Rotator Cuff Tendinopathy

Posted on September 2, 2018 by Mark

Rotator cuff tendonitis (tendinopathy) is a degenerative condition which impacts one or more rotator cuff tendons located in the shoulder. The patient may experience shoulder pain while resting and this can get worse if they lift or move their arm above the shoulder.

The impacted tendon usually feels tender. Treatment can help alleviate these immediate, painful symptoms. There are certain exercises that the patient can perform after the pain has resolved to prevent a recurrence of the injury.

Thomas & Bigler Knee & Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada and surrounding locations.

Symptoms

Rotator cuff tendonitis is the most common reason behind shoulder pain which manifests slowly over time or after a rotator cuff injury that has not healed adequately.

The symptoms of this condition are as follows:

Pain when the shoulder is at rest, during specific motions or at night.
Experiencing pain especially with overhead motions such as during swimming or racket sports.
Pain felt less commonly with arm movements below the shoulder level.
Tenderness when the impacted area is pressed which may feel thicker as well.
A creaking sensation known as crepitus felt when there is movement in the shoulder.

Causes

Overtraining

A common cause of this condition is overuse due to work or exercise. The most common reasons for rotator cuff tendonitis are repetitive overhead motions such as during swimming, throwing, or playing tennis. Many people make the mistake of training too hard within a short span. It is important to avoid this mistake and pay attention to the initial warning signs.

Work-related

A person working at a desk for extended periods and overusing a keyboard or mouse can develop rotator cuff tendonitis, especially if they have poor posture. The seemingly subtle shoulder movements which occur when operating a mouse can lead to rotator cuff tendonitis over a period.

Treatments

The treatment for this condition comprises two parts. The primary goal is to address the symptoms including a reduction in the pain and swelling to enable proper movement. The secondary objective is to identify the underlying causes and treat them.

Exercises

Exercises are vital after the swelling and pain have reduced. The shoulder’s normal function must be restored. It is important to release the tension in taut muscles while strengthening the weak ones, which the patient can achieve with certain exercises.

In general, the external rotator cuff muscles or those muscles that rotate the shoulder joint outwards are weak in comparison to the ones which rotate the shoulder joint inwards.

Medications

A physician may prescribe anti-inflammatory drugs such as ibuprofen to treat the patient in the initial stages but usually not in the long-run. The patient should not take ibuprofen if they have asthma. Furthermore, the physician will always check for contraindications prior to prescribing medicines.

Electrotherapy

The patient may find treatments such as interferential stimulation, ultrasound, laser or magnetic field therapy beneficial in decreasing pain and swelling.

Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas for orthopedic surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

What is a Frozen shoulder?

Posted on August 29, 2018 by Mark

Frozen shoulder or adhesive capsulitis is a condition in which the shoulder joint becomes stiff and painful. The signs of the condition usually start slowly. They worsen over a period and subsequently resolve between one to three years.

The risk of frozen shoulder development heightens if the patient is recovering from a medical condition or procedure that does not allow them to move their arm, such as a mastectomy or stroke.

Frozen shoulder treatment involves range-of-motion exercises, and at times, the doctor will inject numbing meds and corticosteroids into the joint capsule. In a small number of cases, the patient may require arthroscopic surgery to make the joint capsule loose enabling it to move more freely.

It is not common for a frozen shoulder to occur again in the same shoulder. However, some patients may develop this condition in the opposite shoulder. Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in The Sagebrush State.

Stages of Frozen Shoulder

The shoulder capsule becomes thick, stiff, and tight in case of a frozen shoulder. Thick tissue bands, known as adhesions, develop. There is insufficient synovial fluid in the joint in many cases.

The main symptoms of a frozen shoulder are severe pain and the inability to move the shoulder, even with assistance. A frozen shoulder develops in the following three stages:

Stage 1: Freezing

The patient slowly experiences incremental pain in the “freezing stage.” The shoulder loses its range of movement as the pain level worsens. This stage usually lasts for six weeks to nine months.

