Friday, February 10, 2017

The 3 Most Common Symptoms of a Torn Ankle Ligament (And What You Can Do About Them)

Almost all of us at some point in our lives have missed a stair, slipped on ice or just rolled our ankle and felt the pain of a sprained ankle.  When the ankle is over rotated, the ligaments of the ankle can become stretched which is what causes the pain and swelling associated with an ankle sprain.  However, many people are unsure of the severity of the sprain and if their has been damage to the ligament.  Therefore, it is very important to understand that a sprained ligament and a torn ligament are not the same thing.

Sprained ligaments are ligaments that have been abnormally stretched. Ankle sprains classified as mild to moderate indicate sprained ligaments.

Torn ligaments are those that have been partially or fully torn. It’s confusing, but ankle sprains that are classified as moderate to severe indicate that ligaments have been torn—a serious injury.

The three most common signs of torn ligaments are:

1.     Pain. The first symptom is pain immediately following the injury. The amount of pain alone is not always enough to diagnose a tear, but it’s a clear-cut sign that a tear might have occurred. If a person has experienced an ankle injury in the past, they can compare pain levels to get a feel for how severe their current injury is.

2.     Swelling and bruising. Because the foot and ankle bear most of the body’s weight, swelling and bruising always occur following an injury. The degree to which swelling and bruising occur depends on the individual and severity of the injury.

3.     Instability. A surefire way to tell if a ligament has been torn is to assess the degree of instability. Severe lack of stability, balance, and ability to bear weight are often signs that a ligament has been torn.

If you have any of the symptoms above, it is best to seek the expertise of an orthopedic specialist to determine the severity of the injury develop an appropriate treatment plan.   In most cases, these injuries can be managed with rest and the use of a temporary brace.  When these injuries are not treated properly, they can lead to further damage to the ligament and possibly require surgical correction.

At Advanced Bone and Joint, Dr. Anthony Lombardo leads our Foot and Ankle Team.  Dr. Lombardo is board certified by the American Board of Podiatric Surgery and is a fellow of the American College of Foot and Ankle Surgeons. He has over 20 years of experience in treating all forms of foot and ankle conditions and has offices in both St. Peters and O'Fallon.

What Are Vertebral Compression Fractures and How Are They Treated?

As we age, back pain can be attributed to many different causes.  One of the most common, and painful, is what are known as “vertebral compression fractures”.    Although the cause for these compression fractures is not limited to aging, it is most common in those 60 and over.  These fractures occur as the vertebrae weaken over time through osteoporosis or other bone related conditions.

When the vertebrae are weakened, even the act of sneezing and coughing can be enough to create small hairline fractures in the spinal column.  Because these compression fractures will typically occur on the front side of the vertebra, it can cause you to lose height and/or develop a hunched back, otherwise known as kyphosis.  As the vertebrae become weaker they are no longer able to provide a normal level of stability to the spine and this can eventually lead to the collapse of one or more vertebrae.   

In many cases, the symptoms begin as a simple backache, however, the pain can become more severe and limit the ability to carry out normal daily activities such as cooking or showering.  Initially your health care provider may have you try more conservative treatment such as rest, pain medication, or bracing.  Often times these treatments do not provide pain control, allow for return of normal function, or are associated with significant side effects (nausea, vomiting, grogginess, increased risk of falling).  Left to heal on their own, most people will experience a moderate level of pain or discomfort for several months.

Kyphoplasty - a simple, minimally invasive surgical option - can be considered if the conservative care is not relieving the pain.   This 30-60 minute procedure works to stabilize the fracture and reduce pain.  A small needle is advanced into the fracture, guided by x-ray.  Medical cement is then injected and once this hardens it keeps the fractured bones from shifting and causing pain.  No incision is necessary and most often pain relief is immediate.  The procedure can be completed in ambulatory or outpatient setting without need for general anesthesia or admission to the hospital.

I have completed hundreds of these procedures with excellent results.  I also work with each patient to decide on what treatments are best for them.  Every patient and fracture is unique and it should be handled that way. 

If interested in further discussing non-surgical back care, please contact me for an appointment at 636.441.3444.

Pain Management Physician

Tuesday, January 17, 2017

Understanding Achilles Tendonitis and How to Treat It

Achilles tendonitis is the inflammation of the achilles tendon due to overuse or injury and is common in athletes especially runners or those who play sports during the weekends or infrequently.    It normally develops after abrupt changes in training, training on uneven surfaces and using worn or poorly fitted shoes. If left untreated, this could lead to degeneration of the tendon.

The most common cause is overuse of the foot or excessive stress transmitted to the tendon. Too much stress will lead to micro-injury of the tendon fibers and, if not given proper time to heal, the body is not able to repair the tendon before it is injured again.

Managing Achilles Tendonitis with Conservative Managements

Mild cases of achilles tendonitis usually respond to over the counter pain medications and resting the tendon so that it may heal.

On the other hand, if the pain is chronic, Physical Therapy is often used.  A Physical Therapist will teach patient how to stretch the calf muscle and Achilles tendon to avoid injury. Strengthening of the calf muscle as well as the ankle and foot is also necessary to stabilize the ankle. Additional strengthening exercise include heel lifts and eccentric strengthening.

Physical Therapy program can also be combined with different forms of ultrasound therapy or steroid injections by a physician.

In addition, correct footwear must be worn like shoes that are softer over and under the heel.

Surgery is a rare treatment for achilles tendinitis and is only performed when the tendon is already ruptured. Surgical options include gastrocnemius recession, debridement and repair and debridement with tendon transfer. The type of surgery to be performed depends on the location of injury and the amount of tendon damage.

The most important factor to expedite healing the tendon is to seek the advise of an orthopedic or foot specialist so that treatment can begin before the damage worsens.

At Advanced Bone & Joint, our team specializes in muscle, bone and joint injuries - including sports injuries and overuse injuries. Contact us today to schedule a consult with one of our Orthopedic Specialists! We have offices in St. Peters and O'Fallon, MO.