If you or someone you love has suffered a shoulder injury or has experience frozen shoulder in the Louisville, Kentucky-area, board certified physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Temporomandibular Joint Dysfunction

    Posted by Orthopaedic Specialists

    Jaw pain, TMD, and TMJ - what is it?

    Jaw pain. We’ve all been there at some point in our life – our jaw locks up as we take a bit of our dinner, you bite down wrong and feel a shooting pain in your face, there’s a pesky click every time you shift your jaw – whatever it may be, it’s actually quite common to develop what’s know as TMD, or temporomandibular dysfunction.

    What is TMD? Or TMJ?

    You may have heard it both ways, when it comes to the abbreviation, but the two refer to separate terms. TMJ refers to the actual temporomandibular joint, which connects your jawbone to your skull, while TMD stands for temporomandibular dysfunction, but is used to describe any malfunction of the TMJ. The two terms are used rather interchangeably when it concerns jaw pain, even if the medical terminology classifies them as distinctly unique entities.

    When it comes to TMJs, humans have two of them: one for each of the joints on either side of the face that connects the two points of contact between the jawbone and skull. These joints may not be as commonly associated with joint-centric injuries or diseases as other joints in the body are, but it can be just as susceptible to arthritis, injury, genetically-inherited disease, and overuse. However, just like other joints in the body, jaw pain and TMD can be managed, even if it can’t be cured.

    How Do I Know if I Have TMD?

    11-12 million adults have pain in the TMJ region, and as it turns out, women are 2x as as likely to develop TMD than men, particularly women between 35-44 years old.

    So, how do you know if you have fleeting jaw pain or TMD?

    Well, firstly, there are three classes of TMDs that you can reference to see if your pain fits into a TMD category:

    • Disorders of the joints, including disc disorders (degenerative joint disease)
    • Disorders of the muscles in the jaw (myofascial pain)
    • Headaches associated with a TMD

    If your jaw pain fits into any of these three classes, you may want to get it checked out by a dental or orthopaedic specialist.

    Other symptoms of TMD are:

    • Pain or tenderness of the jaw, especially around the TMJs
    • Earaches or an aching pain in and around your ear
    • Difficulty or pain while chewing
    • Aching facial pain
    • Locking of the TMJs
    • Decreased jaw mobility
    • Headaches and migraines
    • Neck or shoulder pain
    • Clicking, popping, or grating sounds at the TMJs
    • Facial fatigue
    • Tinnitus
    • Change in position of the teeth or jaw
    • Toothaches

    Diagnosing TMD is not usually an invasive procedure. Dental or Orthopaedic specialists will take you through a series of movements and exercised to gauge the mobility of your jaw and the severity of the TMD – if your dentist is trained to recognize TMD, they may even do it during a regularly scheduled dental checkup. If necessary, additional diagnosis methods such as X-Rays, CBCT Scans, or MRI Scans may be conducted to assess further damage, especially if the TMD is the result of an injury.

    What Causes TMD?

    Speaking of, what does cause TMD? As mentioned before, the temporomandibular joints are susceptible to genetically-inherited diseases and other conditions, such as arthritis, but sometimes, there is no cause that can be pinpointed as the origin of dysfunction. This goes case-by-case, however, and there has been evidence supported by research that potential explanations could include:

    • Bruxism (teeth grinding/clenching)
    • Dislocation of the disc between the ball and socket joint
    • Arthritis in the TMJ
    • Stress/Behavioral Reasons
    • Acute trauma

    A recent study by the National Institute of Dental and Craniofacial Research identified clinical, psychological, sensory, genetic, and nervous system factors that may put a person at higher risk of developing chronic TMD.

    How is TMD Treated?

    If TMD is like other forms are arthritis, that means that the condition isn’t curable. It is, however, manageable. Most TMDs go away on their own, and there have been less studies conducted on treatments which means less forms of treatment available to the public, but if the pain persists and interferes with daily life, after consulting with a professional, general treatments may include:

    • Heat and Cold therapy
    • Change in diet to soft foods for mandibular rest
    • NSAIDS and other over the counter pain meds
    • Nightguards/mouthpieces
    • Physical Therapy
    • Conscious change in jaw habits, like:
      • Jaw clenching
      • Gum chewing
      • Avoiding jaw movement for yawns
      • Keeping pressure off the jaw
      • Practicing good posture

    Less conventional, but still non-invasive action may also be suggested. Acupuncture, meditation and relaxation techniques, and transcutaneous electric nerve stimulation (TENS) have often been accepted as treatments for TMD, usually used in conjunction with other methods.

