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"Dr. Dave, Thank you very much for giving me my shoulder back. You are a miracle worker!" | | Bill Byma #11 (Former Canadian National Volley Ball Team) |
Submitted by admin on Thu, 10/02/2008 - 14:41.
What We Treat
Sports Injuries - Details |
| Stains and Sprains |
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When you overdo it physically, you may experience sudden pain and swelling around a joint or a muscle. The injury you have may be a sprain or a strain. Here's the distinction:
Sprain. A sprain is a stretching or tearing of ligaments. Ligaments are tough bands of fibrous tissue that connect one bone to another. Common locations for sprains are your ankles and knees.
Strain. A strain is a stretching or tearing of muscle or tendon. People commonly call strains "pulled" muscles. Hamstring and back injuries are among the most common strains.
Symptoms
Sprains and strains vary in severity. Signs and symptoms depend on the severity of the injury.
Sprains
Sprains can cause rapid swelling. Generally, the greater the pain and swelling, the more severe the injury.
Mild. Your ligament stretches excessively or tears slightly. The area is somewhat painful, especially with movement. It's tender. There's not a lot of swelling. You can put weight on the joint.
Moderate. The fibers in your ligament tear, but they don't rupture completely. The joint is tender, painful and difficult to move. The area is swollen and may be discolored from bleeding in the area. You may feel unsteady when you try to bear weight on your joint.
Severe. One or more ligaments tear completely. The area is painful. You can't move your joint normally or put weight on it. If the sprain occurs in the ankle or knee, when you try to walk, your leg feels as if it will give way. The joint becomes very swollen and also can be discolored. The injury may be difficult to distinguish from a fracture or dislocation, which requires medical care.
Strains
As with sprains, signs and symptoms of strains will vary depending on the severity of the injury. Common signs and symptoms include:
Pain
Stiffness
Swelling
Bruising
If you have a severe strain, the muscle or tendon is torn apart or ruptured. You may have significant bleeding, swelling and bruising around the muscle, and your muscle may not function at all.
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| Shoulder Injuries |
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| Rotator Cuff Injuries |
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The rotator cuff is the name for the tendons that surround the shoulder joint. The rotator cuff is important in allowing the shoulder to function through a wide range of motions. A rotator cuff tear occurs when there is an injury to one of the rotator cuff tendons. Rotator cuff tears occur in many shapes and sizes, but can be thought of as a hole in one of the tendons around the shoulder joint. Like most orthopedic conditions, the most common mechanisms of a rotator cuff tear are separated into 'repetitive use' and 'traumatic injuries.' In repetitive use injuries to the rotator cuff, repeated activities cause damage to the rotator cuff tendons. Over time, the tendons wear thin and a rotator cuff tear can develop within the tendons. Traumatic injuries to the rotator cuff are seen after events such as falling on to an outstretched hand. The traumatic event can cause a rotator cuff tear by injuring the rotator cuff tendons. A rotator cuff tear is seen both in the young and old, but they are much more common in the older population. Usually in younger patients, there is either a traumatic injury, or the patient is demanding unusual use of their shoulder, as seen in professional athletes. |
| Frozen Shoulder |
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Frozen shoulder, or adhesive capsulitis, is a condition that causes restriction of motion in the shoulder joint. The cause of a frozen shoulder is not well understood, but it often occurs for no known reason. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue.
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| Knee Injuries |
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| Hamstring Injuries |
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| IT Band Syndrome |
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Iliotibial band syndrome is due to inflammation of the iliotibial band, a thick band of fibrous tissue that runs down the outside of the leg. The iliotibial band begins at the hip and extends to the outer side of the shin bone (tibia) just below the knee joint. The band functions in coordination with several of the thigh muscles to provide stability to the outside of the knee joint. If the muscles of the hip are not functioning in a balanced manner, the resulting biomechaics can lead to improper use of the Tensor Fascae Lattae, which then leads to a tightening of the Iliotibial Band. |
| Shin Splints |
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Shin splints are most commonly due to overuse. When the overuse causes irritation to the tendons and the attachment of these tendons to the bone, the condition is called medial tibial stress syndrome. This is what most people are talking about when they use the words shin splints as a diagnosis. Medial tibial stress syndrome, or shin splints as most people call this problem, is commonly seen in athletes who suddenly increase their duration or intensity of training. This type of shin splints may also be seen in athletes who have very high demand training levels, such as marathon runners, even if their training levels are not dramatically increased.
