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How to Prepare for Knee Replacement Surgery

You’ve made the decision to have knee replacement surgery, and the date has been set. You’re looking forward to getting your mobility back, resuming your usual activities and feeling less pain. 

You may be wondering how to prepare for knee surgery and what you can do to make sure that your recovery goes as smoothly as possible. Know that there are steps you can take not only to prepare your body, but also your home. 

Each person’s recovery is different, and yours may be faster than most. Still, you’re likely to have some difficulty getting around during the first several days, and possibly longer. Spending a little time to prepare now will pay off later when you get back home. You’ll lower your risk of injury, and you just might hasten the healing process. 

Create a Checklist 

This simple step can save you considerable stress. Your list doesn’t have to be in any particular order, though it might be helpful to create it based on the timeline for completing the items. (Some steps can be done several weeks ahead of time, whereas others need to be done shortly before your surgery.) 

And, you don’t have to create the list all at once. In fact, you’ll probably think of things you want to add as you count down the days to your surgery. 

You may be tempted to put this off, especially if your surgery date is several weeks, or months, away. But time goes by quickly, and that day will roll around before you know it. You could even start your list now, while you’re reading through this blog post.

It’ll feel good to check off the items on your list as you complete them, and you won’t have to worry that you’ve forgotten something. 

Set Your Home Up for Success

Just as everyone’s recovery is different, so too are the “home prep” steps. The following are suggestions that are helpful for most, if not all, people who are preparing for knee replacement surgery.  

  1. Evaluate your sleeping arrangements. Specifically, if your bedroom is upstairs, then you will want to set up a temporary bed downstairs. It may only be for a week or two — just until you can navigate the stairs with relative ease. 
  2. Consider adding safety rails in the bathroom(s) you’ll be using. Falling in the bathroom could lead to a serious injury. Safety rails, also called grab bars, will make it easier to sit down and stand up when using the toilet. 
  3. Move tripping hazards out of the way. This includes rugs and floor mats, loose electrical cords, furniture that protrudes into walking areas and any clutter that might block your path. 
  4. Place items you’ll need within reach. This could be a two-phase step. First, consider items you normally store in upper cabinets or on top closet shelves that you might need during your recovery, such as blankets. Move those items to a lower space. Then, closer to your surgery date, set up a table near your bed and/or the chair you’ll use most often, and place items like tissues, lip balm, lotion, reading materials, remote controls, eyeglasses and, perhaps, medications on the table. (Just be sure that pets and children cannot access any drugs.) 

Pre-Op Exercises to Strengthen Your Leg Muscles

Performing exercises before your surgery to strengthen the muscles around your knee, as well as other leg muscles, can help your body recover more quickly after surgery. 

These are three common pre-op exercises that can give your recovery a head start. If you feel pain while doing any of these, stop. 

  1. Straight leg raises: Lie on your back and bend your “good”  knee so that the sole of your foot rests flat on the floor. Tighten the thigh on your other leg (the one with the injured knee) and keep the leg straight. While bending your ankle and pulling your toes toward you, raise your straight leg about 12 inches off of the floor. Hold it there for 2 to 5 seconds before slowly lowering it back to the floor and relax. Do up to three sets, with 5 to 20 repetitions per set. 
  2. Seated knee extensions: Sit in a chair and raise the leg with your injured knee until the leg is straight. Hold it there for 5 seconds and then slowly lower it back to the floor. Do up to three sets, with 5 to 20 repetitions per set. 
  3. Thigh squeezes: While lying on your back, tighten the muscles in the front of your thigh by pushing the back of your knee down toward the floor. Hold for 5 seconds and then let go. 

Ask Family or Friends if They Can Help You

If you are having knee replacement surgery on your right knee, depending on the type of surgery you are having, you may not be able to drive for several weeks afterward. So, it’s a good idea to check with family and/or friends to see who can provide transportation to other appointments, including your follow-up visits, while you’re recovering. 

While you’re asking, see who can pitch in to take care of errands, like trips to the grocery store and pharmacy. Are delivery services an option? Will you need help with tasks around your home? Do you have a dog that will need to be walked? 

Even if you have everything covered, if you live alone you should still arrange for someone to stop by and check on you several times while you’re recovering. It’s always best to play it safe. 

Post-Op: Exercises for a Faster Recovery

The recovery time for MAKO robotic-assisted total knee replacement surgery is much shorter than it is for traditional knee surgery. Based on our past patients’ experience, we’ve found that those who undergo MAKO surgery are typically up and moving around two to three weeks post-surgery. By comparison, traditional methods usually involve a recovery time of six to eight weeks. 

You can do post-op exercises to help speed your recovery along. The following are three you can try. Start with fewer sets and repetitions, and gradually build as you grow stronger. If you feel pain while doing these, stop. 

  1. Hamstring curls: You can do these while standing up or lying on your stomach. If you’re standing, stand near something you can use for support if you need it. If you’re lying on your stomach, fold your arms and place them under your head. Bend your knee on the leg with the new knee and slowly draw your heel up toward your buttocks. Then, slowly lower your foot back to the ground and relax.
  2. Knee and hip flexion: Lie on your back with your legs out straight on the floor. Make sure you keep your kneecaps facing straight up toward the ceiling as you do this exercise. Slide your foot on the leg with the new knee toward your buttock, bending both your knee and your hip joint. Slowly slide your foot back out, returning your leg to the starting position. It won’t hurt to do both legs, alternating as you do your sets.
  3. Standing hip adduction: Stand near something you can use for support if needed. Slowly swing the leg with the new knee out to the side as far as you can, while keeping your knee straight. Then, slowly bring the leg back to where it was when you started. 
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Looking for a Way to Relieve Arthritis Pain? Try an Anti-inflammatory Diet

Inflammation is the body’s natural and necessary response to cell damage caused by trauma or injury, chemicals and other toxins, pathogens such as bacteria and viruses, and other irritants. It’s the way the body starts to heal itself.

But at times this response can be triggered when it shouldn’t be (as in the case of autoimmune diseases), or it can spiral out of control (as with sepsis). When this happens, instead of healing, inflammation causes more damage.

Signs of acute inflammation include:

  • Pain
  • Swelling
  • Loss of function (such as a joint)
  • Redness
  • Heat

Diagnostic tests can be useful in determining whether inflammation is causing or contributing to your joint pain. If it is, treatments are available to help control and possibly eliminate the inflammation.

First, though, you may want to try making some changes to your diet to see if that helps to relieve the pain.

Inflammation and arthritis

Although the role of inflammation is generally understood to be different in rheumatoid arthritis than in osteoarthritis, there is evidence that inflammation can be associated with both diseases.

There is also evidence to suggest that adopting an anti-inflammatory diet — one designed to reduce inflammation throughout the body — could be helpful in alleviating the joint pain associated with both types of arthritis.

It’s important to note that no diet alone can completely eliminate arthritis pain. But, when combined with other lifestyle factors such as proper sleep and exercise, an anti-inflammatory diet may be useful in reducing joint pain.

Research supports the potential benefits of this type of diet in other medical conditions as well, such as cardiovascular disease, diabetes and possibly even dementia.

The connection between diet and inflammation

Without getting too technical, here’s how researchers believe food affects inflammation:

By increasing inflammatory markers. A marker is a diagnostic sign of a disease or condition. An example is C-reactive protein, or CRP, which circulates in the blood and is produced by the liver in response to inflammation. Certain foods, such as processed sugars, appear to increase CRP levels.