    More advanced treatment methods include prescription muscle relaxers, anti-anxiety medication, prescription pain relievers, and antidepressants, as they each focus on the inflammation of the muscles surrounding the joint and behavioral aspects that may be leading to jaw pain.

    Doctors recommend staying away from any permanent changes to the jaw joint, teeth, or bite without going through all potential avenues of conventional, non-invasive treatment first, but if the TMD is due to an underlying issue that can be fixed, sometimes corrective dental treatments can be utilized to treat jaw pain.

    What About Surgery?

    As stated before, most of the times, pain will go away on its own. Surgery is very rare in TMD cases, so unless its a severe case, no surgery is required or suggested – in fact, it’s discouraged. If you’ve surpassed all conventional treatments and the pain is still unmanageable or there are additional issues arising, such as advanced joint deterioration, lingering injury trauma, tumor formation, or bone issues, you may be prescribed for surgical treatments, which may include:

    • Arthrocentesis
    • Arthroscopy
    • Open-Joint Surgery

    Need help managing your joint pain? If you or someone you love suffers from TMD in the Louisville, Kentucky-area, physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    Why Does My Gout Flare Up At Night?

    Posted by Orthopaedic Specialists

    Gout, Attacks at Night, and how to treat it

    While all forms of arthritis seem unbearable at times, a particularly painful, rather common and, most of the time, unexpected strain is gout. Perhaps you’ve heard the term, but don’t know how to characterize the form of arthritis – but now, suddenly, the joint of your big toe has become affected and you’re looking for any kind of relief available. What is gout? Why does it attack at night? And what can I do to help it?

    If you’re experiencing sudden, severe gout flare ups, don’t hesitate to get a specialist’s opinion. While you wait for your appointment, here’s a short guide to gout and night-time flare-ups.

    What Is Gout?

    Gout is a specific form of arthritis that usually manifests in the joint of the big toe. While it can affect any joint, over 50% of gout cases occur in the big toe, with the ankle, lesser toe joints, and knees also common sites of inflammation.

    It’s characterized by common arthritis symptoms, but in sudden and severe attacks, usually at night. A study published in Arthritis Rheumatology found gout attacks were 2.4 times more likely to happen during the night and early morning than the day. Associated symptoms include:

    • Acute pain
    • Swelling
    • Redness
    • Heat

    This affliction is caused by Hyperuricemia, which means that there is too much uric acid in the body. Uric acid is your body’s naturally-produced method of breaking down purines found in foods and the body. But when there is an overproduction of uric acid, it crystalizes and builds up in joints, fluids, and tissues within the body.

    There are certain factors that can contribute to this overproduction, including:

    • Gender – Males are more prone to Hyperuricemia
    • Weight – Increased weight causes an increased production of uric acid, which can lead to Hyperuricemia and gout
    • Diet – Alcohol (particularly beer), high-fructose foods and drink, red meat, organ meat, anchovies, sardines, mussels, scallops, trout and tuna are all high-purine foods
    • Health Conditions – Hyperuricemia has been linked to increase with the presence of congestive heart failure, high blood pressure (hypertension), insulin resistance, diabetes, sleep apnea, metabolic syndrome, and kidney problems
    • Certain Medications – Diuretics have been linked to a higher risk of Hyperuricemia

    Gout flare-ups can last from days to weeks, and are often followed by long periods of remission that can last up to years without symptoms before another flare-up occurs.

    One of the worst features of gout is its propensity to manifest at night, when you’re at your most vulnerable and pain seems so much more intense. Along with a disturbed sleep schedule that can bleed into other parts of your life, it’s not fun to deal with.

    So why does gout flare-up at night, when you least expect it to?

    Potential Reasons for Gout Flare-Ups at Night

    Dropping Body Temperature

    The natural drop in body temperature when you’re resting can contribute to uric acid crystallization in the joints. And, since the body’s extremities usually drop to an even lower temperature than the rest of the body due to blood flow and the body’s protective measures for its organs, toes and fingers are prime locations for uric acid crystals to accumulate.

    Change in Breathing

    What the change in your breathing actually does is acidifies your blood. With less expulsion of carbon dioxide, the excess escapes to your blood, increasing the amount there in a condition called respiratory acidosis, which encourages the formation of uric acid crystals.

