The shoulder is one of the most intricate joints in the body and given that it is subjected to a lot of lifting and movements, there are chances for it to tear or dislocate. The shoulder is a ball-and-socket joint with the socket in the shoulder, and the ball in the upper arm. The joint space between the two bones is surrounded by cartilage, and the space between the two is filled with fluid. Especially in athletes, due to forceful movement, this joint could get dislocated or the cartilage could tear.

The Bankart lesion is when there is a tear of the cartilage in the central anterior shoulder. This causes the cartilage to be damaged, allowing the humeral head to slip down from the socket. When the arm is extended down or to the side, it is commonly dislocated. This can happen posteriorly also, but this movement and so the injury is less likely than an anterior dislocation. If there is also a fracture of the shoulder bone with this dislocation, then it is known as bony or osseous Bankart lesion.

Causes: Bankart lesions can be acute or chronic. Acute is when there is sudden dislocation due to sports activity or accidents. Repetitive use of the shoulder can also lead to chronic Bankart lesions. This is usually seen in sportspersons like swimmers, tennis players, and weightlifters.

Signs and Symptoms:

Pain: The most common symptom with Bankart is shoulder pain that restricts any kind of movement. One may find it difficult pick up things or lifting your hands and in some cases, it is difficult to even sit straight.
Weakness: The shoulder feels weak and one is unable to perform normal activities
Instability: One may lose the grip and strength.
Limited movement: The range of motion of the shoulder may be reduced compared to before the injury.
Crackling: The damage to the fibrous cartilage produces a crackling sound, which can be heard during the movement of the shoulder.
Diagnosis: A combination of symptoms, physical examination, X-ray, and MRI can help in confirming the diagnosis.

The course of treatment depends on the cause and condition of the patient. An exercise regimen is prescribed as the first step in the treatment process. If there is inadequate progress, or if the pain seems to be recurrent, open or closed shoulder surgery may be recommended to include the following:

Arthroscopy (closed surgery) to repair the cartilage damage
Ligament re-attachment
Bone reshaping
Cartilage build up and reshaping
Ligament repair to improve stability
Any of these shoulder surgeries would be followed up with measures to reduce further injury. It is therefore advised to visit a doctor in case of any such discomfort as he/she will be able to find out the severity of the situation and devise a treatment plan accordingly.

Bankart's Lesion - What Exactly Is It?

Spondylolisthesis refers to the condition which affects your spinal bones or lower vertebrae. Due to this condition one of the lower vertebrae overlaps the bone directly beneath it. Although a painful condition, it can certainly be treated with both surgical and therapeutic methods.

People with spondylolisthesis often find it difficult to perform routine activities. They usually encounter symptoms such as- persistent pain in the pelvic region, lower back; stiffness in the legs, hamstrings and hip muscles.

What causes spondylolisthesis?
The causes of spondylolisthesis can vary with lifestyle, heredity and age. Children may develop this condition due to an injury or birth defect. Nevertheless, people belonging to all age groups are susceptible to spondylolisthesis if the condition is genetic.

Over exercise or strenuous physical activities can cause spondylolisthesis because over stretching and carrying heavy weight or strain puts too much stress on the lower back.

Participating in sports like football, gymnastics, weightlifting are likely to trigger spondylolisthesis.

Spondylolisthesis can also be triggered due to sondylolysis. The vertebrae safeguard the spinal cord and work with tendons, ligaments, joints and muscles to provide flexibility, structure and support to the neck. Any sort of damage or wear and tear in the protective cartilage and bones in the neck can lead to cervical spondylosis, which in turn leads to spondylolisthesis.

What is the treatment for spondylolisthesis?
Treatment of spondylolisthesis depends on the severity of the pain. While non-surgical methods help ease the pain, a surgery is recommended when the bone has slipped to such an extent that your spine doesn t respond to medications.

Non-surgical treatment includes the following-

Taking anti-inflammatory drugs like ibuprofen to ease pain.
Practicing a few physiotherapy exercises to reduce lower back pain.
Use of minimally invasive Epidural Steroid Injections (EPIs) to get relief from lower back pain and pelvic pain caused by inflamed spinal nerves. When over-the-counter medications fail to treat tSpondylolysthesishe condition or ease the symptoms, then a surgery is inevitable.
Discectomy- It is a surgical procedure that makes small incisions to remove a part of the damaged disc to relieve pressure from the surrounding spinal cord or nerve root.
Laminotomy- This refers to a minimally invasive procedure that removes a part of the lamina which is the upper surface of the vertebra. This process is used to create more space within the spinal canal.
Foraminotomy- With this method excess bone tissues are removed so that they don t make the foramen narrow and compress the nerve root. Removing these extra tissues reduce back pain and ease symptoms triggered by nerve compression.
Medical attention is crucial for countering symptoms of spondylolisthesis. Although this condition may not seem life-threatening, if left untreated, it can lead to chronic, persistent pain and permanent nerve damage.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Spondylolysthesis - A Condition Which Affects Your Spinal Bones!

If you are the on the wrong side of your fifties, then you will know the importance of regular checkups to the orthopedist. Aging related physical changes such as greying hair and wrinkles are a few things that you can cope with easily, however, when it comes to the health of your bones and muscles, you need to be very careful. You need to be particular about being active, as it can help reverse or reduce the risks of most of the bone disorders that you may suffer from. Ageing affects both the muscles and bones, but not always in the same manner. So, it is important that you understand how each is affected by ageing.

