Ask the Kayal Orthopaedic Center Expert:

By Robert A. Kayal, MD, FAAOS

UPPER EXTREMITY PAIN: FAQs ABOUT COMMON ELBOW INJURIES 

It’s no secret that, while exercise and recreation keep us healthy, they occasionally lead to nagging aches, injuries and musculoskeletal pain. When left unaddressed, these conditions may become chronic, requiring a long-term hiatus from offending activities. To prevent this, it’s important to discuss pain and immobility with a qualified NJ orthopedic expert.

Whether caused by (1) overuse, (2) wear and tear, (3) repetitive motion, or (4) sports and conditioning, a slow-healing elbow injury is frustrating and restrictive. Our orthopedic surgeons see a variety of elbow conditions, and two of the most prevalent are golfer’s elbow and tennis elbow. It is not unusual to see increasing elbow injuries during the NJ autumn, since the mild weather spurs enthusiasts to spend their time outdoors.

GOLFER’S ELBOW: Also known as medial epicondylitis, golfer’s elbow impacts patients who are overusing forearm muscles and tendons. The condition begins when microscopic tendon tears lead to ongoing inflammation and pain—which can come on gradually or quickly. Golfer’s elbow is typically caused by repetitive, improper technique in your golf swing, baseball pitch, racquet sport or weight training regimen. Pain may become worse as you grip a club or racquet, throw a ball, twist a doorknob or flex wrist to forearm.

Golfer’s elbow symptoms may include pain and soreness inside the elbow; stiffness when making a fist or straightening the arm; and numbness or tingling that radiates into the lower arm or hand. To diagnose this elbow condition, your orthopedic specialist will perform a thorough examination and discuss your activities/medical history.

After ruling out other damage using x-ray or MRI, our team may recommend rest, ice, physical therapy and brace immobilization. If symptoms persist, you may need one or more cortisone shots, in combination with rehab. In rare cases, surgery is recommended. Surgery for golfer’s elbow typically entails removing damaged tissue, shaving the bone and repairing or reattaching the tendon to take pressure off of the elbow joint.  

TENNIS ELBOW: Similar to golfer’s elbow, tennis elbow occurs when microtendon tears develop into pain and inflammation. This pain occurs on the exterior of the upper arm near the elbow, and is often caused by racquet sports. However, tennis elbow may also be caused by repetitive wrist twisting—as when using a screwdriver, painting a wall or moving a computer mouse.

Tennis elbow symptoms include worsening joint pain, weakening grasp, and discomfort that radiates from the outer elbow into the forearm and hand. Pain typically worsens when the wrist is bent backward, or while grasping something and straightening the elbow. Extreme stiffness may also prevent full arm extension.
  
To diagnose this elbow condition, your Kayal Orthopaedic surgeon will examine your arm, discuss your activity and medical history—and may recommend an x-ray to rule out other joint conditions. Like golfer’s elbow, the best treatments for tennis elbow include rest, ice, physical therapy, anti-inflammatory medications and immobilization. However, persistent or recurring tennis elbow may need surgical debriding, or “cleaning up” of damaged tissue. Your surgeon can also clean out scar tissue and repair/reattach the extensor tendon to take stress off of the elbow joint.

Are You Limited by Elbow Aches, Pains and Immobility? 

CALL THE KAYAL ORTHOPAEDIC CENTER TODAY!

If elbow pain, stiffness and numbness are preventing you from enjoying your favorite activities, it’s time to call our team of leading NJ orthopaedic surgeons. Our helpful staff can arrange an initial consultation, schedule elbow imaging and return you to the links, court or baseball diamond quickly and safely. Call 201-447-3880 today—or login online to request an appointment through our Sage Intergy Portal.

Shoulder Problems? Ask the Kayal Orthopaedic Center Expert!

By Robert A. Kayal, MD, FAAOS

FAQs about Shoulder Injuries

Your shoulder joint is composed of a variety of bones, muscles, tendons and ligaments. Because of its extreme range of motion, it is an inherently unstable joint that is prone to injury. Shoulder pain occurs for a variety of reasons, including degeneration, arthritis, falls, impacts or traumatic accidents. 

Kayal Orthopaedic Center, PC is a leader in NJ shoulder repairs. Successfully treating hundreds of cases of shoulder pain, restricted mobility and structural damage each year, we’ve developed a unique treatment approach that’s customized to the individual needs of each patient. Educating patients in a detailed, easy-to-understand manner, we then perform thorough assessments and outline possible treatment options—so you can decide which course of action you’d prefer to follow. Most importantly, we prioritize aftercare to ensure complete rehabilitation and freedom from shoulder pain. 