Stage 2: Frozen

During this stage, the pain may actually reduce. However, the shoulder remains stiff. Routine activities may become insurmountable in the four to six months of the “frozen” stage.

Stage 3: Thawing

In the “thawing” stage, the shoulder movement gradually gets better. It takes between six months to two years to return to the normal or close to normal range of motion and strength.

Treatment Options

This condition commonly improves over time. However, it may take up to three years to resolve. The goal of the treatment is pain control and the restoration of strength and motion by physical therapy.

Non-surgical Treatment

A majority of individuals with frozen shoulder respond to simple treatments, oral meds, and physical therapy to address the pain and restore movement.

Surgical Treatment

The doctor may discuss surgery with the patient if therapy and other conservative methods are unable to relieve their frozen shoulder symptoms. Notably, the patient should discuss their potential for recovering with continued conservative treatments, and the risks associated with a surgical procedure.

Frozen shoulder surgery is usually recommended in “Stage 2: Frozen.” The surgery aims to stretch and release the stiff joint capsule. Manipulation of the shoulder under anesthesia and shoulder arthroscopy are common techniques for treating this condition.

Manipulation under anesthesia

In this procedure, the patient is made to sleep. Subsequently, the doctor will force the patient’s shoulder to move. This will cause the scar tissue and capsule to stretch and tear. This helps release the tightening and improves the range of motion.

Shoulder Arthroscopy

In this surgical procedure, the doctor will slice tight parts of the joint capsule with pencil-sized instruments via tiny incisions placed on the shoulder. Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.

Chronic Shoulder Injuries

Posted on August 22, 2018 by Mark

Chronic shoulder pain or gradual onset of shoulder pain may manifest over some time. The athlete may not be aware of the exact time of the injury, and it may have been causing them slight discomfort while they continue to train.

The shoulder joint is complex, and there are certain injuries which may appear to have occurred suddenly. However, in reality, these injuries may have been developing slowly over a period. A chronic shoulder injury may cause acute pain to the patient.

Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding communities.

Types of Injuries

Glenoid Labrum Tear

The glenoid labrum refers to a fibrous tissue ring that connects to the rim of the glenoid shallow hole or shoulder blade socket where the arm bone or ball or humerus is located.

Frozen Shoulder

The medical term for frozen shoulder is adhesive capsulitis. This is a condition that leads to pain and limited movement in the shoulder joint.

Shoulder Impingement Syndrome

The shoulder impingement syndrome is also known as thrower’s shoulder or swimmer’s shoulder. It occurs when the tendons of the rotator cuff become impinged as they pass through the shoulder joint.

Winged Scapula

A winged scapula is indicative of another condition and is itself not an injury. The condition is characterized by the shoulder blade’s protrusion out on the back instead of it lying flat against the chest wall’s back.

Shoulder Subluxation

When the shoulder dislocates partially, it leads to shoulder subluxation or shoulder instability. The shoulder joint is such that it allows a vast range of motion. This makes it likely to be less stable.

Clavicle Muscle Attachments Inflammation

The clavicle or collarbone has various muscle attachments along its entire length. These attachments may become swollen or painful.

Subscapularis Inflammation

The subscapularis is a strong muscle that rotates the arm inwards. It belongs to the rotator cuff muscle group. Throwers frequently experience an injury of this muscle, and it can be challenging to treat.

Shoulder Tendonitis

Shoulder Tendonitis or Tenosynovitis refers to a degenerative condition of any of the tendons around the shoulder joint, typically rotator cuff tendons. However, it can also happen in the triceps and biceps tendons.

Rotator Cuff Tendonitis

Rotator cuff tendonitis or tendinopathy alludes to a degenerative condition which impacts one or more of the rotator cuff tendons present in the shoulder.

Long Head Biceps Inflammation

The biceps muscle bifurcates into two tendons at the shoulder. The longer tendon extends over the top of the upper arm and connects to the top of the shoulder blade.