    Dropping Cortisol Levels

    As you sleep, your body slows its natural production of cortisol, which plays a critical role in the fight against inflammation, which is why corticosteroid shots are used to help treat arthritic conditions, including gout.

    Dehydration

    As you sleep and stop the consumption of fluids that you supply the body with during the day, your system draws on the water it retains, as well as both sweats it out and expels it out by breathing, which depletes its stores that are maintained throughout the day. As water content decreases by absorption and expulsion, uric acid concentration in the blood and joints increase, which leads to Hyperuricemia, and consequently, gout flare-ups.

    Sleep Apnea

    Sleep apnea, which is a disorder characterized by a decreased intake of oxygen when asleep, contributes even further to the change in breathing, but in a different way. Instead of carbon dioxide as the main culprit, with sleep apnea, decreased oxygen results in higher levels of the naturally-produced purines that cause Hyperuricemia and gout. It’s been reported that there is a 50% risk increase of gout with the presence of sleep apnea.

    How to Help Gout Flare-Ups

    Luckily, all is not hopeless when it comes to treatment and prevention of gout. Since attacks are sudden and relatively short-lived, there are plenty of ways to prevent or mitigate the effects. If you suffer from frequent or in-frequent gout flare-ups, make sure to consult a doctor for professional guidance and treatment options, but in the meantime, there are a couple of things you can do to help gout stay out of your joints.

    Keep a Healthy Lifestyle

    While some of the primary risks and factors that contribute to the formation and development of gout relating to personal health, keeping a healthy lifestyle is critical in all factors of life, not only in managing gout. Big factors that you can actively monitor, however, can be:

    • Maintenance of proper hydration to combat dehydration and to flush uric acid out of your body
    • Paying attention to your diet to avoid high-purine foods (alcohol (particularly beer), high-fructose foods and drink, red meat, organ meat, anchovies, sardines, mussels, scallops, trout and tuna)
    • Weight control
    • Regular exercise to improve sleep

    These are all lifestyle factors that will benefit other facets of your health, and should be considered even if you haven’t experienced a gout attack recently.

    Seek Treatment

    Professional treatment should always be an option, especially if the pain is frequent, lasting, or debilitating when it occurs. Common medical treatments for gout include:

    • Prescription pain medications
    • Corticosteroid shots
    • Colchicine

    Since gout is a form of arthritis, it isn’t curable – but it is treatable, and the symptoms can be highly managed to reduce pain, duration, and other side effects.

    Non-Steroidal Anti-Inflammatory Drugs

    IMPORTANT: DO NOT take Aspirin, however, as Aspirin has ben known to increase uric acid in your blood and make gout attacks worse.

    Over the counter medications are still an option for those who don’t want or don’t have the option of prescription treatments. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox DS, Naprosyn), and Celecoxib (Celebrex). Pairing NSAIDs with a cold compress or ice pack can also alleviate symptoms.

    If you or someone you love suffers from gout or arthritis in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

    An Overview of Meniscus Tears

    Posted by Orthopaedic Specialists

    Different types of meniscus tears and if they need surgery

    The meniscus is one of the many cartilage-fueled shock absorption cushions that your body has to keep your bones and joints protected. Acting as the main protective measure in one of the major joints of the body, the two menisci of the knee are located between the top of the shinbone and the bottom of the thigh-bone, termed the lateral meniscus and the medial meniscus. Tears in the meniscus happen to be one of the most common causes of knee pain, with symptoms of a tear manifesting as:

    • Pain
    • Popping sounds
    • Stiffness and swelling
    • Locking, catching, or giving away of knee
    • Lack of usual range-of-motion in knee

    Meniscus tears happen every day to everyone, with causes ranging from heavy use and high levels of activity to joint disorders and arthritis to the simple wear-down of cartilage that allows everyday tasks to put you at risk. So how are they avoided, then? And how are they treated?

    Well, like all injuries that affect particular demographics more – in this case, athletes and the elderly – there are certain exercises and preventative measures to aid in strengthening the muscles around the meniscus. To learn more about preventative measures, call 502-212-2663 and get a consultation on your knee pain, or check out Dr. Grossfield’s videos on knee injuries in the Videos section.