If you have shin splints, you may notice:
Tenderness, soreness or pain along the inner part of your lower leg
Mild swelling
At first, the pain may stop when you stop running or exercising. Eventually, however, the pain may be continuous.
Shin splints are caused by an overload on the shinbone and the connective tissues that attach your muscles to the bone. The overload is often caused by specific athletic activities, such as:
Running downhill
Running on a slanted or tilted surface
Running in worn-out footwear
Engaging in sports with frequent starts and stops, such as basketball and tennis
Shin splints can also be caused by training too hard, too fast or for too long.
Shin splints are most common among runners, particularly those just starting a running program. If you have flat arches, your feet may have a tendency to roll too far inward (pronate) when running — which can contribute to shin splints.
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| Runner's / Jumper's Knee |
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Patellar tendonitis is the condition that arises when the tendon and the tissues that surround it, become inflamed and irritated. This is usually due to overuse, especially from jumping activities. This is the reason patellar tendonitis is often called "jumper's knee." Patello-femoral pain syndrome, also called Runner's Knee or chondromalacia patellae, is due to irritation of the cartilage on the undersurface of the kneecap. Chondromalcia is usually treated with therapy and rest, but sometimes with arthroscopic knee surgery. Relief can be found by stretching and releasing tension from the muscles surrounding the knee cap. |
| Ankle Injuries |
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Ankle sprains cause an injury to the ligaments around the ankle. Sprains can cause significant ankle pain, as well as swelling and a feeling as though the joint may 'give-out.' Tendonitis can occur in any of the tendons around the joint and cause ankle pain. Tendonitis occurs when the tendons, the attachments of muscles to the bone, become irritated and inflamed. Achilles tendonitis causes ankle pain in the back of the joint. Achilles tendonitis is the most common type of tendonitis around the ankle joint. One of the most common injuries is an inversion sprain (rolling over on your ankle). This can result in tearing (straining) the peroneal muscles in the lower leg, and stretching the ligaments in the ankle. Because the ligament is stretched, it will allow more movement at the injury site. The peroneal muscles will also be strained and injured, leading to weakness in those muscles. The combination of loose ligaments and weak muscles allows for further injury to the ankle. These components must be resolved before full recovery will be expected. |
| Achilles Injuries |
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The Achilles tendon can tear or rupture during sudden activity, like jumping or sprinting, or during violent tendon stretches. The injured area will be swollen, tender, and bruised. |
| Plantar Fasciitis |
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Plantar fasciitis is a common problem that causes pain under the heel bone and in the arch of the foot. Plantar Fascitis is an irritation to the tough, fibrous tissue that forms the arch of the foot. Patients with plantar fasciitis complain of pain under the heel with lengthy walks and prolonged standing. The condition is thought to be a chronic repetitive strain injury. Surgical intervention has been the last resort for patients when other treatments of plantar fasciitis do not work. The problem is that the success rate of surgery is not excellent, and surgery has potentially complicating side-effects. |
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Repetitive Strain Injury - Details |
| Tennis Elbow |
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Tennis elbow, also called lateral epicondylitis is a very common injury that results from overuse, injury, or strain of the tendon that attaches the forearm muscles to the bony part of the outside of the elbow. It is called tennis elbow because tennis players are prone to getting it (50% of tennis players may have this condition), this medical condition is not limited to tennis players. Tennis elbow can occur with any activity that involves repetitive gripping, turning, bending, or extending the wrist backwards. |
| Golfer's Elbow |
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Golfer's elbow, also called medial epicondylitis is a very common injury that results from overuse, injury, or strain of the tendon that attaches the forearm muscles to the bony part of the inside of the elbow. Called golfer's elbow because golfer's are prone to getting it, this medical condition is not limited to golfer's. Golfer's elbow can occur with any activity that involves repetitive gripping, turning, bending, or flexing the wrist forwards.
