Author Archives: Peter Sweeney

ACL Injuries: One of the most common knee injuries

The term ACL stands for anterior cruciate ligament. This is the location of one of the most common knee injuries.

The ACL is among the tissue bands that hold the bones in your knee together, which also provide stability to your knee. There are many ways that you can tear or stretch your ACL. It could be a sudden movement. It could also be because of a sharp or quick turn when you are jumping or running.

More often than not, an ACL injury can be very painful. When your ACL is injured you would find it hard to walk or put any pressure on your leg.

First aid

The most appropriate treatment for an ACL injury will depend on a number of factors, including how severe the injury is. There are a number of treatment options that your doctor might suggest. The most basic option is part of First Aid. This is sufficient only when you have suffered a minor injury. The First Aid will involve putting ice on your knee, staying off your feet for a certain period of time, as well as keeping your leg raised. You can also wrap your knee with an ace bandage to help reduce the swelling. You may also use crutches in order to keep the weight from your knee.

Medicines

Normally anti-inflammatory medicines are prescribed by the doctors. Their main purpose is to reduce the pain and swelling. In some cases, she or he may prescribe stronger medicines. If you have excessive pain, your doctor may inject steroid medicines in your knee.

Knee brace

If your ACL has been damaged you may have to wear a knee brace. This is especially for when you are running or taking part in any sporting activity. It provides the additional support that you need for these activities.

Physical therapy

In some cases of ACL injury, you would need physiotherapy a few days in a week. This would help your knee get back in working order. During these sessions you would be doing exercises that make the muscles that surround your knee stronger. They would help you get back the full range of motion as well. You would be shown the exercises with the expectation that you would also do them at home.  

Surgery: Surgery is very much a last resort. However, it is normally needed where your ACL has been torn so badly that nothing else can be done. Surgery to correct an ACL tear is pretty common among athletes. However, you may also have to get surgery done on your ACL if it gives away when you are walking. This would essentially involve the removal of the damaged ACL. It would be replaced with tissue that would help a new ligament grow in its stead. If you undergo physical therapy after surgery you should be fully fit to play professional sports 12 months after the surgery.


Conditions That Cause Back Pain

It is said that prevention is always better than a cure. This often applies for conditions that cause back pain.

Core Strengthening or Flexibility Exercises

One of the best ways to prevent back pain is through exercise.

When you exercise on a regular basis it helps make you stronger and it is easier to control your body weight. Low-impact aerobic exercises can make your heart healthier and at the same time without minimal pressure on or chance of injuring the back or spine. However, before you get started with an exercise programme you should talk to a doctor or an expert first.

Broadly, there are two kinds of exercises that you can do – core-strengthening exercises and flexibility exercises. Core-strengthening works on your back and abdominal muscles. These muscles become stronger and protect your back. Flexibility training will make your core a lot more flexible, along with your lower and upper limbs.

Diet

Diet is also an important part of the process of preventing back pain. Make sure that there are sufficient amounts of vitamin D and calcium in your diet, as these are needed for your bones to be healthy. When your diet is healthy it would have a positive effect on your weight.

Smoking

It has normally been seen that a lot of people who smoke on a regular basis suffer from back pain as well. This is in comparison to people who do not smoke in the same age group and have the same height and weight.

Body weight

The weight you carry and the place you carry it are also rather important factors in this particular regard. It can decide whether you develop back pain or not. Obese people are normally at far greater risk of developing back pain compared to people who have a normal weight. The same is also applicable for people who have more weight on their abdomen compared to their butts and hips.

Standing posture

When you are standing you need to make sure that your pelvic position is a natural one. You should stand upright and your head should be facing forward. Your back should be straight and your weight should be balanced in an even manner on both feet.

Your head should be in line with your spine and your legs should be straight.

Seating posture

When you choose a seat for work, choose one that provides good support to your back. It should provide you proper arm rest as well as a swivel base. When you are sitting you should keep your hips and knees level. Your feet should also stay flat on the floor. You can also use a footstool if you want. Ideally, you should be able to sit in an upright position. The small of your back should have all the support that you need in this case.     