    As for treatment, not all meniscus tears are the same – there are actually six common types that are treated, and each tear relies on a number of different factors to determine which avenue of treatment should be taken, including age, the body’s response to non-surgical treatment, and any damage that extends beyond the meniscal tear.

    The most important takeaway is that not all tears require surgery, and our job at Orthopaedic Specialists PLLC is to diminish your need for invasive surgery – most often arthroscopic knee surgery – or to help you recuperate from it.

    So what are the six most common meniscus tears?

    Categorizations

    Before we delve into the list, it’s important to mention that meniscal tear diagnoses are usually very detailed, and can have an effect on the type of treatment received. Your particular tear may be described in terms of:

    • Category

    Every tear is categorized as either an acute tear or an degenerative tear.

      • Acute tears occur in weight-bearing situations, which is why this is usually the category athletes and injuries due to unnatural positions fall into.
      • Degenerative tears, on the other hand, is a category that usually holds more statistics for the elderly and are usually less severe than acute tears. These types of tears develop from a weakened meniscus, which happens naturally as the body ages, much like degenerative disc disease in the back.
    • Location

    The location of the tear is critical in the ability to treat the injury non-surgically, and, alternatively, if surgical repair is even a viable option for treatment. There are four primary locations used to describe tears: anterior horn, posterior horn, central, and peripheral.

      • Anterior horn tears are located in the front of the meniscus and are usually caused due to sudden twists or trauma, with pain occurring during knee extension.
      • Posterior horn tears are located in the back of the meniscus and are one of the most common locations for tears, with pain occurring along the joint line and back of your knee – such as when you squat down.
      • Central tears are located on the inner side of the meniscus. This part of the meniscus does not have a blood supply and is therefore not responsive to repair. Most pain from central tears happen when twisting or rotating your knee.
      • Peripheral tears are located on the outside of the meniscus. If a meniscus can be surgically repaired, peripheral tears are the most likely to respond to surgical treatment.
    • Completeness

    Depending on the extent of the injury, meniscus tears have a sub-classification of either complete or incomplete.

      • A complete tear travels all the way through the meniscus, meaning that a piece of the tissue is entirely separated from the rest of the meniscus.
      • An incomplete tear stops before total separation, meaning that the tissue is still partly attached to the body of the meniscus.
    • Stability

    Additionally, a second sub-classification that tears are sorted into are stable and unstable tears, which can also be a crucial factor in concluding if surgery is necessary.

      • A stable tear is a best-case scenario meniscus tear because it does not move and may potentially heal on its own, depending on the location in terms of vascular or avascular zones.
      • An unstable tear is the opposite – it is the worst-case scenario meniscus tear, since it does allow the meniscus to move abnormally, which will likely develop to be a problem if not surgically corrected.
      • Pattern

      The six types of meniscus tears are actually in reference to the type of tear pattern, so now, we’ll get deeper into the types of tears that you may be diagnosed with.

        Radial Tear

        Coming in as the most common kind of tear, this centrally-located injury lies within an avascular zone of the meniscus – and where there is no blood flow, there can be no natural repair, and this type of tear must be resolved with surgery that trims the damaged portion of the meniscus so that no further tearing occurs.

        Intrasubstance/Incomplete Tear

        Intrasubstance or incomplete tears – known by both names – are stable tears and usually mild injuries that don’t require surgery. They are, however, usually signs of early degeneration in the meniscus, which should be monitored and treated with preventative PT to prevent more serious meniscus injuries later in life.

        Horizontal Tear

        As a surgically-responsive form of meniscal tears, horizontal tears “go with the grain,” so to say, meaning that the tear follows the curved fibers of the meniscus. So, rather than removal, there is an opportunity for repair via stitching the tear together, although the success of this is highly dependent on the location of the tear. As with all central and avascular-located injuries, if the tear does not have access to blood flow, the body will not be able to heal.

        Flap Tear

        In the case of the unusual tear pattern flap tears in the meniscus present, this type of tear has the potential to cause a ‘catching’ sensation in the knee, as a part of the tissue has been torn and peeled back from the rest of the meniscus, causing it to get stuck in the joint. This type of tear is usually mended surgically, where the flap is trimmed away so that it no longer catches. In most cases, this tear will not need much tissue trimmed away to fix the problem.