Common Questions about Shoulder Injuries

1. HOW DO SHOULDER INJURIES OCCUR?

In cases where acute trauma did not cause your shoulder injury, we look for underlying causes. These may include wear and tear on your shoulder muscles and joints, the presence of arthritic conditions, and lifestyle or occupational factors that have led to repetitive stress. You can also injure your shoulder without realizing it by incorrectly lifting something heavy or carrying heavy objects over long distances.

2. WHAT ARE SOME OF THE MOST COMMON SHOULDER INJURIES?

Some of the most frequently of the most frequently occurring shoulder conditions treated by the Kayal Orthopaedic Center include:

• Tendonitis and bursitis: Tendonitis occurs when the shoulder tendons become inflamed, causing pain and mobility restrictions. Bursitis is a similar affliction that affects the bursa, a fluidic sac which shields and protects your shoulder.
• Shoulder dislocation: A dislocated shoulder, which occurs when the humerus bone is physically separated from the socket of the shoulder, causes severe pain and impedes movement and range of motion.
• Frozen shoulder: Generalized inflammation can restrict shoulder movement, typically leaving patients unable to raise the affected arm beyond a certain threshold.
• Rotator cuff tears: Usually caused by repetitive stress, a rotator cuff tear occurs when tendons and muscles in the shoulder’s rotator cuff weaken and tear.
• Sprains: A shoulder sprain occurs when shoulder ligaments tear, and is typically caused by acute stress.  
  
• Labral tears: The shoulder’s labrum is a stabilizing tissue which compensates for the overall lack of support in the relatively shallow joint of the shoulder. A labral tear increases your likelihood of suffering a dislocated shoulder, and while this condition most commonly affects older patients, it can also occur suddenly as the result of an acute injury. Symptoms of a labral tear include aching pain in the shoulder joint, sudden restrictions of movement often described as a “catching” sensation, and activity-specific pain that occurs during shoulder movement.
• Shoulder fractures and bone breaks: Both collar bone and shoulder bone fractures can cause shoulder pain, and usually occur as the result of heavy force being applied against the bone during an accident.
• SLAP lesions: “SLAP” is an acronym for “Superior Labral tear, Anterior to Posterior.” It refers to an injury affecting the ball-and-socket joint of the shoulder, in which the superior labral ligament develops a lesion from overuse, typically as the result of strenuous or repetitive overhead movement. Symptoms include a constant but dull (rather than sharp) pain in the shoulder, and those affected by SLAP lesions typically report being awakened during the night by shoulder pain.
• Shoulder problems for the “overhead athlete”: Athletes who engage in sports that require a lot of overhead movement, such as softball, baseball and tennis, often develop rotator cuff problems and are at increased risk of both SLAP lesions and labrum tears. Stretching both before and after activity—and taking care to use proper form—can help you avoid these conditions.

3. WHAT METHODS ARE USED TO DIAGNOSE THE SPECIFIC NATURE OF A SHOULDER INJURY?

In our clinic, we use cutting-edge imaging and diagnostic technologies which include arthrograms and arthroscopic examinations, CT scans, X-rays and MRI scans. These are used to supplement physical examinations, during which we will make an initial assessment of your injury.

4. HOW ARE SHOULDER INJURIES TREATED?

It depends on the nature of the injury, but we favor minimally invasive and rehabilitative treatments before resorting to surgery. During your aftercare, we prioritize physiotherapy and range-of-motion recovery techniques to speed healing and minimize the possibility of further injury.

WANT TO LEARN MORE?

CALL THE KAYAL ORTHOPAEDIC CENTER TODAY!

On behalf of my team of leading NJ orthopedic surgeons, I invite you to contact us if you have questions about shoulder pain, or wish to arrange a consultation appointment for shoulder pain or a shoulder injury. My staff has elite credentials and the breadth of experience to successfully treat any shoulder injury, no matter how minor or serious, with compassionate and attentive care. To schedule an appointment today, call 201-447-3880.

Knee Problems? Ask the Kayal Orthopaedic Center Expert!

By Robert A. Kayal, MD, FAAOS

During my years as an experienced NJ knee surgeon, I have helped hundreds of patients overcome the pain and immobility associated with debilitating knee injuries. My elite team of knee surgeons delivers patient-focused service that consists of: (1) educating patients, in-depth, about their knee injuries, (2) recommending the best treatment options, and (3) working to eliminate pain and achieve full rehabilitation. Whether your knee injury is sports-related—or was caused by a fall, an accident or a bone condition—we look forward to expediting your return to health. 

FAQs about Knee Injuries

1. WHY ARE KNEE INJURIES SO COMMON AND COMPLEX?
Knee injuries are the most common joint injury, plaguing athletes and people of all ages. Knee injury complexity results from the joint’s elaborate anatomy, which consists of a sophisticated union of bones, cartilage, ligaments, tendons and muscle. Bones include the lower portion of the femur (thigh bone), the upper portion of the tibia (shinbone), and the patella (knee cap). Together, these elements flex and extend with the help of ligaments and tendons, which protect the joint against abnormal movement. In addition, the knee is cushioned by the meniscus (cartilage padding), which helps to absorb the shock of impact and activity. Each of these joint elements serves a critical purpose, and when one fails due to injury—the knee joint is no longer mechanically sound.  