By fighting oxidative stress. Oxidative stress occurs when free radicals (unstable atoms) outnumber antioxidants, leading to oxidation. Free radicals can damage fatty tissue, DNA and proteins in the body. Foods rich in antioxidants can help to remove free radicals from the body.

By “switching off” the inflammatory process. The pathway that signals the body to begin the inflammatory process can also signal it to stop the process. Omega-3 fatty acids convert into compounds called resolvins that can stop the inflammatory process.

Foods that may relieve arthritis pain

As noted above, a diet that includes foods high in antioxidants may reduce joint pain by helping to rid the body of free radicals. The following is a partial list of antioxidant-rich foods:

  • Berries – blackberries, blueberries, raspberries, strawberries
  • Cherries – tart cherries appear to be most effective for fighting inflammation
  • Citrus fruits
  • Pineapple
  • Leafy greens – arugula, broccoli, Brussels sprouts, collards, kale, mustard greens, spinach, Swiss chard
  • Red kale
  • Beets
  • Avocados
  • Beans, lentils and pulses – black beans, chickpeas, kidney beans, lentils of any color, mung beans, navy beans, peas, pintos, red beans
  • Artichokes
  • Cabbage
  • Cauliflower
  • Tomatoes
  • Carrots
  • Bell peppers
  • Mushrooms
  • Sweet potatoes
  • Onions and garlic
  • Purple or red grapes
  • Whole grains – especially brown rice, whole corn, whole oats and whole wheat
  • Almonds and pecans
  • Dark chocolate – go for at least 70% cacao, and watch the sugar content
  • Spices such as ginger, paprika and turmeric
  • Chili peppers
  • Green tea
  • Olive oil – most experts agree that olive oil has anti-inflammatory properties — just be careful not to overdo it

Foods high in omega-3 fatty acids that could help turn off the inflammatory process include:

  • Fatty fish – anchovies, herring, mackerel, salmon, sardines and tuna
  • Tree nuts – especially walnuts (and walnut oil)
  • Pecans
  • Ground flaxseed
  • Chia seeds

Foods that may exacerbate arthritis pain

Just as there are foods that may help to relieve pain from arthritis, some foods could make it worse.

Sugary foods and drinks have been shown to increase CRP levels, for example, and thus could contribute to inflammation. Most baked goods and pastries, sodas and other sugar-sweetened drinks are obvious foods in this category.

Other, less obvious foods are often high in sugar, too, such as breads, crackers, granola, energy bars and even salad dressings and ketchup. It helps to check the label, particularly if a food is marketed as “low fat.” Sugar is often used to replace fat in such products.

Other foods that have been associated with inflammation:

  • Highly processed foods — this could include most foods with an ingredient list that contains hard-to-pronounce items
  • Foods high in saturated fats — red meat, full-fat dairy products, rich desserts made with cream, butter, lard, margarine and certain types of oils
  • Trans fats — hydrogenated and partially hydrogenated oils often found in fast food, fried foods, cookies and donuts
  • Processed meats — bacon, sausage, salami, hot dogs, jerky, pepperoni
  • Foods high in omega-6 fatty acids* — mayonnaise and the following oils: canola, corn, peanut, safflower and sunflower
  • Refined carbohydrates — white bread, white rice, instant mashed potatoes, semolina pasta, sugary cereals, crackers made with refined flours
  • Excessive alcohol
  • Excessive salt – more research is needed to be conclusive, but high levels of salt in the diet may cause inflammation

*Note that the body needs some omega-6 fatty acids. The goal is to achieve a healthy balance of omega-3 and omega-6 fatty acids.

Let good sense guide you

These lists are not exhaustive, and there’s no such thing as an “arthritis diet” that will magically make your joint pain disappear. With that in mind, it can’t hurt to try adding some of the “good” foods on these lists to your diet and eliminating or at least cutting back on some of the “bad” foods.

The key is to diversify your diet. For instance, it’s not a good idea to pick a food — say, salmon, or pineapple — and load up on it. That could have adverse effects you didn’t anticipate.

If you think about it, these lists, taken together, represent the usual advice for a healthy diet:

  • Eat plenty of colorful fruits and vegetables
  • Choose whole grains over processed ones
  • Opt for “healthy” fats from nuts, seeds, avocados and olive oil
  • Reduce your intake of red meat, processed meats, full-fat dairy, simple carbohydrates and sugary foods and drinks
  • Limit alcohol and salt

Also bear in mind that no two people are alike. What works for someone else might not have the same effect for you. If adding or eliminating certain foods doesn’t ease your joint pain, try some of the other options.

Gradually, you’ll find the anti-inflammatory diet that works best for you.

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5 Hip Replacement Symptoms to Watch For

It’s not unusual for people who are in their fifties or older to experience hip pain. The decades can take a toll on a person’s bones, muscles and joints, leading — in some cases — to osteoarthritis.

Younger people can also have hip pain, of course. Sometimes joint injuries can cause discomfort years later. So can extra body weight and repetitive movements (e.g., those made while training for and playing sports). Low back issues and genetic factors can play a role in hip pain. Even a difference in leg length, which may affect more than half of the population, can cause gait problems. These issues may eventually lead to the need for hip replacement.

So how do you know if your hip pain is caused by a temporary injury to the soft tissues around the joint, or an issue such as uneven hips, which might be addressed through the use of orthotics, or something longer term, like arthritis, that may warrant surgery?

Sometimes the location of the pain can help determine what’s causing it. Sharp discomfort in the groin area or on the inside of the hip is often an indication of a problem with the hip joint itself, whereas pain on the outside of the hip or in the upper thigh or outer buttock area may be associated with the soft tissues (ligaments, tendons, muscles, etc.) that surround the hip joint.

If you have persistent pain and/or stiffness in one or both of your hips, it’s a good idea to have it checked by a medical professional. Depending on the underlying cause, it may just need some extra attention. Not all hip pain calls for surgery or a joint replacement.

There are some warning signs, though, that could indicate a hip replacement may be necessary. We’ve compiled a list of five common hip replacement symptoms to be on the lookout for.

1. Stiffness in your hip limits your normal range of motion

Your hip doesn’t move as freely as it used to, and the stiffness is bad enough that it keeps you from engaging in regular everyday activities — like going for a walk, or squatting down to pick up something. One leg might feel as though it’s dragging, compared with the other leg, and you might have an actual limp. Maybe you wobble when you walk.

Your hip joint might feel as though it sticks, or locks up, especially when you start to stand up after sitting for a while. The stiffness might be worse in the morning, when you first wake up. You may also have a dull ache in your hip or groin, along with the stiffness.

Stiffness can come on gradually, and you might not notice it much in the beginning. These are common signs that you have stiffness in one or both of your hips:

  • It’s harder to put on your shoes and socks.
  • You can’t walk the same distance you normally would, or it takes you considerably longer.
  • Getting out of a car is a challenge.
  • It’s difficult to lift your leg in front of you, to the side, or behind you.
  • You have to use your hands to push against something or pull yourself up when getting up from the floor.

2.  Recommended treatments don’t relieve the pain

You’ve tried a variety of treatments to eliminate the pain — including medications such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen, and injections of cortisone or hyaluronic acid. You may also have tried physical and/or occupational therapy, at-home remedies, transcutaneous electrical nerve stimulation (TENS) and even minor surgery.