        Complex Tear

        Complex tears are exactly what they say they are – complex in nature pertaining to both the tear pattern and surgical reparations. Since complex tears are identified by a combination of tear patterns, both radial and horizontal tear patterns often occur and make any potential surgical option complicated. If surgery is at all considered, often times, the surgeon will treat each portion of the tear differently – removing some parts while attempting to completely repair others, which is why this tear is very dependent on location.

        Bucket-Handle Tear

        Bucket-handle tears usually require surgery due to the nature of blockage that occurs. Similar to a horizontal tear, these tears occur along the grain of the meniscus, but are deeper and involve a larger part of the meniscus. Because of this, the torn part can separate from the rest of the tissue and cause the knee to become stuck and immovable, which is why surgery becomes more urgent in order to restore movement.

        For more insight into what your meniscus tear looks like, visit VeryWellHealth for images.

        If you or someone you love has suffered a knee injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

        Kentucky’s Finest Summer Fitness

        Posted by Orthopaedic Specialists

        Summer Fitness options in Louisville Kentucky

        There isn’t a season anywhere in the world that can keep fitness fanatics down – not rain, not snow, not heat…maybe hail. But in Kentucky, summer fitness can be a time to drag feet and skip out on days due to the sweltering heat and heavy humidity. Or, alternatively, it can also be a dangerous time for those who thrive in challenging their body’s limits.

        Summer fitness doesn’t have to be a pain point for anyone, though, regardless of whether you’re dreading it or ignoring the seasonal change.

        In fact, it could be the perfect time to expand your fitness reach and challenge yourself to new exercises and targeted training areas. If the weather proves to be just a little too hot for your usual activities, Louisville alone offers plenty of options for summer-friendly fitness adventures.

        Summer Water Workouts

        The swimming pool is deeply rooted in the history of fun summer activities, and water workouts are a great way combine summer and fitness. Consider water-based activities such as lap swimming, kayaking, canoeing, or paddleboarding for a quick cool-off option and an exploration opportunity – Louisville’s hidden water spots are beautiful and great for these types of workouts.

        In addition to being a great workout in a new environment, most of these activities are family and pet friendly – a great way to spend time with your loved ones, have fun, and achieve your fitness goals in one!

        Don’t have a kayak, canoe, or paddeboard? No worries! You can find rentals all around Louisville who offer a variety of different products and services.

        • Endless Summer Paddle and Coffee
          • Offers paddleboard lessons, community paddleboarding, paddleboard yoga, bootcamp-style paddleboard workouts, and a 5-hour, 10-mile paddleboard adventure if you’re up for the challenge. And, after lessons and events, you can even stop by their coffeeshop for coffee, fresh juice, smoothies, snacks, and SWAG!
        • Nachand Canoe and Kayak Rentals
          • Choose from 4-8 hour rentals of single kayaks, double kayaks, 3-person canoes, and stand-up paddleboards. They’ll even give you all the tips and techniques for a first-time paddler to have a successful trip out on the water.
        • Blue Moon Canoe and Kayak of Kentucky
          • A guided river adventure that you can choose from a half-day, 1-4 hour option or full-day, 4-8 hour option for whatever best fits your schedule. Their course is 5 miles long and provides a shuttle to the put-in site and from the endpoint once you finish.

        Summertime Trails

        Even just shifting the location of your workouts can make a difference in temperature. Kentucky is a beautiful state with tons of shaded, canopied trails for you to hike, run, or walk. The natural landscape and varied ground-surface provides a new element of challenge for your body, and works more areas of the body, so that you get a more encompassing workout in the same amount of time. The natural shade cover of the trees keeps the ground from becoming too hot, so shifting to trail activities might be a great summer fitness expansion for runners or low-impact walkers.

        Make sure you maintain safety measures, however, and always let someone know where you are and about how long you will be there. Be aware of your surroundings, the time of day, and the trails you walk so that you can stay safe while obtaining your fitness goals and soaking in the beautiful Kentucky nature!

        Summer Fitness Classes

        Not all fitness benefits from the outdoors, though. There are plenty of gyms and indoor classes to take advantage of in these hot summer months, and you can always consider checking out classes such as:

        • Sunrise yoga: An outdoor stretching and balance workout that avoids the heat of the day.
        • Pilates: A low-impact mind-body exercise that focuses on full-body strengthening and core work.
        • Cycling: A high-intensity, guided indoor bicycle workout.
        • Dancing: A varied form of cardio that ranges from hip-hop to jazzercize to exercise poles and more.
        • Boot camps: HIIT workouts that combine callisthenic workouts with cardio exercises for an intense, challenging fitness method.
        • Cardio Kickboxing: A whole-body cardio exercise with foundations in the martial art.
        • Barre: A class that offers low-impact aerobic exercises combined with higher-intensity activities that focus on core strength and flexibility.