Suprascapular Neuropathy

Suprascapular neuropathy typically happens due to traction damage to the suprascapular nerve. This leads to a burning or aching pain behind as well as on the side of the shoulder joint.

Pec Major Tendon Inflammation

The Pectoralis Major tendon is quite weak in the area where it connects to the arm or humerus bone. This tendon can become swollen at this site. Racket players, throwers, rowers, swimmers, and weight trainers commonly experience this injury.

Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.

What is a Clavicle Fracture?

Posted on August 15, 2018 by Mark

A clavicle fracture (broken collarbone) also known as a fracture of the clavicle bone extends from the front part of the shoulder to the sternum (or breastbone) in the middle of the chest.

Thomas & Bigler Knee & Shoulder Institute, led by judicious board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in this region of the southwest.

Treatment for Clavicle Fracture

In case the patient suspects that they have a clavicle fracture, they must contact a doctor or seek medical help immediately. The doctor will order an x-ray to confirm the fracture.

The patient’s arm will be made immobile using a figure of eight bandages, collar, and cuff, or sling. The figure of eight bandage helps prevent shortening of the collarbone as it heals. This bandage is usually preferable to the sling.

The primary goal in the initial stages of the injury is pain relief. Therefore, the doctor typically prescribes pain meds for relief. Following a period of complete immobilization (one to two weeks), the patient’s arm should be delicately moved to prevent stiffness of the shoulder.

Shoulder flexion exercises to 90 degrees are particularly useful in preventing such stiffness. This involves moving the arm from its position on the side upwards horizontally.

The rehabilitation process will involve restoring the complete range of motion via mobility exercises and stretches and making sure that the strength is not impacted.

The injury may take four to six weeks to heal. The patient should not engage in any sports or even running until the injury has healed completely. However, the patient may still be able to undertake cycling on a stationary bike.

These types of fractures typically do not require surgery. Surgical intervention is more likely for open fractures (fractures where the bone goes through the skin) or if the bones do not fuse together after six weeks.

Surgical Treatment

Collarbone fracture surgery involves placing the broken fragments of the bone back in position and preventing them from moving out of place until the fracture has healed completely. This will enable the patient to improve strength in the shoulder once it heals.

A common surgery to treat collarbone fractures is the Open Reduction and Internal Fixation procedure. In this procedure, the surgeon will initially reposition or reduce the bone pieces into their natural alignment. After that, they will use special material hardware to hold the bone fragments in position. Some standard internal fixation techniques include the use of plates and screws.

The surgeon will attach special screws and metal plates to the outer surface of the bone to hold the bone pieces in place after they are reduced into their natural position.

After the surgery, the patient may experience a small patch of numb skin beneath the incision. This will resolve over time. The patient may be able to detect the presence of the plate through the skin.

Even after the collarbone heals, the screws and plates are typically left in place. But if the patient is uncomfortable, these may be removed.

At times, surgeons use pins to hold the bone fragments together once the ends are put back in their normal position. Cordial orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and other towns and cities in this part of southeastern Nevada.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Discussing AC Joint Sprain

Posted on August 8, 2018 by Mark

An AC joint separation, also known as an AC joint sprain, is an injury to the ligament that holds the acromioclavicular joint together on the upper part of the shoulder. It typically occurs due to a fall on an extended arm.

AC joint sprains can be classified as a very mild (grade 1) to a severe (grade 6) injury.

It is essential that the patient receives early treatment and support for this surgery to prevent problems in the long run or shoulder deformities.

Symptoms

The symptoms of this condition include pain at the end of the collarbone on the upper part of the shoulder. The pain may extend throughout the shoulder area initially. However, it can become localized to a hard point atop the shoulder later on.

What is an AC Joint Separation?