2. WHAT ARE THE MOST COMMON KNEE INJURIES?
Knee conditions (and their symptoms) vary from mild to severe, and may be caused by acute activity or long-term overuse. While the scope of knee injuries is too broad to cover within one blog, the following injuries are common: 

• ACL Injury: The ACL, or anterior cruciate ligament, limits excessive rotation and forward movement of the knee. It is commonly injured during a sudden, impactful stop (i.e. – landing from a jump), during a twisting motion, or during a blow/force to the joint. ACL tears are common in basketball, skiing, football, and other activities that require jumps or rapid changes in direction.  
• PCL Injury: The PCL (posterior cruciate ligament) limits excessive backward movement (or hyperflexion) of the knee joint. PCL injuries commonly occur during: (1) car accidents—when the shinbone strikes the dashboard and is forced backward, and (2) sports injuries, when athletes misstep—or fall on their knee with full body force.
• MCL Injury: The MCL provides knee-joint stability, and prevents excess “opening” of the knee joint. It is commonly injured during sudden impact to the outside of the knee. This type of blow may be sustained during contact sports, or during a severe fall. 
• Torn Meniscus: Torn knee cartilage usually refers to a tear in the meniscus, which is a rubbery cartilage section that attaches to the ligaments. The meniscus ensures even application of body weight across the knee joint, and absorbs shock during jumping, cutting, pivoting or impact. Traumatic injury (usually excessive bending and twisting of the knee) may cause a meniscus tear. This type of cartilage damage is also common with joint degeneration, since the meniscus can “wear out” over time.   
• Fracture:  Fractures to any bone in the knee (patella, femur and tibia) generally occur during falls, car accidents or other traumatic blows to the joint.    
• Osteoporosis: As you age, your bones may become brittle and fragile. Called osteoporosis, this condition leads to joint degeneration and increased susceptibility to fractures and trauma. The Kayal Orthopaedic team will address not only your acute, osteoporosis-related knee injury, but will also assist you with long-term disease prevention and management. 

3. WHAT ARE THE MOST COMMON SYMPTOMS OF KNEE INJURIES?
The most common symptom, of course, is pain. You may experience throbbing, aching, shooting or nerve-related pain, depending upon the location and extent of your injury. Other common knee injury symptoms include:

• Joint swelling and stiffness
• Redness and “hotness”
• Weakness and immobility
• Locking, popping or crunching
• Obvious joint deformity

4. HOW WILL YOU DIAGNOSE MY KNEE INJURY?
Often, my team of NJ orthopedic surgeons can establish a diagnosis with just a physical exam and medical history. However, your injury may also require diagnostic imaging, such as MRIs, CT scans and x-rays. Our office staff deals with your insurance company and obtains necessary authorizations for further testing—so you’ll have a diagnosis promptly and efficiently. 

5. HOW DO KAYAL ORTHOPAEDIC SURGEONS TREAT KNEE INJURIES?
While treatment for knee injuries is as varied as the conditions, themselves, there are a few customary treatment options. First, your NJ orthopedic surgeon may prescribe icing, elevation and acute anti-inflammatory medications to reduce swelling and relieve pressure. If your injury does not require surgery, knee surgeons may recommend physical therapy and home exercises to strengthen and re-stabilize the joint. Physical therapy will focus on strengthening the quadriceps (front thigh) muscles, as well as the hamstrings (back thigh) muscles. Balance and flexibility exercises may also prove helpful.

If these conservative treatments are not indicated—or are not helpful after a period of time—knee surgery may be required. 

6. WHAT TYPE OF SURGERY IS AVAILABLE FOR KNEE INJURIES?
If nonsurgical rehabilitation is not effective or recommended, there are several types of surgery that may be performed for knee injuries. These include knee arthroscopy, minimally invasive knee joint replacement, unicompartmental arthroplasty and total knee replacement. To get the details about each of these cutting-edge surgical options, visit our Patient Information Center or make an appointment today.

MORE KNEE INJURY QUESTIONS?
CALL THE KAYAL ORTHOPAEDIC TEAM!

As the regional pioneer of the partial knee and patellofemoral knee replacement technology, I’ve performed more of these surgeries than any other orthopaedic surgeon in the area. My team and I are experts in diagnosing and treating all types of knee injuries and bone conditions, so there’s no better place to seek NJ knee injury care. We specialize in attentive, customized treatment, and boast a staff of compassionate, qualified experts. Call 201-447-3880 to schedule your appointment today!