        From family activities at the YMCA to specialized classes and lessons around Louisville, there’s a place for everyone at any skill level, from first timers to seasoned athletes.

        For teens wanting to explore indoor workouts, PlanetFitness is offering free membership for anyone aged 14-19 through August 31st. Louisville alone has 18 different locations, but this promotion is also valid at all 2,217 locations nation-wide.

        Staying Outside?

        If you don’t mind the heat, there is nothing wrong with sticking to your routine – there must be additional precautions taken, however, with a higher risk of heatstroke and other heat-related injuries. In order to keep in shape and on-track to your summer fitness goals, take the necessary safety measures to ensure you keep in tip-top shape all year-round.

        • Hydrate
          • Even if your workout is set to be a short one, hydration is extremely important in any environment. Don’t get caught in the easy dehydration trap and always have water or electrolyte drinks on hand.
        • Give Yourself Time to Acclimate
          • Especially if you’re unfamiliar with the heat, take it easy for a while to give your body a chance to acclimate to the high temperatures. When you do up the intensity, make sure you’re listening to your body so that you avoid heat-exhaustion, heat-stroke, and heat cramps.
        • Dress appropriately
          • Wear light, loose, sweat-wicking clothing to avoid heat retention. If you exercise in sunny areas, apply and reapply sunscreen, and since summer is a prime mosquito season, consider spraying on some bug spray as well. In some environments, shorts may not be the best choice of clothing – if you are in a tick-infested or poison ivy/oak/sumac dense area, invest in cover-clothing made of lighter material.
        • Get a buddy
          • Just in case of heat-related injuries, it’s always a good idea to have an exercise buddy, or at least letting someone who you are in regular contact with know how long your workout should last, just as a precaution in the hottest months.
        • Avoid the 10-4 Heat Wave
          • Just as the days are cooler at night and early in the morning (which are the best times to work out), the hottest times of the day should be avoided when exercising in the summer to prevent heat-related injuries.

        If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

        Injury Prevention for Older Athletes

        Posted by Orthopaedic Specialists

        How to Prevent Injuries as you Age

        No one likes coming to terms with getting older. It happens across the board, whether fitness is a regular part of your schedule or not, regardless of whether you are an artist, a coach, an engineer, or a pro-badminton player. What does matter, however, is how sports injuries are addressed, treated, and most importantly, prevented. Without injury prevention for older athletes, there would be a heavier stream of patients revolving through the doors of specialists. Injuries need to treated immediately and with care, not left to heal on their own as they might have done before.

        Why Am I Getting Injured More Often As I Age?

        One of the most common ways aging athletes get injured is self-inflicted over-exercise. Now, wait a minute. Over-exercise? Is that possible?

        The answer is yes. Overwhelmingly so, according to an article published by the National Library of Medicine – 70% of injuries in the elderly over a 3-year study were due to overuse.

        Granted, ‘overuse’ is a rather large umbrella term used to pinpoint a scapegoat for the origin of lists and lists of injuries. Some of the most common injuries in older athletes that have roots in overuse are common enough that seasoned athletes write them off as a solitary injury, which becomes more and more risky as you grow older.

        The Most Common Injuries in Older Athletes Due to Overuse:

        • Muscle Strains
        • Shin Splints
        • Stress Fractures
        • Achilles Tendon Tears
        • Tennis Elbow

        Every single injury listed stems from repetitive impact or movement without proper rest, recovery, and prevention. While these afflictions can be found in both younger and older athletes, the subsequent expected recovery time and treatments have the potential to be seen as equal – as the same as it always had been.

        Herein lies the problem, and why aging athletes are at such a greater risk. With more experience, more stamina, and a well-oiled structure and schedule, it is often assumed that aging, healthy, fit bodies do not undergo the same changes as aging bodies of any other kind. While it remains true that by treating your body right, some changes will not begin to affect you until much later, it does not offset all of the risks.

        Prevention Methods

        By acknowledging the risks and potential for prevention, aging athletes take their future into their own hands. These methods and measures do not have to be forthright and drastic. It does not have to mean that you can no longer play sports, or that you are either fated to be injured if not taken or will never be injured if you do, but it decreases the opportunity for risk and injury by enough that the time taken will be well-spent.