Although these methods may provide some level of short-term relief, steadily returning pain is a hip replacement symptom to be aware of.

3. You have difficulty sleeping

Pain in your hip may make it hard to get in a comfortable position so you can fall asleep, particularly if you’re accustomed to sleeping on the side that is hurting.

Once you do go to sleep, the pain may cause you to toss and turn. The disruption in your sleep cycle can leave you feeling tired when you wake up and throughout the day.

4. Tests show that you have arthritis or joint damage

The hip is a ball-and-socket joint where the femur (thigh bone) joins the pelvis. The “ball” is the femoral head (the upper end of the femur), and the “socket” is the acetabulum, an area on the outer edge of the pelvis that is formed by three bones. The joint capsule, which is a connective tissue that attaches to the bones, and the muscles and ligaments that surround the hip joint stabilize the hip and provide support.

Cartilage separates the bones from each other and helps to cushion them as they glide back and forth across each other. The surface of the joint has a thin lining called the synovium, which produces synovial fluid that lubricates the cartilage and helps ease movement. Over time, the cartilage can break down, and as it wears away, the bones are left rubbing against each other. This is how osteoarthritis develops.

In people who have rheumatoid arthritis, an inflammatory disease can develop at any age, the synovium swells and becomes thicker, and as that occurs, chemical substances are produced that destroy the cartilage.

Soft tissues like cartilage don’t show up on an X-ray, but an X-ray can still be useful in diagnosing osteoarthritis. That’s because it will show hip arthritis symptoms such as narrowing of the space between the bones in the hip joint, as well as any bone spurs that might have formed around the joint.

For cases that are more complex, magnetic resonance imaging (MRI) may be appropriate. An MRI is a more detailed image that does show soft tissues, including cartilage.

5. You’re feeling emotional distress

Persistent pain can be debilitating. It can keep you from doing activities you enjoy and make it hard to get through the day. As the pain continues, you may start feeling frustrated, impatient and perhaps even a little hopeless.

Know that there is help. If it turns out that your symptoms do warrant a hip replacement, the surgery can rid you of the pain you’ve been experiencing and get you back to your normal activities. Depending on the type of surgery, you could be back in full swing in a matter of weeks.

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Post Op

Home Recovery Tips for After Your Surgery

Once your surgery is over, your body can begin the healing process and you can be on your way to resuming your usual activities, free of pain. To help speed your recovery and reduce the risk of injury while you heal, there are steps you can take ahead of time to set up your home and simplify your daily routine. 

Ideally, you can also arrange to have a friend or family member take you home after your surgery, help you at home while you’re recovering, and provide transportation to and from your follow-up appointments and any other medical appointments you may have until you can safely drive.  

Having another person around who can assist you during your home recovery can make life easier in countless ways, but for now let’s focus on what you can do before your surgery.

How to Prepare Your Home for After Surgery

While it’s important that you follow your post-operative care instructions for walking and moving about after your surgery, you also want to avoid falling and possibly injuring yourself. Taking a few precautions before you have surgery can greatly reduce your chances of tripping or slipping. Here are some things to think about:

  • Will stairs be an issue? If your bedroom is upstairs, then you might want to look into having a bed set up temporarily in a room downstairs. If you will need to use the stairs, then having a railing to hold on to will make going up and down them much safer. 
  • Do you have room to move around? You can be proactive by clearing away objects and clutter that might get in your way — especially if you’ll be using a walker. Arrange your furniture so there’s enough space for you to walk around without bumping into it. Take up any rugs or mats that might cause you to trip. Get loose cords and other fall hazards out of your walking paths. 
  • Is your bathtub/shower as safe as possible? Even if you have grab bars in your bathtub or shower, consider adding a mat designed to keep you from slipping on wet surfaces. 
  • How’s your lighting? Is there enough light in the areas you’ll be using to easily see where you’re going? If not, add more lamps or install brighter bulbs. Adding nightlights in key areas is an inexpensive and effective way to help prevent a potentially dangerous middle-of-the-night tumble. 

By taking these steps before surgery, you can increase the likelihood of successful home care after surgery. And that leads us to some other things you can do to prepare for your home recovery.

Post-Operative Care at Home

Just like you can arrange beforehand to have someone drive you to and from your surgery, you can plan ahead to simplify or have help with your day-to-day routine once you’re back home. 

For example, map out your meals for a week or two and stock up on groceries and other household items you’ll need. Create a list of easy-to-make dishes and/or make a few meals before your surgery that will keep safely in the refrigerator (or freeze them). 

Also, be sure that you have an adequate supply of prescription and over-the-counter medications you take for existing conditions, and have a plan in place for getting any new prescriptions filled following your surgery. Have your medications in a spot that will be easily accessible (bearing in mind the safety of others who share your home, including pets). 

Speaking of pets, if you have a dog, cat or other pet that will need to be taken care of, either make arrangements for a family member or friend to attend to your pet’s needs or consider having your pet stay elsewhere while you’re recovering from surgery. 

Something else you can do that just might make a big difference is to jot down your emergency contact information and your doctor’s phone number, and keep both within reach or in a spot that someone else could find easily. Even though you might have all of that stored in your cell phone, another person might not be able to access it that way. 

You can probably come up with other ways to make your life easier in the days and weeks just after your surgery. As you go about your daily activities, keep in mind how much you’re having to lift, lean over or reach down to accomplish whatever it is you’re doing. Then, ask yourself if there’s a way to make that easier while you’re recovering — like using a long-handled shoe horn to put on your shoes, or having a reach extender (also called a grabber or gripper tool) handy to pick up things from the floor. 

The Advantages of Home Recovery

Less-invasive surgical procedures typically lead to shorter recovery periods, and for many people home recovery is an option. One of the main advantages of home care after surgery is the greater level of comfort you’ll have in your own home. You’ll be in a familiar environment, with easy access to family and friends who can provide emotional support and other assistance as you recover. 

Post-operative care at home is also considerably less costly than receiving care in, say, an inpatient rehabilitation facility. Most insurance companies recognize the value of home care after surgery, as long as it’s deemed a safe alternative for a particular patient. Even when health plans do provide coverage for post-operative care in a facility, it’s for a limited number of days and there are virtually always out-of-pocket costs for the patient. 

While every situation is different, there’s a very good chance that you’ll be able to begin your recovery at home either the same day as your surgery or within a day or two afterward. Greater Phoenix Orthopedics encourage you to follow the tips in this post and make your recovery as safe and smooth as it can be. 

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Hip Pain

Hip Pain Remedies You Can Try at Home

If chronic hip pain is keeping you awake at night or interfering with your daily activities, you may have already tried some hip pain remedies. No doubt you’re hoping to find relief without resorting to surgery, and we can offer several suggestions for how to help ease your hip pain.

Several types of stretches and exercises can help make your pain less severe, and you can do most, if not all, of them at home. You might also unknowingly be doing some exercises that are worsening your condition.

If you’re still experiencing hip pain related to osteoarthritis after trying these and other treatments at home, then surgery may be your best option — but let’s try these options first.

Stretches to Ease Hip Pain

Stretches are some of the simplest hip pain remedies to try at home. Tightness in the structure of the hip joint can result in preventing the joint from moving freely and possibly even pinching muscles, ligaments and nerves in and around the capsule.