The HyProCure Procedure

The HyProCure Procedure is a permanent surgical solution for your flat feet fixing an implant into the area of the feet known as the Sinus Tarsi. The Sinus Tarsus is a space that occurs naturally between your heel bones and the ankle bones. If your feet are aligned properly your sinus tarsi would always be in an open position. If your feet are not aligned properly it would collapse when you put weight on your feet. This means that simple actions such as walking, jumping, and running would be bad for your sinus tarsi and, by extension, your feet. In spite of this condition being so common, it is undertreated.

This is a common problem

It is seen among people of all ages across the world. Our feet are the very foundation on which our bodies depend for support. Even if one foot is aligned the wrong way it can have a bad effect on the upper parts of your body, such as knees, back, and hips. It could cause a lot of other side effects or symptoms.

The solution

HyProCure is fundamentally a titanium stent that is placed in your sinus tarsi in order to make sure that the area does not collapse.

This in turn means that your ankle bone is stabilized. One of the greatest aspects of this process is that it is minimally invasive. The procedure can be performed under local anesthesia and will stabilise the foot. This also allows a normal range of motion at the joint. This way, the overall alignment and balance of your feet and ankle are improved. The arch of your foot would appear to be normal as well. In fact, most patients treated with this procedure start to walk normally within a few weeks.

After the treatment, over a number of months the bones, ligaments, and tendons all across your foot and the entire body continue to adapt to this improved position.

A few quick facts about HyProCure

FDA (Food and Drug Administration) of the USA (United States of America) cleared this particular procedure back in 2004. It is an evidence based procedure. Foot and ankle surgeons in more than 40 countries around the world use this particular procedure.

Patients include both adults and children who have various levels of activity. The HyProCure implant is made from titanium and this means it would never set off metal detectors. This means that you would be able to take CT (computed tomography) scans and MRI (magnetic resonance imaging) tests without any problem whatsoever.

Conclusion There are certain situations where HyProCure could be just what the doctor ordered. Apart from misaligned feet if you have pain in your heels, hammertoes, and bunions, the HyProCure procedure could be the answer.


Finding a Bone Specialist

It is important to have trust and confidence in those who care for your health. For this reason diligence is required when identifying a specialist to advise on or treat a bone condition. There are many steps in this process, the most important of which are outlined below.

Seek Recommendations for a Bone Specialist

You can always get started by asking your main general doctor for a referral. You may also get a good recommendation from other healthcare professionals, family members and friends. It is important that you do some research on your own. Look up the credentials of the doctor as well as her or his experience. There are plenty of websites from which you can get some great information.

Researching the Credentials of the Doctor

One of the first things that you need to check is proper certification. Your chosen doctor needs to have been certified by an appropriate authority. When a doctor is certified it means that she or he has the right training, experience and skills needed to treat you. This means that they would be able to cure the problem that you may be facing right now. You should also make sure that the doctor you have chosen has never been penalized for malpractice.

Consider Her or His Experience

Experience is also a vital factor when it comes to choosing such doctors. There is often a correlation between a doctors experience and the level of benefit they can provide to a patient. You can always ask the doctor how many people with your condition she or he has treated already. In case you already know that you need a certain procedure you can ask the doctor how many such procedures has she or he performed earlier.

Consider the gender

It may be necessary to ensure you are at ease with the gender of your bone specialist. This is because you might have to discuss personal information openly with her or him and you may not be comfortable in doing so with someone from another gender. In this context you can also ask them about the recent training that they may have had with respect to your gender and the condition that you are suffering from. You may also ask her or him about her or his experience in this particular regard.

Conclusion : In the end you need to look up the quality of the healthcare facility where your treatment would be done. This is because you need the best and you cannot really compromise. Normally people who have been treated at highly rated healthcare facilities have fewer complications and their survival rates are a lot better. You must also take into account the location of the hospital. Quite often, after a procedure you may have to visit the facility frequently for follow ups and rehabilitative care. As such, the location needs to be a consistent one as well.