        1. Stretching

        Some of the preventative steps are as simple as establishing a thorough warm up and cool down routine instead of cutting corners and only doing one or the other. Stretching not only lets your body adjust to the level of activity you partake in, but also improves and maintains joint and muscle flexibility, which naturally decreases with age.

        2. Incorporating New Exercises into Your Routine

        A step further into stretching would be integrating new facets into your workout regiment. Lower-impact activities that benefit different areas of your life and body – such as balance exercises, core work, yoga, or water aerobics – can give your body a much needed rest while still giving it the movement it needs and the stimulation you crave. Becoming a well-rounded athlete only reaps benefits, especially when overuse and limited movement becomes a reality as you age.

        3. Upgrading your Equipment

        One benefit of growing older is that you accrue resources along with your experience. Higher-quality equipment not only lasts longer, but is also more comfortable and easier on the body. If you were a runner, there is an obvious rift between running in on-sale, thin-soled tennis shoes than any name brand that specializes in cross-country running. Upgrade your equipment that might be old, ill-fitting, tearing, or that brings the potential of injury by malfunction due to wear-and-tear. Upgrading your equipment could also involve upgrading your environment. Training alone gets riskier as you age and become more susceptible to injuries, but the surfaces your practice on play a role in impact on the body, as well.

        4. Modifying your Workouts

        While the idea does not seem feasible or particularly enticing to some, even small changes can make a big difference in the long-run. These modifications can range anywhere from a change in schedule – giving yourself a longer recovery time, such as going one week on, one week off – to a change in the actual activity that allows for aches and pain. Going down a weight set, avoiding the butterfly stroke, or avoiding a hilly part of town are all ways that you respect your body and its limitations.

        5. Listening to your Body

        This brings us to the most important preventative measure of all – listening to your body and paying attention to what it tells you. As you age, you should begin to get familiar with your body’s signals, tricks, and nuances, and then listen to them. You know best when limits are being approached, and when you need to rest where you would have gone on previously. Pain is not optional, and injuries are not inconsequential. By taking injuries seriously and treating them appropriately, you invest in a healthier future, even if it means coming to terms with the fact that recovery may take longer than it has before. By stopping once you are in pain, you allow the body’s healing process to begin building a stronger, more resilient you. Listening to your body takes the ‘over’ out of ‘overuse’, and can be the most important weapon in your arsenal of preventative measures against sports injuries as you age.

        If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.

        Employee Spotlight: Bailey Belcher

        Posted by Orthopaedic Specialists

        Meet our employee in the spotlight, Bailey Belcher!

        Bailey Belcher Barrell Racing

        When ATA College Grad and X-Ray tech Bailey Belcher isn’t working hard at Orthopaedic Specialists PLLC, you’ll likely find her on her horse Hot Rod. She’s been training with Hot Rod – a 4 year-old Kentucky born and bred quarter horse, since he was only one.

        Bailey is inspired by the improvements they are making together in local and regional races. Bailey started barrel racing in 7th grade after having spent many years before that doing weekend trail riding.

        She loves the speed and the challenge of the sport, and has competed in many different places including cities around Kentucky, Indiana, Tennessee, and as far away as Texas when she qualified to up against some of the fastest racers in the country at the “All American” races. Her dream goal would be to make it far enough to participate in the National Finals Rodeo “NFR” events.

        When asked what advice she’d give to someone interested in getting into barrel racing, Bailey says, “You have to have a lot of grit and dedication. This means going to ride every day, even when you really don’t feel like it. You’ve also got to be able to identify and fix problems – get after it and not be scared of it.” When asked who she looks to for inspiration, Bailey talks about her dad. Even though he doesn’t ride horses, Bailey really admires his mental strength and his work ethic. “My dad is tough – he doesn’t ever give up, and that’s how I want to be.”

        Bailey does a great job working with Dr. Grossfeld at Orthopaedic Specialists, and her passion for horses and barrel racing inspires the entire office. Go Bailey!!

        Where Can I Play Pickleball in Louisville, Kentucky?

        Posted by Orthopaedic Specialists

        Pickleball has been America’s fastest-growing sport for three years running, with over 2.4 million new players since 2019. Described as a cross between ping pong, tennis, and badminton, Pickleball is accessible for people of all ages and backgrounds. It’s addictive and fast-paced, and if you haven’t tried it yet, it’s about time!   