The right stretches can reduce stiffness, improve your mobility (making it more flexible) and strengthen muscles that support the joint. Try the following four stretches when you’re feeling less pain and stiffness, like after taking a warm shower or bath or after you’ve been up moving around for a while. Start slowly and gradually add more sets and/or repetitions as your pain subsides.

Stretch #1: Knee lift

  1. Lie on your back with both legs out straight against the floor.
  2. Keeping one leg straight, pull the other knee up toward your chest and use both hands on top of your knee to gently coax it further toward your chest.
  3. Hold for 10 seconds and then gently lower your leg back to the floor.
  4. Do the other side and then repeat 5 to 10 times for each knee.

Stretch #2: Double hip rotation

  1. Lie on your back with both knees bent and your feet on the floor.
  2. While keeping both shoulders on the floor, gently lower your knees to one side and turn your head in the opposite direction.
  3. Hold for 20 to 30 seconds and then bring your knees and head back to the center.
  4. Repeat on the other side.

Stretch #3: Bridge

  1. Lie on your back with both knees bent and your feet on the floor. Keep your arms at your sides, palms facing down.
  2. While engaging your abdominal muscles and keeping your shoulders and upper body on the floor, push down through your heels and slowly lift your pelvis and lower back.
  3. Hold for 3 to 5 seconds.
  4. Starting at the upper part of your spine and moving toward your tailbone, gradually roll your back and pelvis back down to the floor.
  5. Repeat 5 to 15 times.

Stretch #4: Hip extension

  1. Stand with your legs straight and spaced shoulder-width apart. Support yourself by holding on to the back of a chair, counter, table or wall.
  2. Keeping one leg straight, lift the other leg behind you without bending it at the knee.
  3. When you’ve lifted it as high as you comfortably can, tighten your buttock and hold for 5 seconds.
  4. Lower the leg and do the other side.
  5. Repeat 5 to 10 times on each leg.

Exercises to Help Reduce Hip Pain

One of the most important steps you can take to ease hip pain — especially if it’s related to osteoarthritis — is to exercise regularly. Like, every day, if possible. Not only can exercise help reduce pain and stiffness in your joints, but it can also improve your flexibility and balance.

Just like stretching, the right kind of exercise can increase the range of motion in your hip joints and strengthen the muscles that support them. Here are three easy, low-impact forms of exercise that can be effective hip pain remedies:

Walking

If you’ve been relatively inactive, then walking is a great way to start increasing your activity level. You use just about all of the major muscle groups in your body while you’re walking, and you can gradually increase your pace and distance as you build up your strength and endurance. Walking poles can give you extra stability and help ease any pain you might feel in your hips as you’re walking.

Swimming

This is one of the best exercises for people with chronic hip pain because the buoyancy of the water reduces the weight on the joint. If the pool is heated, so much the better for your joints, and you don’t even actually have to swim to benefit from being in the pool — walking through the water and doing water aerobics can go a long way toward reducing your hip pain. You might even be able to find an aquatic class specifically for people with arthritis at your local YMCA, health club or rehabilitation center.

Yoga

You don’t have to go to a yoga studio or fitness facility to do yoga. It’s a great hip pain treatment you can do at home, as long as you’re careful about which poses you do. Many yoga poses are designed specifically to help reduce stiffness in the hips by stretching and strengthening the muscles that support the hip joints. With a quick search online, you’ll discover which poses are best for addressing stiff or painful hips, and plenty of online classes are available as well. Remember to begin with gentle stretches and avoid overdoing it.

Exercises to Avoid if You Have Hip Pain

While we encourage anyone who suffers chronically to be active, there are certain kinds of exercise that you should steer clear of if hip pain is a problem. You don’t want to engage in exercises that will add more strain on your hip joints; those can include high-impact exercises that involve running and jumping, weight-bearing exercises, and exercises that are done while standing.

Many stretching and strengthening exercises that are traditionally done while standing can instead be performed while seated in a chair or on the floor, which can also be helpful if balance is an issue. The key is to avoid exercises that could ultimately increase your hip pain by adding to the burden your hip joints already have, and possibly even leading to an injury.

When to Seek Surgery for Osteoarthritis Hip Pain

Try the hip pain remedies we’ve suggested for a few weeks and see if you notice any difference in your pain level or frequency. If your pain persists, if it’s keeping you awake at night or making it difficult to walk, climb the stairs, and get in and out of chairs and/or the bathtub, then it might be time to consider surgery.

You don’t have to just resign yourself to putting up with the pain. In fact, doing so could lead to other health issues, such weight gain and diminished cardiovascular health. Bear in mind, too, that the healthier you are when you have surgery, the better your outcome may be.

If other hip pain remedies fail to provide the relief you need, then hip resurfacing or a minimally invasive total hip replacement might be the right course of action. For more information or to schedule a private consultation, contact us.

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Explaining Knee Pain When Sitting or Squatting

If you’re experiencing knee pain from squatting motions, sitting, or knee flexion, there is a possibility that your knee’s ligaments, tendons, or cartilage have been damaged or degraded.

To put scientific jargon into layman’s terms, if you’re experiencing front, back, inner, or outer knee pains, here is a break-down of what it could be.

Common Knee Pain Diagnoses

The anatomy of the knee is complex and interconnected in many ways.

Whether the pain resides with the back, front, or medial/ lateral (side) parts of the knee, the damage may originate from any part of the knee’s anatomy.

It is difficult to decipher where the pain may be coming from, which is why diagnosing the specific area of pain can help you understand which part of your knee has been affected.

Here are a few common questions you can ask yourself when experiencing knee pain when sitting or squatting.

  1. Is the pain coming from the front, sides, or back of my knee?
  2. Is my knee pain coming from standing, sitting, flexing, all of the above? Not sure?
  3. How active am I?
  4. Have I started new activities? 
  5. Am I wearing different footwear than normal? 

Answering these questions can help you pinpoint the possible cause of your pain and help give your doctor a better idea of where your knee pain is coming from.

With this knowledge in mind, there are four common diagnoses that are associated with acute knee pain. 

1. Jumper’s Knee (Patellar Tendonitis)

Jumper’s Knee is usually a result of the overuse of the Patellar tendon (refer to the picture above).

Oftentimes jumper’s knee is symptomatic of overload and overuse of your quadriceps (quad) muscle group.

The quad muscles are involved in a variety of movements which include jumping, kicking, squatting, running, or any generally explosive movement involving the legs.

Energy and the pressure of impact are often distributed among the Quad muscle. After extended use, however, the pressure begins to cause inflammation in the tendon.

Repeated use especially after sustaining the injury can lead to tears. 

Inflammation is usually a result of microscopic tears in the tendon.

This triggers a healing response from your body, flooding the damaged area with blood, nutrients, antioxidants, and other fluids that are designed to help the healing process. 

For the old, but young at heart, the cause of Jumper’s Knee is usually due to repetitive microdamage and degradation.

While resting the knee seems like the best method of healing, small and steady movements and use of your affected knee is also a vital part of the recovery process.

Here are a few symptoms to determine if you have Jumper’s Knee.

