Noora Hospital

Torn or damage cartilage is not just a problem for the sportsmen. It can occur to anyone. It is generally caused due to a direct hit on the body parts. Its treatment is far more complicated than a simple bone injury. The best sign to know whether or not you have injured your cartilage is to check out your activities. If you have hurt your joint and don’t notice major symptoms, like if you are still capable of putting weight on and move the joint, you might have had a cartilage injury. It doesn’t hurt you a lot in the beginning, but might get worse later. 

Here are the initial care and self-treatment procedure: 

1. Protection: It is the first thing that has to be kept in mind. You must protect the affected area from any further injury. Thus, providing an external support, for example, use a knee brace. 
2. Rest: Provide complete rest to the affected joint. The rest is must during the first two or three days. Crutches may help the situation if you’ve got an injury around your knee or ankle. It is then advisable to return back to light activity over the next few days or weeks, as prescribed by the doctor. 
3. Ice: It is best to apply an ice pack to the injured area for about 15 to 20 minutes in every two to three hours. This must be repeated in the first two to three days. 
4. Compression: Use a bandage to provide the needed compression to the injured area to avoid any swelling and movement. This will not let things go beyond control. 
5. Elevation: You must keep the injured area raised. Keep it supported on a pillow to reduce swelling. 

If there is an unbearable pain, take painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). If your condition doesn’t improve after the initial therapy, you must consult a doctor immediately. 

1. Physiotherapy: It can be helpful in treating the affected joint. If there is any difficulty in moving the affected joint, you must opt for physiotherapy. A professional will be able to teach you exercises that will strengthen your muscles and provide support to the joint. This will help you in getting rid of the pain. It can be also beneficial at a time when you are recovering from any surgical procedure. 
2. Surgery: If physiotherapy doesn’t work, it means you have severe cartilage damage. In that case, you might be advised to take up surgical procedures to set things in proper shape. Surgery is done either by opening the joint or by Arthroscopy. There are various types of surgery which can be done. 1st the old and successful surgery wherein damaged part of the cartilage is debrided and filled with normal cartilage from the non-weight bearing part of the joint. 2nd is ACI (Autologous Chondrocyte Implantation) is a 2 stage procedure wherein chondrocyte is grown using stem cell and implanted in defect part in 2nd stage. 3rd is multiple drilling of the area usually done in children.

If ur suffering from severe knee pain with x ray showing grade 3 arthritis  better to go for knee replacement surgery.

Acupuncture is a Chinese method of treatment which aims at maintaining the energy balance in the body. The procedure involves stimulating the energy channels of the body by using fine steel needles. It enhances the production of endorphins (pain controlling hormones) in the body, therefore less pain.

Signs you are suffering from arthritis

Arthritis is a disorder that is characterized by inflammation and swelling in the joints. The symptoms of arthritis are tenderness in the joints, fatigue, fever and stiffness in the joints that worsen in the morning. Initially, the smaller joints in the body are affected; it then progresses to joints in the elbows, wrists and the knees.

Causes behind it

Arthritis is caused when the immune system starts attacking the membrane surrounding the joints. Inflammation occurs, resulting in destruction of the bone and cartilage. It causes the ligaments and the tendons holding the joint to weaken. The joints then starts to lose their original alignment and shape.

Dietary guidelines you must follow

You need to follow dietary guidelines such as avoiding refined and processed foods as they can contribute to the inflammation of the joints. You also need to steer clear of foods which may trigger a reaction from your immune system. Mild exercises to strengthen the joints may be performed to improve mobility.

Acupuncture and arthritis

The procedure begins with the practitioner applying alcohol to the affected spot and tapping the area with a needle. The disorder determines the number of needles required, the spots of insertion and the depth to which they have to be inserted. The duration for which the needles are kept in the body ranges from a few minutes to an hour. In order to enhance the effect of the needles, they may be heated or energized electrically. You may experience a tingling sensation in case electricity is used.

Acupuncture is a holistic method of treatment that has no side effects. It does not involve chemicals; so it is safe to use. It will not cure the disorder, but can reduce the pain to a large extent. One of the added benefits of this procedure is that no matter, which part of the body is subjected to this process, it does help calm your mind down.

Plantar fasciitis is an orthopedic problem that gives rise to pain in the foot and heel due to strain or pressure on the plantar fascia. This is a ligament or connective tissue which lies in a flat band, connecting your heel with the toes and effectively, providing a basis for the motion of the feet in general. Inflammation, swelling and bruising of this tissue or ligament can lead to excessive pain in the heel.