Changes in your muscles due to aging
As you age, your muscles tend to lose strength and size. This can make you prone to fatigue, weakness and a decrease in your tolerance levels to exercise. The various factors that play a role in this are:

Modifications in your nervous system can impair the ability of the muscle to contract.
The muscle fibers in the body reduce both in size and number.
The replacement rate of the muscle tissue in the body falls.
Changes in your bones due to aging
Ageing impacts the structure of the bone and leads to a loss of the bone tissue. Aging causes low bone mass, thus rendering them weak. This means a simple fall can have a serious effect on your bones.
The various causes that can bring about these changes are:

Loss of vital minerals such as calcium
Being physically inactive
Undergoing hormonal changes in the body such as menopause, wherein the body loses minerals from the bone tissues. In case of men, progressive decline of sex hormones can lead to changes in the bone structure.
Common conditions that affect your musculoskeletal system in your old age:

Osteoporosis: This disorder results from a loss of bone density resulting in fragile bones. This makes the bones highly susceptible to fractures and breakage.
Rheumatoid arthritis: An autoimmune disorder that usually develops after the age of 40; here, the immune system of the body attacks the body tissues, thus leading to inflammation in your joints.
Osteoarthritis: It is a disorder of the joints which is caused by deterioration of the cartilage that cushions the joints.

Old Age - How It Impacts Your Muscles & Bones?

Clubfoot is a deformity of the foot in infants. The condition is usually present from birth. This happens when the tissues linking the muscles to the tendons are shorter than usual, as a result of which the infant s foot appears twisted and out of shape. The condition can be mild or severe, depending on the symptoms. Often times, babies who are born with clubfoot have it in both the legs.

How to identify if your child has clubfoot?

Since the condition is present from birth, the symptoms are also easily observable. Identifying the following signs can help detect if your child is born with clubfoot-

  A foot that turns downward and inward and toes that point towards the opposite foot
  The affected foot may appear half an inch shorter than the normal foot size
  The heel of the affected foot may be smaller in size than it normally should be
  The calf muscle on the affected leg will be underdeveloped (appear slightly smaller)
  If the condition is severe, the foot may be twisted upside down

Despite its unusual shape, clubfoot does not cause pain or discomfort. The doctor will most likely notice the symptoms after the infant s birth. He/she will recommend appropriate treatment of the condition, or refer to an orthopaedic who specializes in muscle and bone ailments.

What is the treatment of clubfoot?

Clubfoot is curable so parents need not worry about their child living with a lifelong deformity.

Depending on the severity of the condition, the orthopaedic will either use devices, resort to stretching methods, or will recommend surgery.

  Ponseti Method (stretching and casting) - It is the standard treatment worldover. It starts at birth or anytime within two weeks of age and has best results in younger kids. It involves stretching the clubfoot and casting it in correct position several times over the months to restore the foot shape.
  French Functional Method (stretching and taping) - The doctor will stretch the affected foot and tape it in position several times over a couple of months to realign the shape. It, however, has very limites following.
  Surgery - Surgeries may be needed in older neglected kids or adults. The surgeon performs a surgical procedure (Achilles tenotomy) to lengthen the tendon of the clubfoot and realigns the joints and bones. Following the surgery, the child will need to be in a cast for about 2 months. Further, to prevent the recurrence of the condition, the child will be advised to wear braces for a year at least.
  Devices - They are adjunctive maintenance devices which are used by doctors in treatment of clubfoot. They are applied to the body to stabilize and limit or protect the movement of the damaged joint.

Parents should seek medical intervention if their baby is born with clubfoot. If the condition is not treated early, the child may face difficulty walking, or may even develop other disorders affecting the joints, like arthritis.

Clubfoot - Ways To Identify & Treat It Well!

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

Osteoporosis is a disease that affects the bones of a patient. This is most commonly found in women, especially in those women who are close to or going through, menopause. Hormonal changes around this period in a woman's life usually lead to various changes in her body. One of these changes include loss of bone tissue which can leave the patient with brittle and weak bones, a condition that is also known as osteoporosis. This condition literally imbibes the word porous, meaning hollow bones. It is born from an acute deficiency of calcium and vitamin D. The DEXA Scan or bone density test, also known as the Dual Energy X-ray Absorptiometry Scan, is one of the most effective tests that can help you in detecting this kind of damage or thinning bones. Here's why.

    Fractures: The DEXA Scan is an important one because it sends low energy beam to areas like your joints and tissues to show how susceptible you are to fractures. It does so by measuring the strength of the tissues as well as the bones to see how brittle they may be.
    Other Ailments: Measuring the thinning of your bones can also point to the presence of other ailments that may have gone unnoticed or undetected, earlier. These can include kidney disease, hyperparathyroidism which happens due to overactive secretions of the said gland, as well as liver disease due a malfunctioning liver, intestinal disease and various disorders in the intestinal tract, and a serious vitamin D deficiency. With this scan, you can get an insight into the other parts of the body affected by the bone density and whether or not they are functioning properly.
    Estrogen: Simply checking the estrogen levels cannot ascertain whether or not you have osteoporosis, as a high estrogen level can be credited to a particularly heavy period cycle. It does not show the bone health the way a DEXA Scan does.
    Easy and Standardised: This method of scanning usually happens with the help of a mounted X ray machine type, hand held gadget which can be extended to conduct the scan. This is an easy and standardised method that releases low levels of radiation which also makes it a healthier option.
    Bone Density Scores: The T Scores and Z scores point towards the bone density and help in diagnosing the condition efficiently. With a systematic scoring system, it is a sure shot test for osteoporosis.

Osteoporosis is a serious condition. The first step in treating the same is to get a detailed scan like the DEXA scan done, so as to test the extent of the bone thinning to ensure that proper and timely treatment takes place.

Why is the DEXA scan important for osteoporosis patients?

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