  1. Tenderness and pain originating from the front of your knee (beneath your knee knee cap)
  2. Pain with sudden movements
  3. Pain with extending your knee

2. Runner’s Knee 

Runner’s Knee is usually the result of irritating the lining and soft tissues in the knee. It is known as Runner’s Knee because the repetitive movements of running can easily cause pain and inflammation. These repeated movements are usually felt with knee pain when squatting.

Runner’s knee is a common term used to describe a group of conditions that create pain behind and around the patella or kneecap.

The conditions can include anterior knee pain syndrome, patellofemoral malalignment, chondromalacia patella, and iliotibial band syndrome.

For patients with runner’s knee the pain is often most acute when the knee sits in a flexed position. While there are many different diagnoses for Runner’s Knee, it is usually a series of linings and soft tissues that have become irritated due to consistent pressure.

Runner’s Knee is usually more common in women, particularly middle-aged women. Weight can also be a contributing factor to the development of Runner’s Knee along with failure to stretch/ warm-up. 

As the name of the condition suggests, Runner’s Knee is a common injury in people who enjoy recreational or professional running.

However, this is a problem that is not exclusive to runners. As previously mentioned, there are a number of reasons that one may develop Runner’s Knee including biking, hiking, and impact sports.

Here are a few indicators that you may have Runner’s Knee.

  1. Pain coming from the sides of your knee
  2. A grinding originating from your knee after a period rest
  3. Popping and pain from knee loading (walking up stairs or squatting)
  4. Pain or snapping along the outside of the knee 

3. Baker’s Cyst (Popliteal Cyst)

The popliteal area refers to the area behind the knee. Most symptoms of a Baker’s Cyst include general stiffness, a mass in the back of the knee, and pain in the back of the knee.

The injury is a result of cartilage or soft tissue damage which, in turn, causes a build-up of what is known as synovial fluid (a lubricant that greases the joint for movement).

After continued movement, the body produces a large amount to help cushion the knee, but the fluid pushes out the back of the knee and a cyst begins to form behind the knee.

Unlike some other knee pains, a Baker’s Cyst might go undetected. Some common ways to diagnose the pain is if you experience any of the following symptoms.

  1. Feel and/or see a lump behind the knee
  2. Pain when completely flexing your leg or inability to flex entirely.

4. Iliotibial Band Syndrome

Also known as IT Band Syndrome (ITBS), Iliotibial Band Syndrome is a series of connective “bands” of tissues that have become inflamed from overuse.

The pain is usually felt at the side of the knee as opposed to the front and back. 

When referring to this image, the pain is usually felt around the femoral condyle and top of the lateral collateral ligament. (Found as the cut ligament near the Lateral Meniscus). 

Most people easily call IT Band Syndrome a Runner’s Knee as Runner’s knee can include ITBS as noted above.

It is rather easy to confuse, especially because of the anatomical makeup of the bands of tissues. 

A common way to help detect the difference is if the epicenter of the pain is coming from the side, then it is usually a good indicator that you have IT Band Syndrome.

To help determine if you have ITBS these are a few questions you can ask yourself.

  1. Is my knee pain affecting the general kneecap area?
    1. This is usually a sign of a different cause of Runner’s Knee.
  2. Is my knee pain primarily in the sides of my knee
    1. This is usually a sign of ITBS.

ITBS specifically affects the outer side of your knee, whereas runner’s knee is a generalized pain to the knee.

To better diagnose your knee pain when squatting or sitting, call and visit the offices of Greater Phoenix Orthopedics, located in Scottsdale,  AZ. We provide solutions for total knee replacement surgery using a minimally-invasive technique with MAKO robotic-assisted technology.

Recovering from Knee Pain

Recovery is different for everyone, but not impossible. Chances are, if you’ve done research on your knee pain, you have come across R.I.C.E. (R – Rest, I – Ice, C- Compression, E – Elevate).

If you are looking for more in-depth tips on how you can recover and treat your knee pain, feel free to contact us here at the offices of Greater Phoenix Orthopedics.

Categories
Orthopedic Surgery

How Do I Know When To See An Orthopedic Surgeon

Orthopedic surgeons are medical doctors who specialize in problems with the musculoskeletal system. The human body has over 300 bones and joints and when one of those is not functioning properly it can cause daily pain and disability. Orthopedic surgeons provide patients with these symptoms options for treatment to help improve activities of daily living, pain control and prevent further injury. If you have pain in any of your joints, common problem joints are knees, hips, spine, wrists, fingers, an orthopedic surgeon can evaluate you for definitive treatment. If you have an emergent situation, such as a broken bone or signs of infection, do not wait for an appointment with a surgeon and head to the ER for immediate care. 

Indicators That You Should See An Orthopedist

General indications that you should see an orthopedist

  1. You are experiencing chronic pain

    • Chronic pain is defined as pain that lasts longer than twelve weeks. If you experience pain, even on and off, for longer than twelve weeks it is important to have an evaluation. 
  2. Inability to perform activities of daily living (ADLs) 

    • If you have pain, a limited range of motion, or instability in a bone or joint that prevents you from accomplishing daily tasks such as brushing your teeth, washing your hair, driving, or folding laundry, it is a good indication that you should seek an appointment. 
  3. Limited range of motion

    • Our joints are responsible for allowing our bodies to move in many different directions and participate in different tasks. When a joint is injured or damaged by disease it can lose the ability to move in different directional planes. This is a loss of your range of motion. A few examples of this include if your shoulder cannot reach above your head to grasp something or if your hip will not rotate enough for you to put your socks on normally. If you are losing range of motion it is a sign you should seek professional advice to prevent the problem from progressing. 
  4. You suffered an injury that is not improving

    • Patients often experience what seem like minor injuries, a sprained ankle or a tweaked knee, that fails to improve with conservative treatment after forty-eight hours. After an acute injury, if you have tried all of the basics including over the counter medications, rest, ice, elevation and compression (RICE), and your pain is not improving or worsening it is time to consult a medical professional. Some of these injuries can be evaluated by a primary care doctor, but oftentimes if conservative treatment has failed you will be referred to an orthopedic specialist for definitive diagnosis. 
  5. Your joint feels unstable when weight bearing (standing) or moving 

    • If you feel uncertain that a joint will perform its task; for example, if you are walking and feel as if your knee is going to lock up or buckle underneath you causing a fall, it is important to be evaluated. If you feel wobbly, uncertain, shaky or overall unstable when trying to perform a basic function like walking, sitting down, or climbing stairs it is a sign that something is not functioning properly in one or more of your joints. It is important to determine the underlying cause of the instability with an orthopedic surgeon. 

Common complaints that an orthopedic specialist can help treat: 

  • Shoulder Pain that prevents you from sleeping, combing your hair, dressing, working, etc
  • Trouble climbing or descending stairs
  • Tingling or Numbness in your hand Hands, especially after working on the computer or in the mornings 
  • Pain from Repetitive Motions such as golf, tennis, or work-related activities 
  • Prolonged painful joints 
  • Twisted Ankle where the pain persists or when you have instability 
  • Swollen Wrists
  • Swollen Joints 
  • Worsening Injury
  • Weak, Stiff and Bruised Muscles that do not heal with rest and time 

What To Expect From Your First Appointment With An Orthopedist

For your first appointment with an orthopedic doctor, you should bring any previous treatment records and imaging studies that you have had in the last few years regarding the area you wish to have evaluated. If you do not have any imaging studies often offices will send you for plain x rays prior to your visit to assess the bony anatomy of the problematic joint. You should also bring your picture ID and insurance cards to the appointment and be prepared to fill out a full medical history, not just pertaining to the current injury. Some offices like Dr. Martin’s are now all digital and you can fill this history outline prior to your visit. 

dr martin examining xrays

During the first visit, you will be asked about the history of your condition, this may include questions like:

  • When did this pain or disability start?
  • Was there an injury? 
  • Have you had an issue like this before?
  • What treatments or alleviating practices have you tried? 
  • What makes it worse? Better?
  • Do you have a family history of any conditions like this? 