The Impact of Leg Length Discrepancies on Health

When there is a difference in the length of the legs, it is called a leg length discrepancy. If the difference is large enough it will effect the way a person uses these limbs. When a discrepancy is present from birth, the parents may notice an effect on the way a child walks and at times there is a noticeable limp.

Common Causes of Leg Length Discrepancies

A limb length difference is normal and present in all of us. This is because of the difference between the two sides of the body. The tibia and femur are the bones involved in this difference. Growth plates are located between the widened parts of the shaft and end of the bone. When the growth plate gets damaged the bone will have an increased (or decreased) growth rate compared to the one at the other end.

The most usual cause is an injury that heals with the bone in a shortened position. This will lead to the shortening of the bone. For children, the broken bone might grow faster for many years. This will make the bone longer than the one on the other leg. Most children with thighbone fractures have this condition. The bone may be broken in many places leading to a shortening of the leg. Another cause may be a bone infection in growing children. Bone diseases can cause leg length discrepancies including neurofibromatosis, Ollier disease, and multiple hereditary exostoses. Neurological conditions could also contribute to this ailment. Conditions that cause inflammation in the joints, such as juvenile arthritis, could also be a reason.

Symptoms of the condition

The difference in the lengths of the leg is not too much for most of us. Those who have A 3-4% difference will limp noticeably. Since they can only walk with an effort, they tire easily. They are likely to have lower back pain. They are also susceptible to injury.

Physical Examination and Diagnosis of a Leg Length Discrepancy

A physical check will reveal the difference. The complete examination by the doctor will involve many tests, including:

Gait analysis: The way the person walks and sits will show any leg length discrepancy. Children will walk on their toes or flex their knees to compensate for the difference in lengths. The doctor will usually measure the discrepancy. He will place a block under one leg. If the person can stand straight then he measures the size of this block.  

Imaging studies: Another way to know and measure this discrepancy is to do imaging tests. X-ray studies show the images of the bones. The actual measurement of the lengths on this will show the discrepancy.  Scanograms use a special type of X-ray with three images along with a ruler to measure the length of the bones.

Computerised tomography tests: This gives a detailed image of the bone and soft tissues of the leg. The doctor will recommend a variety of treatments depending on the size of the discrepancy. Some of them are nonsurgical while others might involve surgery.


Key Facts about Hip Joint Replacement

Hip Replacement is a common operation and is often recommended to treat osteoarthritis and for people aged between 60 to 80. The procedure is also known as an Arthroplasty. In England and Wales each year around 80,000 total hip replacement procedures are performed. Hip replacement surgery has changed greatly over time because of advancements made in surgical technologies and techniques. Below are answer to some of the key questions patients have regarding Hip Replacement surgery.

What is a total hip replacement?

A Total Hip Replacement can be described as a surgical procedure whereby the damaged and diseased parts of a hip joint are removed and then replaced with artificial and new parts. The hip joint is basically located at the meeting of the hip bone and the upper end of the thigh bone. The thigh bone normally has a ball at the end and it usually fits in the socket in the hip bone. This is what allows the joint to perform such a wide array of movements.

What happens during a total hip replacement operation?

Normally hip replacement surgery takes around 60 to 90 minutes to complete. It can be carried out by using an epidural anaesthetic – one where the lower body becomes numb – or a general anaesthetic – one where you are sleeping even as the procedure is being performed. After your anaesthesia has been administered your surgeon would normally make an incision at the side of your hip in order to remove the damaged ball and socket and replace it with new ones, called a prosthesis. The prosthesis can be made from plastic, ceramic, or metals, and used in various combinations.

Who should get a hip replacement done?

If you have any damage or disease in your hip joint, this might be a reason for undergoing a hip replacement. The same also goes for people who suffer from persistent pain in the area that does not let them perform their daily activities. An Orthopaedic Surgeon would be able to tell you if you need surgery or not and if there is any other way in which your pain could be reduced.

Osteoarthritis

There are certain conditions where you need a hip replacement. The most prominent among these is osteoarthritis. It is also referred to as wear and tear arthritis. In this case the cartilage – a flexible and tough tissue that plays the roles of mould and shock absorber – within your hip joint becomes worn away. This in turn causes your bones to rub against each other.