The AC joint is an acronym for the acromioclavicular joint. The separation of the two bones in this joint occurs due to injury to the ligaments joining them. It is also known as a shoulder separation injury. The acromioclavicular joint comprises the collar (clavicle) bone’s outer end and the acromion process of the shoulder (scapular) blade. The acromion refers to a bony process which projects forward from atop the scapular.

Commonly, the AC joint receives an injury due to landing on the elbow, shoulder, or an outstretched arm. When a person falls, they usually automatically outstretch their arm to break the fall. The force of the fall goes up the wrist and arm to the AC joint.

Treatment

The first aid for an AC joint injury is to apply the principles of PRICE, namely rest, ice, compression, and elevation. This involves the application of ice therapy and a compression wrap to the injured area immediately to address the pain and inflammation. The patient will need to wear a sling to ensure that the shoulder is immobile as well as to reduce the pain by taking the weight off the arm.

A doctor may prescribe anti-inflammatory meds such as ibuprofen to mitigate the pain and swelling. They will also diagnose the injury to ascertain its severity.

In case an injury to the AC joint is not adequately treated, it can cause a lump on top of the shoulder in the long-run. The doctor may use ultrasound for minor injuries. In more severe cases, they may use TENS for relief from pain.

AC Joint Taping

To assist with healing, AC joint taping should be used. This will fix the joint and support it into the right position. The joint may require taping for around two to three weeks.

Firstly, apply two or three 2.5 cm zinc oxide tape strips over the shoulder’s top covering the AC joint. This will offer an anchor for the support strip to connect to. In the next step, pass a support tape strip from the front part of the shoulder and down the side of the arm to apply tension to the tape.

Committed orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and other towns and cities in The Silver State.

Dislocated Shoulder Causes and Symptoms

Posted on July 22, 2018 by Mark

Dislocated Shoulder

A dislocated shoulder is a traumatic and painful injury, typically caused due to a fall or during contact sports. In a dislocated shoulder condition, the upper arm bone will move away from its normal position along with damage to the surrounding muscles, tendons and ligaments.

A shoulder dislocated requires prompt medical attention. A full rehabilitation program is essential if the athlete is to avoid re-injuring the shoulder. Profound, dedicated, and board certified orthopedic surgeons at the Bigler Knee & Shoulder Institute provide treatments for dislocated shoulder to patients in Las Vegas, Nevada, and surrounding communities.

Symptoms

The patient will experience sudden severe pain at the time of injury. Bruising and swelling will develop later. The patient may feel the shoulder is popping out of the joint and the injured side will often look different or slightly lower than the other side. The patient will typically avoid moving or turning the arm outwards. If any nerve or blood vessel damage has occurred, the patient may experience a sensation of pins and needles, numbness or discoloration through the arm to the hand.

Causes

A dislocated shoulder is often caused by a fall onto an outstretched arm, twisting or impact to the shoulder. The dislocation takes place when the head of the humerus bone pops out of the shoulder joint.

They are usually either posterior where the head of the upper arm bone or humerus dislocates out of the back of the joint or more commonly anterior where it pops out forwards. The large range of movement available in the shoulder joint makes it particularly vulnerable to injury.

Treatment

To protect the shoulder joint from further damage, once an injury occurs, the patient should not move the shoulder joint. If possible, the shoulder should be immobilized in a sling. Ice packs can be used to improve pain and swelling. Ice therapy can be repeated every hour initially.

Reduction

Reduction is a form of treatment that involves putting the dislocated humerus bone back into the joint. Reduction should only be performed by a fully trained medical professional. The orthopedic surgeon may seek an x-ray before reduction to rule out any small fractures. For active adults below the age of 30, reduction can be a very effective solution for shoulder dislocation.

Immobilization

The shoulder is typically immobilized in a sling in medial rotation with the arm across the body until the tissues have healed. Mobility and strength of the shoulder will be restored after a comprehensive rehab process. The shoulder may be immobilized in a string for a week following a reduction. In case of severe tissue damage, the duration of immobilization may be longer.