After the initial intake, the doctor will perform a thorough examination of the joint testing for range of motion, strength, stability and neurovascular status. The doctor will often then review your images with you along with the exam findings and discuss likely diagnosis. Once you have a likely diagnosis they will outline treatment options for your specific condition.  If the surgeon recommends further testing, they may provide symptomatic care until your follow up to review the advanced images or tests. Throughout this process, you will have the opportunity to ask questions about the diagnosis and treatment. It is important to voice any concerns you have during this time and address any topic you may not understand. We will then provide you with greater detail on our MAKOplasty surgery procedures to see if this is something you want to proceed with.

Categories
Uncategorized

12 Ways to Treat Knee Pain

Knee pain and problems are universal issues and can affect any age group. If you or someone you know are experiencing knee pain, swelling, inflammation or soreness, here are a few ways to combat the symptoms.

1. R.I.C.E 

man pausing from run to remedy knee pain
  • Rest: initially it is important to rest a sore joint, especially with an acute injury. Avoid strenuous activities for 5 days to a week to allow your knee to begin healing
  • Ice: Icing the knee when knee pain appears can help reduce pain and inflammation. Start with ice 2-3 times a day for 15 minutes each session. Never place ice directly on the skin. 
  • Compression: Wearing a over the counter compression sleeve or ace wrap can help reduce swelling and improve the functionality of a sore knee joint. 
  • Elevation: After an initial injury or flare of pain elevating the sore leg above the hip ( ie laying down with the leg elevated) can help the excess swelling drain back into the body. 

2. Keep Moving

  • While recovery is vital, physical activity is also required to expedite the healing process.  Nonimpact activity is often the best treatment for a sore knee because it helps maintain a range of motion while bringing healing elements to the knee. 
  • Exercises like the stationary bike, walking in the water, swimming and the elliptical are recommended. 
  • Stop any activity that makes the pain worse. 

3. Walk Around

  • Without walking around and working the inflammation, the body cannot properly partition oxygen-rich blood and nutrients to the knee. 
  • A brisk 10-minute walk after a meal is advised, but choose a non-impact activity as listed above if walking irritates the knee.  It will serve as a double-edged sword, giving you a chance to digest your food properly and work the knee.

4. Hot & Cold Therapy

  • After the initial injury or flare has begun to heal, using both Hot & Cold Therapy interchangeably will promote a speedy recovery process
  • Hot: Using a heated compress, wrap the compress around your knee and apply pressure for a few minutes. It is important to set the temperature to a reasonably hot setting. The heat promotes blood flow into the injured area.
  • Cold: Using frozen packaged vegetables, ice wrapped in cloth or frozen ice packs, apply the pressure every so often. It is important to let your skin recover and come back to normal temperature after a few rounds of icing. NEVER PLACE ICE ON BARE SKIN. 
  • Be mindful of how you feel while using hot/cold therapy. Do not compress heat or cold against your skin for too long. 
  • A good rule of thumb is 3 Min/Hot to 1-2 min/Cold

5. Change up your tastebuds!

  • Certain anti-inflammatory foods and spices can help the recovery process.
  • Quercetin is a compound that has been found in apples, white & red onions, yellow & green bell peppers, and green tea that has shown to help with inflammation
  • It is recommended that you drink 3 cups of green tea and combine a variety of the aforementioned ingredients
  • Turmeric (curcumin) is also a great anti-inflammatory and can be added to many foods. 

6. Cushion your feet 

  • Switching out your shoe soles for cushioned ones can ease the pressure placed on your knee.
  • Make sure your shoes are supportive but not too  heavy or constricting 
  • Choose gym shoes or hiking sandals over flip flops or flats when walking long distances or standing for extended periods of time 

 7. Regular Stretches

  • The knee joint is interconnected with multiple leg muscles. Proper stretching of the hamstrings, quads, and calves will help alleviate the stiffness.
  • Being gentle with these exercises and stretches goes a long way. Being careful not to over-extend anything is advised. 
  • If you are unsure of where begin, start with a simple forward fold ( bending towards the toes) and other helpful stretches for knee pain!

8. Acupuncture

  • If you’re not afraid of needles, acupuncture is another great way to alleviate sharp pains.
  • A process that involves small needles that penetrate the skin. Studies suggest that acupuncture activates neurohormonal pathways via nerve stimulation.
  • Be sure to find a reputable practitioner who uses sterile techniques.

9. Losing Weight

  • Our knees take on a good amount of our weight. Losing weight will help alleviate some pressure on the knees. Each pound you lose can unweight your knees by around 5 pounds! 
  • Some aerobic exercises that can be done with higher intensity (not involving the knees) can be biking, swimming, rowing machine, weighted ball exercises, etc.
  • As a precaution, it is good to warm up sufficiently and hydrate well. Taking a few preventative measures will not only help with recovery but strengthen it.

10. Deep-Tissue Massage

  • Knee Pain may also be attributed to jumbled and knotted muscle fibers. Deep tissue massages to the hamstrings, inner thighs and around the knee may alleviate the pain. 
  • If you have a deep tissues massage be sure to hydrate well and stretch lightly after to avoid muscle cramping.

11. Use a Crutch (if needed)

  • Pretty self-explanatory, but using a crutch can relieve a sore knee of stress and pain. 
  • Following the RICE principle is advised.

12. Be Patient

  • Your age and overall health can determine the speed and length of your recovery. The severity of your knee pain and inflammation is something to take into consideration as well. 
  • Time and proper care of your knees will be a marathon. Taking a step at a time will go a long way (pun intended)
  • If you have waited but your pain is worsening or you have developed new symptoms like clicking, locking, or instability in the knee please follow up with a medical provider. 
Categories
Uncategorized

Partial vs. Total Knee Replacement: Which is Right for Me?

Patients dealing with debilitating knee problems like arthritis are often faced with a decision to proceed with a partial or total knee replacement.  Both surgeries can produce excellent results but there are significant differences between the two procedures that can affect overall satisfaction. Here are some things to take into consideration when deciding between partial vs total knee replacement.

  1. Age
  2. Overall Health
  3. Fitness level
  4. Recreational Activities
  5. Previous Injuries or Procedures

Run-Down of Partial and Total Knee Replacements

The human knee is made up of three compartments: 

partial knee diagram
Knee Diagram
  1. Medial (inside)
  2. Lateral (outside)
  3. Patellofemoral (under the kneecap).

A total knee replacement involves resurfacing all three compartments with metallic biomaterials designed to function similarly to cartilage.  A partial knee replacement selectively resurfaces one of the three compartments with similar but smaller implants. The most commonly used biomaterials are cobalt chrome, titanium, and polyethylene plastic.