Health Factors to Consider Before Running an Ultramarathon

Before you decide to run an Ultramarathon, you need to know how it could affect your health. There are a range of health consequences related to this activity, ranging from cuts, bruises and blisters to full on hallucinations. Below are some of the key health issues to be aware of and take steps to prevent these when both training for and running an Ultramarathon.

Temporarily blurred vision

Ultramarathons last considerably longer than a traditional marathon. There is a chance that your cornea could swell and this could lead to your vision becoming significantly blurred during the run.

Bites and stings from insects

Ultramarathons are an outdoor sports and bites and stings from insects can be common place, depending on weather and climate.

Cuts and bruises

Normally ultramarathons are conducted on uneven terrains and this means that there is a heightened chance you could fall and hurt yourself. This is rarely serious and is more likely to take the form of cuts and bruises, as opposed to breaks or fractures.

Heart issues

It is rare to experience heart issues as a result of marathons and this is because when you run your circulatory system and heart are kept in good health.

However, a number of studies also indicate that runners who cover long distances have a higher risk of atrial fibrillation. At a basic level, this is a problem where your heartbeat becomes abnormal. Other research has also proved that you may have to contend with temporary cardiac dysfunction following such a long run. This is especially true for participants who have had the least amount of training prior to the run.

Respiratory issues

In 2014 a study was done among ultrarunners where it was found that many suffer from respiratory diseases. This may be attributed to the flora and dust that is common on the trails where such events are conducted.

Exercise related hyponatremia

As a long-distance runner, you should be aware of this, as it is a potentially deadly condition. Hyponatremia involves the sodium of your body becoming diluted by drinking an excessive amount of sports drinks or water. This way the cells can swell and burst, leading to your death.

Hypothermia

This is a condition where your body temperature drops too low. This happens because in an ultramarathon it is natural for your energy stores to be depleted and the weather conditions tend to change. In fact, in marathons like these, heat illness is rather common as well. This is because of the intense effort required to complete an Ultramarathon.

Gastrointestinal issues

People who run normal marathons burn more carbs and they need only gels and sports drinks in order to get by. Ultrarunners burn a higher amount of fat and this is why they need proper food. An Ultramarathon runner has to deal with more gastrointestinal issues. Apart from these they suffer from issues such as muscle cramps, stress fractures, and blisters.


Open MRIs for Claustrophobic Patients

In general, MRI (Magnetic Resonance Imaging) is a medical imaging examination where a strong magnetic field is used in conjunction with radio waves in order to get detailed information about the tissues and organs in your body. In an MRI, radiation or x-rays are not used. Normal MRI’s often look similar to a cylinder that covers the entire body and while the scan is taking place a patient may hear loud noises.

Open MRIs are normally used in order to help make space for claustrophobic, pediatric, and obese patients. It would be open either on 2 or 3 sides. In an open MRI you have a more relaxed and less confined environment. The noise levels of Open MRI’s are on the lower side as well and altogether this is a lot less stressful environment for patients.

Preparing for an Open MRI

You should follow all the instructions that your healthcare provider has given you. An MRI is a process where radio waves and a strong magnetic field are used in order to get detailed internal pictures of you body. Due to this there are detailed metal safety checklists, as metallic implants or objects taken inside an MRI can be dangerous.

Make sure that they do not have any metal fasteners on them such as zippers, snaps, and buttons. You should also let the authorities at the facility where you would get your MRI done know if you have a glucose monitor or an insulin pump. The imaging devices may lead to these devices not functioning the way that they should.

How long will the exam take?

These exams normally take between 15 and 20 minutes.

What happens during these exams?

At first you may be asked to change to a robe or gown. This depends on the kind of MRI exam that would be done on you. You would also have to remove the following:

  • jewellery
  • watches
  • hair clips
  • piercings
  • dentures

In short, you would have to leave all items that contain metal such as your cards that come with magnetic strips. They can be stored in lockers outside the room where the MRI would be done. The MRI scanners are usually operated by radiologists or radiographers who are highly trained to conduct and interpret MRI results.