Surgery

If the shoulder dislocation recurs, or if the bones are fractured, the patient may require surgery. Surgery should ideally be performed as soon as possible after the injury. Several surgical techniques can be used to treat shoulder dislocation. The choice of technique will depend primarily on the patient’s lifestyle and activity.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide shoulder dislocation treatments to patients in Las Vegas, Nevada, and other cities and towns in The Battle Born State.

Rotator Cuff Strain / Tear

Posted on July 11, 2018 by Mark

Rotator Cuff Strain

A tear to any of the four rotator cuff muscles in the shoulder is called a rotator cuff strain or tear. The injury is common in throwing and racket sports, and may range from mild to severe. The job of the rotator cuff is to rotate the arm at the shoulder and provider support around the joint.

Treatment in case of rotator cuff tears will begin by reducing pain and inflammation, followed by a comprehensive rehabilitation program including mobility and specific exercises to strength the muscles. Salient, dependable, and board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for rotator cuff tears to patients in Las Vegas, Nevada and surrounding locations in this area of the southwest.

Symptoms

Symptoms of a rotator cuff tear will include sudden pain in the shoulder, which may be accompanied by a feeling of tearing. The pain may radiate down into the arm.

Signs of shoulder impingement may occur where the tendon pinches between the ball and socket of the shoulder joint when moving the arm out over head height. Pain may worsen over time and weakness in the shoulder may progress to a point where the patient is unable to lift the arm up to the side.

PRICE Therapy

The basic first aid for a rotator cuff tear in the muscle or tendon involves rest and application of PRICE principles – protection, rest, ice, compression, and elevation. Ice or cold therapy should be applied quickly to stop the swelling, inflammation and pain from worsening. The patient can use ice therapy for 10 minutes every hour, reducing it to three to four times a day as pain mitigates.

For more severe rotator cuff injuries, a sling can sometimes be more useful. Once the acute phase has passed, the patient can begin mobility and strengthening exercises as long as no pain occurs. If the PRICE efforts do not help to eliminate the pain and restore the shoulder movement, the patient will require professional medical treatment.

Orthopedic Treatment

To start with, an orthopedic surgeon may prescribe pain relief and anti-inflammatory drugs to address a rotator cuff tear. The surgeon may order imaging studies such as x-rays or MRI to determine the exact diagnosis and rule out a fracture. Some patients may have to receive a steroid injection directly into the site of the problem to help improve inflammation and enable the patient to proceed with rehabilitation.

Once the pain is eliminated, the surgeon will recommend a full rehabilitation program including stretching and strengthening exercises. Shoulder massage, including cross friction massage, to the rotator cuff tendon can break the injury down to its acute stage to allow correct healing of the injury to occur.

Range of motion and mobility exercises in the shoulder joint should start as soon as these can be performed without any pain. The first priority is pendulum exercises, particularly if it is a severe tear or following surgery. Stellar, committed, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas in this part of southeast Nevada for rotator cuff injury treatments and surgery.

Acute Shoulder Injuries

Posted on July 5, 2018 by Mark

Acute Shoulder Injuries An acute shoulder injury may occur due to sudden direct impact on the shoulder joint, overuse or overstretching of the shoulder muscle, tendon or ligament, or twisting of the shoulder joint.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provides acute shoulder treatments to patients in Las Vegas, Nevada and surrounding locations.

Typical Injury Occurrence

Acute shoulder injuries occur frequently due to a fall onto an outstretched arm or overstretching or overloading or through direct impact. Most often, the athlete will experience a sudden sharp pain along with discomfort and mobility loss.

At times, there will be inflammation and swelling. It is vital to treat acute shoulder injuries right away using the PRICE principles of immediate first aid. Ensure that you seek the advice of a medical professional in case of severe pain or you have any concerns about the condition.