While many problems can lead to knee replacement, the most common diagnosis is osteoarthritis.  This “wear and tear” disease results in the destruction of the protective, white, cartilage layer on the ends of the bones in a joint.  When all of the cartilage has been destroyed, exposing the underlying bone, it is commonly referred to as “end-stage” or “bone on bone” arthritis.  This and other signs of arthritis can easily be seen on a plain x-ray. Advanced imaging techniques such as CT scan or MRI are typically not needed to diagnose osteoarthritis.  Patients can often maintain good function for years with non-operative treatment. When symptoms worsen and stop responding to conservative treatment, knee replacement procedures can be considered.  

How do Partial Knee Replacements Work?

A good candidate for a partial knee replacement would have radiographic signs of “bone on bone“ arthritis in only one compartment of the knee with localized pain to that same compartment.  Patients with widespread pain in the knee who are unable to localize their symptoms are typically better candidates for total knee replacement. 

A partial knee replacement can be performed manually or with robotic assistance.  A manual partial knee replacement requires the surgeon to prepare the ends of the bones for implants using specialized jigs that help to align the components. A robotic-assisted partial knee replacement uses a robotic arm to help prepare the ends of the bones in a more accurate and precise way. Validation studies have shown better alignment of implants can be achieved with robotic technology. It is hoped that better alignment will lead to longer-lasting implants.  Although robotic technology has only been available for partial knee replacements for about 10 years early survivorship studies are encouraging.

Robotic-Assisted Procedures

Robotic-assisted procedures help provide a more thorough and efficient method of surgery. A robotic partial knee replacement starts with a CT scan of a patient’s knee. The CT scan is used to construct a three-dimensional image which is stored in the robotic system memory.  This allows the robot to understand the unique bony anatomy of a patient’s knee. At the time of surgery special reflectors are fixed to the patient’s femur and tibia.

The surgeon then identifies unique landmarks on the patient’s knee using special probes that the robot can “see“.  The robot can then confirm that the three-dimensional CT scan image in its memory is accurate and since it knows where the patient’s “knee” is in relation to the two reflectors it can “track“ the patient’s knee as the surgeon moves it in space. 

In this way when the surgeon identifies the system, the best location for the implants the robot knows exactly where that position is.  The robot’s arm, holding either a saw or a burr, is then used by the surgeon to remove bone in the precise location where the implants are to be placed.  Although the surgeon has to manipulate the robotic arm to remove bone the system “guides” the surgeon’s hands by allowing only the precise amount of bone to be removed to accommodate the implants.  After preparing the bone with the robotic arm the implants are typically cemented in place and the knee incision is repaired with suture.  

The majority of partial knee replacements are performed on an outpatient basis with most patients leaving the surgery center or hospital within one hour of waking from Anesthesia. Physical therapy is generally not required and most patients return to work within two weeks of surgery.  Patients usually experience 2 to 3 days of discomfort following the procedure and sometimes require pain medicine. Bandages are removed three days following the procedure and patients are allowed to shower provided there is no bleeding or drainage from the incision. There are numerous advantages to partial knee replacement but also some disadvantages.

Pros:

  1. Minimally invasive
  2. Quick recovery
  3. No PT (Physical Therapy) required
  4. Minimal discomfort
  5. All ligaments are retained
  6. More natural knee motion
  7. No long term activity restrictions
  8. Lower complication rates than total knee replacement 

Cons:

  1. Potential for additional surgery if arthritis develops in other knee compartments
  2. Risk of implants wearing out

How do Total Knee Replacements Work?

Total knee replacement can also be performed either manually or with robotic assistance.  Robotic assistance, similar to partial knee replacement, has consistently been shown to be a more accurate and precise technique for aligning and placing implants in a human knee.  Unlike partial knee replacement where a single compartment is replaced, total knee replacement resurfaces all three compartments with biomaterials. The incision is slightly longer than a partial knee incision to accommodate the larger implants.  The overall procedure is similar in that a CT scan is obtained prior to surgery and used to “visualize“ the patient’s knee. Similar trackers are placed in the femur and tibia during the surgery so that the robotic system can “locate” the patient’s knee in space.  After the surgeon determines the best position for implants the robotic arm precisely controls the saw used to shape the ends of the bones so that the implants fit in that exact location. Fine control of the saw-blade also protects the surrounding soft tissue such as ligaments, tendons, and skin.  After the implants are fixed to the ends of the bones the knee incision is repaired and the patient is awoken from anesthesia.

Pros:

  1. Less pain than with traditional knee replacement
  2. No chance of arthritis recurring
  3. High patient satisfaction
  4. Excellent function with few activity restrictions

Cons:

  1. Larger incision
  2. Longer recovery
  3. Greater blood loss
  4. Higher complication rates

Recovery after knee replacement surgery is a very individual process with many factors influencing the speed of recovery. Recovery can be defined in many different ways. For the purposes of this blog, recovery will be defined as either a return to work or activities of daily living.  Patients should never compare their recovery time to others but some generalities do exist. In general, patients recover from partial knee replacement faster than from total knee replacement. Most patients are able to return to work within 2 weeks of having a partial knee replacement but closer to 6 weeks for total knee replacement depending on work conditions.  

Physical therapy is another concern after knee replacement. Most partial knee patients do not require physical therapy but most total knee patients participate in 4 weeks of therapy.  In terms of pain, most patients report varying degrees of discomfort for 2 – 3 days after partial knee replacement but more like 2 – 3 weeks after total knee replacement. While full healing requires 6 to 12 months most patients report 80% improvement in symptoms two weeks after partial knee replacement and six weeks after total knee replacement.

From a functional standpoint, both partial and total knee replacements can provide excellent results. Most patients after either procedure can resume all activities.  The only exception is a general recommendation against impact type exercise such as running. The concern is that the repetitive loads placed on knee implants with running can lead to increased wear and premature failure. Kneeling can initially be difficult for patients undergoing either procedure but with proper instruction, most patients can perform this activity.  Competitive athletes who place huge demands on their knees may notice improved function with a partial knee replacement. This is likely due to the retention of the anterior cruciate ligament (ACL) which allows for more natural knee motion and increased proprioception. Total knee replacements compensate for the removal of the ACL with implants that fit more tightly together. 

Both partial and total knee replacement are excellent options for patients with advanced degenerative diseases of the knee who have failed conservative treatment. Both procedures can result in a highly functional knee that allows patients to resume almost all activities.  There are some differences however between partial and total knee replacement that should be taken into consideration when planning surgery. These differences should be discussed with your surgeon so that you can choose the procedure that fits you and your lifestyle the best.

Categories
Knee Sports Injuries Tennis

Common Tennis Injuries And How To Avoid Them: Protect Against Jumpers Knee

Tennis is an extremely enjoyable yet physical sport that requires agility, speed, strength, endurance, and coordination to play. Due to the multitude of physical requirements to play tennis, it is no wonder that injuries occur regularly. The most commonly thought of injury is “tennis elbow”, however, tennis can cause injury to many parts of your body including the spine, legs (hip, knee, and ankle), and dominant arm (shoulder, elbow, wrist, and fingers). This is due to the high speed of racket swing, the torque placed on the spine, and the repetitive impact and cutting required for quick court movements. Proper form, conditioning, stretching, and body mechanics are key for injury prevention. With these precautions in place and having an understanding of your body’s limitations, tennis can be a “lifetime” sport played at any age. 