        There are now over 10,000 pickleball courts in the United States, an all-new USA Pickleball Association, first-time national tournaments, and local leagues in every corner of the country. In Louisville, there are at least 15 free public courts that host weekly (and sometimes daily) events for players of every level. 

        Here’s the lowdown of where you can play in Louisville, KY, as of June 2022.

        Facilities And Parks With Pickleball Courts in Louisville, KY

        EP Tom Sawyer Park

        The state-of-the-art pickleball complex at EP Tom Sawyer State Park boasts a total of 16 outdoor courts and 4 seasonal indoor courts. The outdoor courts are free and open to the public, 7 am until dusk, 7 days a week. These courts can be reserved for a fee. There is currently an ongoing summer ladder league for all levels of play. The indoor courts are available during the winter months for $5/person. To learn more or reserve a court, contact the Recreation Office at 502-429-7270. 

        Charlie Vettiner Park

        On June 6th, 12 new pickleball courts opened at Charlie Vettiner Park, located at 5550 Charlie Vettiner Park Rd in South Louisville. As part of a $1.3 million investment in the park, other improvements included repaving and rehabilitation efforts.

        Wyandotte Park

        Wyandotte Park, located near Churchill Downs at 1104 Beecher St, offers 6 pickleball courts. The courts are well-lit at night, and there is an ongoing Wednesday evening summer league at this facility. 

        Pickleball Euphoria

        According to their Facebook page, “Pickleball Euphoria is the first dedicated Pickleball facility in Louisville, KY featuring 3 indoor courts with outdoor surface and a pro-shop on-site. Owners & certified teaching pros, Josh & Stephanie, have actively played & competed in pickleball tournaments since 2017. PE strives to provide a top-notch facility, attracting players of all skill levels with offerings of hourly court rentals, lessons, clinics, skills & drills, paddle demos, round robins, leagues, open play and special events.”

        Pickleball Euphoria is a highly-active community of pickleball-players that invites involvement at all levels. It is located at 4209 Gardiner View Avenue, near I-264 at Newburg and Poplar Level Rd. To learn more, visit pickleballeuphoria.com. 

        Springhurst

        Pickleball at Springhurst (via the Louisville Sports Academy) offers 3 reservable indoor Pickleball courts, private and group lessons, leagues, and more. See more at http://www.springhurst.com/sports/pickleball or visit their Facebook page. 

        Berrytown Recreation Center

        Berrytown Recreation Center, located at 1300 Heafer Rd in the east end, has 3 indoor pickleball courts, available on Wednesday and Fridays from 10 am – 12 pm. Call recreation director Jon Pilbean at (502) 456-8148 for more information. 

        Northeast Louisville YMCA

        The Northeast Louisville Family YMCA offers 3 indoor pickleball courts, free for YMCA members. To learn more, click here. 

        Hounz Lane Park

        Hounz Lane Park, located at 2300 Hounz Ln across from EP Tom Sawyer Park, offers 3 outdoor courts for public access and free play.

        Des Pres Park

        Des Pres Park, located at 4709 Lowe Rd, Louisville, KY 40220, offers 3 outdoor courts, open dawn to dusk. 

        The following local parks have at least 1 pickleball court: Sun Valley Park, Riverside Gardens Park, PeeWee Park. 

        Facebook Groups To Join

        If you want to keep tabs on the Louisville pickleball community, there are several public Facebook groups that post regular updates concerning upcoming events around town. 

        • Derby City Pickleball is the largest group, with over 2,000 members. 
        • Louisville Pickleball, another popular Facebook group, currently has around 1,500 members. 
        • Louisville Beginners Pickleball is a private group with over 400 members, designed to promote an inclusive space for those new to the sport.
        • E.P. “Tom” Sawyer State Park – Pickleball is a Facebook group created to share information about pickleball programs and events, specifically about EP Tom Sawyer State Park.
        • Pickleball Squad is another local forum that shares local information, especially concerning play at Wyandotte Park and the YMCA. 
        • Pickleball Forum is a worldwide Facebook group designed for discussion of all-things-Pickleball. Boasting over 68,000 members, this is the largest Pickleball page on the web. 

        To read my blog about common pickleball injuries and how to prevent them, click here.

        If you or someone you love has suffered a sports injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.