Rotator Cuff Strain

A rotator cuff strain means a tear to any of the four rotator cuff muscles in the shoulder. This condition occurs commonly in patients participating in throwing and racket sports. Such tears can be categorized from mild to severe. The treatment initially focuses on the reduction of pain and swelling. After that, the patient undergoes a complete rehabilitation program which involves mobility and strengthening along with sports specific exercises.

Dislocated Shoulder

A dislocated shoulder refers to a traumatic and painful injury that frequently occurs due to a fall or contact sports.

The patient should seek immediate medical assistance. In this injury, the upper arm bone dislocates out of its regular position in the shoulder joint which results in major damage to the soft tissues. It is crucial for the athlete to undergo a complete rehabilitation program to prevent a re-injury to the shoulder.

AC Joint Sprain

An AC joint separation or sprain implies an injury to the ligaments that hold the acromioclavicular joint at the top of the shoulder. It typically occurs due to a fall onto an outstretched arm. Such injuries range from a very mild (Grade 1) to a very severe (Grade 6) injuries. It is important for the patient to seek immediate first aid and treatment to avoid deformity and problems in the long-run.

Clavical Fracture

A clavicle fracture or broken collarbone is also called a fracture of the clavicle bone. This bone runs along the front of the shoulder to the breastbone or sternum in the middle of the chest.

Such fractures result from a fall onto an outstretched arm or the shoulder itself. The primary symptom is pain along the collarbone. This pain may be very severe. There may be inflammation in the area along with a bony deformity which may be felt.

First-Aid Treatment

The P.R.I.C.E. therapy, which is based on the principles of protection, rest, ice, compression, and elevation, should be used in the treatment of all acute shoulder injuries. The patient should apply these principles at home, at least for the initial two to three days. These principles are as follows:

Protection – Protect the injury from any more damage.
Rest – Avoid using the arm or elbow.
Ice – Applying ice or cold therapy topically to the injury area can help in decreasing the pain and inflammation.
Compression – Using compression support for the arm or elbow may help decrease swelling.
Elevation – An upper arm sling can help in proper elevation.

Board certified plastic surgeons at the Thomas & Bigler Knee and Shoulder Institute receive patients from Las Vegas, Nevada and nearby areas for the treatment of acute shoulder injuries.

What is a deltoid contusion?

Posted on June 15, 2018 by Mark

What is a deltoid contusion? The deltoid muscle is a significant muscle on the shoulder, and it has three parts: the anterior, posterior and the middle. This muscle enables the arm to lift sideways.

The front portion facilitates in lifting the arm up forward which is known as shoulder flexion. The back portion allows the arm to lift up backward which is known as shoulder extension. In case the deltoid muscle suffers an injury or strain, it may lead to pain at the side, back or front of the shoulder.

A deltoid contusion refers to a bruise in the deltoid muscle which is located on the shoulder’s side. This condition results from a direct muscle impact, typically from a blunt object or someone’s elbow.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide deltoid contusion treatments to patients in Las Vegas, Nevada and other towns and suburbs in this region of the southwest.

Symptoms

The symptoms of a deltoid contusion may include:

Severe pain in the muscle after impact
Pain and discomfort when raising the arm to the side
Tenderness in the muscle
Bruising
Possible inflammation

Treatment

Grade 1 Deltoid Strain

The patient should apply ice therapy and compression wrap frequently for 15 minutes in one sitting, for the initial 24 hours post-injury. They should undertake light exercises as advised by the orthopedic surgeon to slowly regain weight and strength in the muscle. Ultrasound therapy or professional sports massage may help speed up the recovery.

Grade 2 Deltoid Strain

The patient should apply ice for 3 to 5 days. After that, they should apply heat using hot baths, hot water bottle or ultrasound therapy. The patient can consult a sports injury specialist for a comprehensive rehabilitation plan. After the initial week, the patient will need to undertake light, pain-free exercises.

The patient may also be advised to undertake cycling and stretching exercises. The patient may also consider receiving a sports massage from a sports therapist to expedite the recovery. They may slowly resume sports activities after a period of 2 weeks.