1. Tennis Elbow

examining tennis elbow in patient

How Does It Occur?

Lateral epicondylitis, known widely as tennis elbow occurs as a result of repetitive strain on the tendons joining the forearm muscles to the outside of the elbow. These tendons become inflamed and painful. Tennis elbow is typically caused by overuse and can present as elbow pain, burning on the outside of the elbow, and weak grip strength. The symptoms can worsen with the use of the forearm. 

How Can I Prevent It?

Warm-up and cool down before you practice or play. It is also important to cross-train and condition to prevent injuries. Also making sure to alternate to your nondominant hand and most importantly, honor your body and stop when it hurts. If you are unsure about your form or technique, work with a professional trainer. 

How Is It Treated?

Treatment includes rest, ice, compression, and elevation (RICE), anti-inflammatories (NSAIDs) such as ibuprofen and in some cases bracing. Alternating your grip can help alleviate pain as well.  It is advised that if you have tennis elbow you need to address it immediately to avoid it becoming chronic. 

2. Rotator Cuff Tendonitis/Tears 

How Does It Occur?

Damage to the rotator cuff (the group of muscles, tendons, and ligaments that supports the upper arm around the shoulder joint) often causes significant pain and disability. The rotator cuff is formed by four separate muscles and tendons that come together to support the shoulder and allow for mobility. The rotator cuff tendons can become inflamed, can tear gradually due to overuse, but can also tear due to an acute injury. Rotator cuff injuries often present with pain, tenderness, and weakness in the shoulder, difficulty lifting the arm, and snapping and crackling noises while moving the shoulder. Rotator cuff symptoms are often present in recreational players with improper serving or swing form. 

How Can I Prevent It?

To prevent rotator cuff irritations and injuries it is important to always warm-up and cool down after playing. Utilizing rotator cuff exercises is essential for further injury prevention and rehabilitation. One such exercise you can begin doing is putting your back flat against the wall, forming 90-degree angles with your arms and pressing slowly upward, bringing your thumbs together. This promotes the shuttling of synovial fluids, which lubricate the impinged (pinched) joint. Make sure your serving technique and grip techniques are correct and if you are unsure it is important to get training to improve your form.

How Is It Treated?

Treatment is RICE, activity modification, light exercising of the rotator cuff muscles, and anti-inflammatory drugs. Persistent symptoms or extreme acute symptoms require medical evaluation as tears often require surgery. 

3. Stress Fractures

How Does It Occur?

Stress fractures are small cracks in the bone that are a result of overuse and repetitive impact movements such as running and jumping during tennis. The courts are typically made from asphalt or concrete cured with an acrylic sealant; this material increased the impact on the body. The fractures cause pain, swelling, stiffness, that present slowly and the symptoms will worsen over time. These fractures can occur in several areas including the leg, foot, and lumbar spine (lower back). 

How Can I Prevent It?

Warming up and stretching is always key in injury prevention as well as taking breaks regularly. Listening to your body and not forcing yourself to play through the pain is also important and be sure not to play through pain. When you increase your activity levels, do so slowly and in small increments. Be sure to alternate between low-impact activities like swimming and biking when you plan to participate in high impact activities like tennis.  

How Is It Treated?

Treating a stress fracture is multifaceted but the most important aspect is rest. Avoid the motion/ impact that caused the fracture in the first place to allow the bone time to heal and prevent further injury. If rest and other conservative treatments do not help your pain evaluation by an orthopedic specialist is the next step as more advanced stress fractures may require bracing or immobilization. As fractures exit the acute healing stage, physical therapy can help patients regain strength and stamina.  

4. Ankle Sprain

How Does It Occur?

Tennis is a fast-paced game that requires a lot of multidirectional movement, especially lateral cutting. These abrupt sideways movements lead many tennis players to suffer from ankle sprains by stretching the ligaments too far. Twisting, overextension, changing direction quickly, and catching uneven ground can lead to a sprain. Clay courts provide a softer surface for impact but can pose a greater risk for an ankle sprain. the side of the foot can dig into the surface more easily, resulting in a turned ankle. These injuries lead to loss of range of motion, stiffness, swelling, pain, bruising, and sometimes instability. 

How Can I Prevent It?

When playing tennis it is important to wear supportive footwear with ankle supports that can help prevent sprains. Also, you should be aware of uneven areas of your playing surface that are a pitfall for ankle injuries. As always it is also important to warm up and cool down properly. 

How Is It Treated?

A sprained ankle responds well to rest, bracing, ice and NSAIDs (Nonsteroidal anti-inflammatory drug). An ankle sprain can range from mild to extremely severe and if you suffer an ankle injury  it is important to have it evaluated to make sure you receive proper treatment.

5. Jumper’s Knee

How Does It Occur?

Patellar tendonitis, also known as Jumper’s knee, is an inflammation of the tendon that attaches the patella (kneecap) to the tibia (shin bone). This tendon is responsible for supporting the body on impact and aids in the motion of the leg when walking, jumping, and other movements.  Tennis requires a lot of repetitive jumping which can increase the risk of small tears in the patellar tendon which will lead to tendonitis. This irritation can lead to pain, warmth, and swelling in the front of the knee. Increased activity levels including walking, kneeling, running, ascending and descending stairs. 

How Can I Prevent It?

Avoiding overexertion is the first step in preventing Jumper’s knee and cross-training with non-impact exercises like swimming and biking.  Some players benefit from the use of a brace called achopat strap. 

How Is It Treated?

Like most inflammatory conditions, Jumper’s knee responds well to RICE and NSAIDs. It is important to avoid aggravating activities while the tendon is healing. After the initial pain subsides there are some stretches and strengthening activities that can help prevent a recurrence that can be done at home or in formal physical therapy. If the pain does not respond to conservative treatments or reoccurs it is prudent to follow up with a medical professional. 

How Can I Prevent Tennis Injuries

Tennis is a high impact sport which means cross-training with non-impact activities is imperative in the prevention of injury. Swimming, cycling, and strength-training will all strengthen the muscles and tendons while alleviating some of the excess stress. It is also important to be aware of your body’s limitations and avoid overuse, especially when starting a new sport or progressing your practice. Proper form is integral for tennis players as well due to the high velocity of swings and the unilateral nature of the sport. 

Additionally here are a few more tips to help you avoid injury while playing tennis: 

  • Have The Right Equipment
    • Shoes should be sturdy, lightweight and have proper ankle support 
    • Socks should be well padded 
    • Additional ankle support may be beneficial 
    • Purchase a racquet with the help of a professional to assure weight and size is appropriate 
    • Make sure your grip fits well
    • Make sure your string tension suitable’
    • Ensure your clothing is non-restrictive and not a tripping hazard 
  • Focus on Improving Technique
    • Work with a coach who can make sure your serve, swing, and jumping techniques are safe and effective 
    • Once you have been trained, practice the kinematics of the proper movements 
  • Warm-Up/ Stretch/ Cool Down

Create a routine for yourself with pre and post-game stretches

Continue your cross-training  with non-impact activity and strengthening of the core, shoulder, and spine

Icing problem joints after a workout can help prevent pain and further injury 

  • Take Breaks
    • It is important to allow your body time to recover from impact sports like Tennis, so allow yourself time to reset 
    • If you develop pain, listen to your body and stop playing. Playing through pain can lead to more severe injuries