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| Carpal Tunnel Syndrome |
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Carpal tunnel syndrome is due to squeezing of the median nerve as it passes through the arm to the hand. This nerve is contained in the carpal tunnel, a narrow channel just above the wrist. In carpal tunnel syndrome, the channel starts to shrink, compressing the nerve and causing inflammation. The result is hand pain, numbness, tingling, and sometimes, hand weakness or restricted movement. The ring finger and little finger are usually spared. The median nerve can be compressed at up to 5 locations in the arm on its way into the hand, and when it is compressed outside of the carpal tunnel, the condition is called "pseudo carpal tunnel syndrome". |
| Chronic Over Use Injuries |
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Post and Pre Surgical Rehabilitation - Details |
| Post Surgical Knee Rehabilitation |
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| Post Surgical Ankle Rehabilitation |
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| Post Surgical Shoulder Rehabilitation |
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Nerve Entrapments - Details |
| Numbness and Tingling in Hands and Feet |
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Muscle and Joint Pain - Details |
| Neck Pain and Stiffness |
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| Low Back Pain and Stiffness |
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| Sacroiliac Joint Strain |
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| Sciatica |
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Sciatica is a pain that shoots along the sciatic nerve, radiating through the buttocks and down the back of the leg and as far as the foot. Pressure on the sciatic nerve can have many causes, some serious and some more minor. Sciatica may be the result of something as simple as bad posture, muscle strain or spasm, pregnancy, being overweight, wearing high heels, or sleeping on a too-soft mattress. More seriously, it can result from pressure exerted on the sciatic nerve or its nerve roots by a slipped disc in the back. In some cases, sciatica is due to nerve inflammation caused by a form of arthritis, or is caused by the squeezing of the sciatic nerve by a tumour wrapped around the spinal cord in the lower back (the lumbar spine). The vertebrae are separated from each other by discs made of cartilage, a substance like bone but softer. Each disc has a tough outside layer and a soft inside part that acts as a shock absorber, cushioning the vertebrae when the body moves around. If the disc is damaged by injury or through aging, the inner part can bulge or slip through the outer layer. With a disc herniation, the extruded or "herniated" inner part of the disc may then compress or inflame a nerve root sticking out between two adjacent vertebrae. The disc may even injure the nerve root. If this happens in the lower back area, it leads to pain travelling down the sciatic nerve in the leg. |
| Piriformis Syndrome |
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Piriformis syndrome is a condition in which the piriformis muscle irritates the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve. This referred pain, called "sciatica", often goes down the back of the thigh and/or into the lower back. Patients generally complain of pain deep in the buttocks, which is made worse by sitting, climbing stairs, or performing squats. The piriformis muscle assists in abducting and laterally rotating the thigh. In other words, while balancing on the left foot, move the right leg directly sideways away from the body and rotate the right leg so that the toes point towards the ceiling. This is the action of the right piriformis muscle.
Stretching the muscle often duplicates the pain. To do the piriformis stretch, lie on your back, and flex the right hip and knee. Now, while grasping the right knee with your left hand, pull the knee towards your left shoulder. This adducts and flexes the hip. In this position, grasp just above the right ankle with the right hand, and rotate the ankle outwards. This applies internal rotation to the hip and completes the stretch. Another way to do this stretch is to stand on your left foot and place the right foot on a chair, such that the right knee and hip are flexed at about 90 degrees. Now, using the right hand, press the right knee across towards the left side of the body while keeping the ball of the right foot on the same spot on the chair. |
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Motor Vehicle Accidents - Details |
| Whiplash |
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Home care is intended to relieve the pain and minimize the amount of inflammation in the soft tissues of the neck. Apply ice to the neck for 10 minutes at a time each half hour for the first 24 hours while awake. Do not apply ice directly to the skin. Place a towel between the ice and the neck. Continue to use ice therapy until the pain stops. (After you see the doctor, follow his or her directions for ice therapy.) Whiplash is a nonmedical term used to describe neck pain following an injury to the soft tissues of your neck (specifically ligaments, tendons, and muscles). It is caused by an abnormal motion or force applied to your neck that causes movement beyond the neck's normal range of motion. Whiplash happens in motor vehicle accidents, sporting activities, accidental falls, and assault. The term whiplash was first used in 1928, and despite its replacement by synonyms (such as acceleration flexion-extension neck injury and soft tissue cervical hyperextension injury), it continues to be used to describe this common soft tissue neck injury. Your doctor may use the more specific terms of cervical sprain, cervical strain, or hyperextension injury |
| Tension Headaches |
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Tension type headaches (TTH) are one of the most common forms of headaches yet they are not well understood. Most people describe having a band of pressure around their head that can last from 30 minutes to a week. TTH can be related to muscles tightening in the back of the neck and scalp.
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