Let us look at ways that can help you deal with this pain:

1. Rest: Taking rest and giving your feet a break from all kinds of strain inducing activities can help in relieving the pain. Also, you can keep your feet elevated to help in reducing the pain in the area.
2. Supportive footwear: Using pads within your shoes with gel built into them, or using specific footwear that help in walking without feeling too much of pain is a good way of dealing with Plantar fasciitis. The shoe inserts must be rubber, felt or plastic so that they are soft for your feet. They also give your heel and its arch good support, while Orthotics pulls the ligament so that there is less stress on the same. You can also pull on a pair of night flints which will keep the foot and the ligament stretched while you enjoy a good night of sleep.
3. Exercise: Indulging in mild muscle strengthening exercise that also involves stretching and heel hooks can help in alleviating chronic pain that you may be suffering from. Lie flat on your back and take a towel. Lift your leg and hook your foot into it. Now press against the towel and pull down the towel simultaneously. Repeat at least ten times per foot. This will give you flexibility and strength in the area.
4. Painkillers: Use pain killers only when absolutely necessary and with due advice from the doctor or Orthopaedic specialist. The use of Ibuprofen and other pain relievers can help in numbing the pain inducing nerves in the brain and give you instant relief.
5. Anti-inflammatory drugs: Your doctor may prescribe anti-inflammatory medication that can bring down the swelling for more comfortable functioning when you are on your feet. Naproxen is one such drug that helps in bringing down the inflammation. Also, corticosteroid injections can relieve severe pain.
6. Surgery: Heel spur removal or Plantar fascia release are some of the surgical options for chronic and severe cases.

Taking care of your feet is a matter of ensuring that you look into the slightest discomfort and report the same to a doctor.

Broken bone is commonly known as bone fracture a d it occurs when an exorbitant amount of force is applied causing the bone to split or shatter. While some minor fractures lead to cracks and crannies, others may lead to complete breakage of the bones. Despite being hard, bones are formed in such a way that they can absorb pressure to only a certain extent, beyond which they break. Statistically, the incidence of broken bones are most common in children and in old age people.

Causes of Bone Fracture
Bone fracture can be caused due to a number of reasons; both intentional and accidental. Some of them include:
1. Accidents and injuries: Sports injuries, being hit by a car and tripping and falling are some of the typical episodes.
2. Old age: Diseases such as osteoporosis and brittle bone disease are common in aged people. As bones tend to become more fragile among the aged, they are at a greater chance of bone fractures.

Type of bone fractures

Primarily bone fractures are of four types, based on the way the bone splits. They are:

1. Complete fracture: This type of fracture refers to a complete breakage of the bone wherein the fracture may occur at various parts of the bone.
2. Incomplete fracture: In this type of fracture, the bone partially breaks instead of splitting entirely.
3. Compound fractures: This is a type of a fracture wherein the bone breaks past the skin. It is also known as an open fracture.
4. Simple fracture: In this type of a fracture, the bone breaks without causing an open wound on the skin.

Treatment of bone fractures
In case of a broken bone, the immediate course of action would be to reach for the first aid box. This can be done to stabilize the bone prior to hospitalization. Icing the injury, elevating the injured area to prevent further swelling and covering the wound with bandages are common measures. In many cases, people also make household splints (made of newspapers) to keep the bone stabilized. Hospitalization and especially surgery, can be also opted for in case of severe fractures.

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket. Shoulder pain can happen due to various reasons, vary from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc.. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are-

• Biceps Tendonitis
• Acromio-clavicular Joint arthritis
• Scapular Dyskinesia
• Trapezitis
• Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
• Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to...

• Bankart lesion

Diagnose Shoulder Pain-

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

1. X-rays: Through an x-ray one can view the shoulder in many different views
2. Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
3. MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
4. Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain-

1. For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
2. Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions --

1. Pain relief and physiotherapy as first step If this fails then following surgical options are available
2. Arthroscopic debridement or repair of labrum
3. Biceps tenotomy or tenodesis

Arthritis --

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Remember "a stitch in time saves nine"

People who regularly work out can go on about its benefits and also show off a toned physique. However, a bad or improper movement can be more harmful than no exercise at all. Read on to know some common exercise moves that are best avoided for their potential harmful effects.

1. Dumbbell punches: By holding dumbbells and punching them forward into the air, you are just spending your energy with absolutely no return from it. It is good as a conditioning one if done for a long time but does not help the shoulders or the arms. Bicep curls and triceps extensions yield much better results than these punches.
2. Shoulder Shrugs: The only muscle that gets worked here is the trapezius, which is at the top of the shoulders and the neck. The arms and the back do not get any benefit and shoulder shrugs can actually cause postural problems and increase shoulder tension. Best avoided if you are not a professional bodybuilder.
3. Thigh machines: One of the most ineffective machines in the gym, the poor posture and no workout for the abs is one of the reasons the outer and inner thigh workouts should be avoided. Better results can be achieved with squats and lunges, which also help more muscles and help in losing weight.
4. Plank rows: While plank rows or board lines work very well for core strengthening, it is not as effective for back and arm strengthening. Better results are achieved with the usual lines for these areas.
5. Lat pull-downs behind the neck: This can be very harmful for people who have even minor shoulder joint problems. The idea is to build arm, torso, and back muscles by pulling a weighted bar down the front and back of the chest area. This can cause misalignment, shoulder impingement, or a tear in the rotator cuff, and in severe cases, even cervical vertebral fracture.
6. Military Presses Behind the Head: Similar to a lat pull-down, here also, a barbell is lifted up and down behind the head and can cause the same problems as the earlier one, including fracture of the cervical spine.
7. Squatting on a bosu ball: These colorful equipment are very alluring but can be really dangerous and can cause ankles and knees to be injured, causing meniscal tears or disruptions.
8. Crunches: When improperly done, crunches produce the same position as one achieves while working on the computer - head forward and rounded shoulder. Crunches are meant to be done by pulling up on the head and not using the abs, as most people incorrectly do.

Make sure you get a trainer's advice on the right ways to work out so as to get the maximum benefits and avoid injuries.