Grade 3 Deltoid Strain

In this case, the patient should immediately seek medical assistance and apply PRICE therapy. The patient can perform painless static contraction from the 2nd week. They can apply heat using a hot bath, hot water bottle, or ultrasound. The 3rd week can involve all these activities as well as an increase in the intensity of the static contraction.

Starting from the 4th week, the patient can undertake rotator cuff exercises and light lateral raises, stretching exercises and cycling are instructed by the surgeon.

The fifth week will involve building up exercises. After that, the patient may slowly start sports specific exercises. The patient will experience a speedier recovery if the surgeon or sports therapist uses sports massage, electrical stimulation or ultrasound.

In case traditional treatments are unable to provide adequate healing of the deltoid muscle, then the patient may require surgery. The patient should seek immediate medical attention if they suspect a grade 2 or 3 injury. Also check for neural symptoms such as numbness, tingling, and weakness in the hand or arm which may be an indication of nerve damage.

Thomas & Bigler Knee and Shoulder Institute, led by board-certified orthopedic surgeons, provides deltoid contusion fracture treatments to patients in Las Vegas, Nevada and other cities and neighborhoods in this area of the country.

Clavicle Fracture

Posted on June 10, 2018 by Mark

A clavicle fracture or broken collarbone, also known as a fracture of the clavicle bone, runs along the front of the shoulder to the breastbone or sternum in the middle of the chest.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide clavicle fracture treatments to patients in Las Vegas, Nevada and surrounding communities.

What is Clavicle?

The clavicle or collarbone refers to the bone that runs along the front of the shoulder to the breastbone or sternum at the front of the chest. It typically gets fractured because of a hard fall onto the shoulder itself or an outstretched arm or due to a collision with an adversary in a contact sport such as American Football or Rugby.

There is a higher possibility of injury if the playing surface is hard.

The bone typically fractures in its middle third. This condition is quite painful. The outer portion of the bone frequently gets pushed down with the inside portion displaced upwards.

In nearly 15 percent of injuries, a distal clavicle fracture occurs where the bone fractures nearer to the shoulder at the acromioclavicular joint. Such fractures have an extended recovery period and have a chance of nonunion.

Symptoms

This type of fracture typically occurs due to a fall onto an outstretched arm or the shoulder. The primary symptom of a clavicle fracture is a pain in the collarbone, which may be extreme. The patient may experience inflammation over the region, and a deformity of the bone may be felt.

The patient should seek immediate medical assistance if they suspect a broken collarbone. The surgeon will confirm the fracture using an x-ray. They will then immobilize the arm with a sling or collar, bandage, and cuff.

Surgical Treatment

A clavicle fracture surgery involves placing the broken bone fragments back into position and disallowing them from moving out till the fracture heals completely. After the patient recovers, this will help strengthen the shoulder.

Open Reduction and Internal Fixation is a standard surgery for the treatment of clavicle fractures. Firstly, the surgeon will reposition or reduce the fragments of the bone to their natural alignment. Subsequently, they will use special material hardware to ensure that the fragments of the bone are held in place. The Common internal fixation techniques involve plates and screws.

The surgeon attaches special screws and metal plates to the outer surface of the bone to hold the bone pieces in place after they are reduced into their normal alignment. After the surgery, the patient may experience a small patch of numb skin beneath the incision. This will become less noticeable after some time. It is possible that the patient may feel the plate from beneath the skin.

The plates and screws typically remain in their position even after recovery if the patient does not experience discomfort in the collarbone region. Sometimes the surgeon may use pins rather than plates to hold the fracture in place after the ends of the bone have been aligned.

Thomas & Bigler Knee and Shoulder Institute, led by board certified orthopedic surgeons, provides clavicle fracture treatments to patients in Las Vegas, Nevada and nearby areas.

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Las Vegas, NV 89117