Musculoskeletal Disorders – An Umbrella Term

The expression ‘Musculoskeletal Disorder’, or MSD, is an umbrella term. It encompasses a number of conditions that affect the musculoskeletal system, which is made up of the following:

  • joints
  • muscles
  • tendons
  • ligaments
  • nerves
  • blood vessels

In these cases, the affected areas experience the following issues:

  • pain
  • tingling sensation
  • numbness
  • loss of strength
  • limited range of motion

These symptoms often occur because the musculoskeletal system undergoes excessive stress. For example, it is common to feel neck pain when you have worked too long in front of a screen.

However, Musculoskeletal Disorders can take many forms. A Musculoskeletal Specialist is able to assist with conditions that affect the musculoskeletal system.

Who is affected by Musculoskeletal Disorders?

Professionals who work for long hours normally suffer the most from Musculoskeletal Disorders. In fact, in Europe anywhere between 40 and 60 percent of workers report an MSD. However, the specific kind of condition that they suffer from depends a lot on the work that they do. In some cases these conditions are caused by work and in others work can exacerbate an existing condition.

Many MSD’s are age-related. An example of an age-related condition would be osteoarthritis.

Accidents can also lead to an MSD.

Musculoskeletal Disorders and load bearing

The WHO (World Health Organization) says that MSD’s occur when a particular part of the body attempts to bear more load than it can carry. Such activities are common. The only way to alleviate the strain of overloading is rest, which allows your body tissues to heal.

Conclusion

Musculoskeletal Disorders can be prevented by keeping in good shape and not overloading from bodies. Having good work environments and learning how to keep your body healthy while undertaking repetitive or strenuous tasks is an important first step. Once an MSD occurs, it is advisable to have a Musculoskeletal Specialist treat it swiftly.


How Has Regenerative Medicine Been A Game Changer?

Since its rise to prominence a few years ago, Regenerative Medicines have been something of a game changer in the domain of health and wellness. The available treatments have grown at an exponential rate and it is highly likely that in the days to come they will have resounding impact on the way musculoskeletal disorders are treated.

Why is this so?

There is a good reason why this is happening. If the discipline of regenerative medicine reaches its complete potential it would be able to replace, regenerate, or re-engineer human cells, organs, and tissues. This would change current treatment practice, as it would attack the root cause of a particular condition or disease and restore the affected area to its normal levels of functionality. This would also mean that you would not have to undergo any long-term medical treatment or regime to cure any disease. Regenerative Medicine could therefore replace many surgical treatments or speed up recovery from acute injury.

What is Regenerative Medicine?

Regenerative Medicine can be regarded as a collaborative effort between various branches of medicine, including biology, engineering, chemistry, and physical sciences. They have all played fundamental roles in this field.

The industry is made up principally of the following components:

  • cell based therapies
  • gene therapy
  • biologics and small molecules
  • tissue engineering – synthetic materials, scaffolds, and biomaterials
  • stem cells for discovering drugs, disease modeling, and toxicity testing
  • biobanking

Cell based therapies are the most widely accessible forms of treatment for musculoskeletal issues. These are in the form of:

  1. Platelet Rich Plasma (PRP) Therapy
  1. Adipose Tissue Regenerative Medicine

Both of these forms of treatment make use of the patient’s own cells to promote healing of injury.

What are the Benefits of Regenerative Medicine?

Regenerative Medicine has a number of benefits, including:

  • No foreign substances
  • An effective alternative to surgery
  • Natural healing without the need for long term medication
  • Minimally invasive treatment without any scarring

Appointments & Enquiries

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Testimonials

Back on the dance floor

Mr Kaser Nazir was my second opinion foot specialist after not being happy with the "verdict on my future before". I had a plantar plate injury. For a full time professional dancer teacher this was devastating. After meeting Mr Nazir I felt instantly reassured and I knew this is all going to be good. He Continue Reading

Monika Molnar

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Recent Posts: London Musculoskeletal Centre | Orthopedic & Sports Medicine

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