Instability and intra-articular joint pathology may commonly occur in the elbow or shoulder. The condition should be treated early to prevent long-term damage and restore normal function and relief from pain.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide treatments for the elbow and shoulder instability to patients in Las Vegas, Nevada, and surrounding locations.

Instability of the Elbow

The elbow may be injured in certain sports or other activities to the point of damage to its cartilage or ligaments. Ligament injuries to the elbow may occur due to twisting injury, a one-time strain, or from repetitive motions that cause cumulative injury. Instability can then lead to painful and abnormal function of the elbow.

Injuries to the elbow may also result in loose cartilage or combining of the cartilage and bone pieces that make the joint motion painful or unstable. Treatment will begin with establishing of a correct diagnosis and determining the cause of the condition. This will involve a physical exam, x-ray and MRIs, and in a few cases, an arthroscopic exam.

Once the correct diagnosis is affirmed, the treatment provider will recommend a customized treatment plan depending on the severity of the condition. This may range from something as simple as balancing and muscle strengthening exercises to invasive procedures such as surgical ligament repair or arthroscopic debridement, or both.

Instability of the Shoulder

Shoulder instability may occur when the head of the upper arm bone is forced out of the shoulder socket. Overuse or a sudden injury may lead to this occurrence. Once the shoulder dislocation has occurred, it will become vulnerable to repeat episodes. If the shoulder becomes loose and repeatedly slips out of place, it is known as chronic shoulder instability.

Shoulder Dislocation

Trauma or severe injury is usually the cause of an initial shoulder dislocation. Once the head of the humerus is dislocated, the socket bone and the ligaments in the front of the shoulder are often damaged. The cartilage rim around the edge of the glenoid may also tear. A severe first dislocation may lead to repeated dislocations, giving a feeling of instability.

Repetitive Strain

In some cases, the shoulder instability may never result in a dislocation. Such patients will have loose ligaments in their shoulders. This increased looseness is sometimes a part of their normal anatomy, but in some cases, it results from repetitive overhead motion. Certain sports activities require repetitive overhead motion, which can stretch out the shoulder ligaments. Some jobs may also involve repetitive overhead work.

Loose ligaments can make it difficult to maintain shoulder stability. A weakened shoulder is challenged due to repetitive or stressful activities, resulting in an unstable, painful shoulder. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas for elbow and shoulder instability treatments.

Multidirectional Instability

In exceptional cases, the shoulder may become unstable without a history of repetitive strain or injury. These patients have naturally loose ligaments throughout the body and may be “double jointed.”

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. call (702) 933-9393; Physical Therapy (702) 933-9394

Tendonitis condition can quickly deteriorate if left untreated. Therefore, once the patient experiences any symptoms, they should consult with a medical professional. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide treatments for tendonitis to patients in Las Vegas, Nevada, and surrounding locations.

Symptoms

Tendonitis usually causes pain in the tissues surrounding a joint, particularly when the joint has been overused during play or work. In a few cases, the joint may feel weak, and the area may become warm, red and swollen. In rare cases, tendonitis may occur due to an infection, which can have symptoms such as rashes or fever.

Other symptoms will vary depending on which tendon has been affected:

Rotator Cuff Tendonitis

This is usually marked by dull, aching shoulder pain that is not limited to just one location. It typically radiates into the upper arm toward the chest. The pain may worsen at night and cause disturbance in sleep.

Tennis Elbow

The main symptom of this condition is pain in the outer side of the elbow. In a few cases, the pain may extend down to the forearm and wrist.

Golfer’s Elbow

This is primarily marked by pain in the inner side of the elbow.

Jumper’s Knee

Pain in this case will usually be felt below the kneecap, but in a few cases, may be felt above it.

De Quervain’s Disease

The patient will experience pain at the back of the wrist, near the base of the thumb.

Achilles Tendonitis

In this case, the pain will commonly occur at the back of the heel, or two to four inches above the heel.

Areas Affected by Tendonitis

Shoulder

Tendonitis in the shoulder often occurs in the form of rotator cuff tendonitis. This involves the tendon of the supraspinatus muscle, which is attached to the upper part of the humerus at the shoulder joint. Other tendons of the rotator cuff are less commonly affected.

People who are typically at risk include tennis players, baseball players, swimmers, carpenters, welders and painters. The shoulder pain will occur on the same side as the dominant hand of the patient.

Elbow

Tennis elbow and golfer’s elbow are two forms of tendonitis that occur in the elbow. Both are overuse injuries commonly occurring among athletes who play throwing and racquet sports. Tennis elbow causes pain on the outer side of the elbow joint. Golfer’s elbow causes pain on the inner side of the elbow.

Knee

Jumper’s knee is a common form of knee tendonitis, which is a common overuse injury among distance runners and basketball players.

Wrist

Wrist tendonitis often occurs in the form of de Quervain’s disease, a condition that causes pain in the back of the wrist at the base of the thumb.

Achilles Tendon

Achilles tendonitis is generally caused due to overuse, particularly in sports that involve running or repeated jumping. It may also be related to poorly fitting shoes or faulty running technique.

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

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. call (702) 933-9393; Physical Therapy (702) 933-9394

The condition of tendonitis should be treated early in order to prevent additional damage. Early treatment will avoid more complex solutions such as surgical repair, and the patient will be able to quickly regain their flexibility and strength. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide tendonitis treatments to patients in Las Vegas, Nevada, and surrounding locations.

First Line of Treatment

The surgeon may first advise the patient to use ice packs over the painful area 15 to 20 minutes, three to four times a day. Ice should also be applied immediately after any activity that aggravates the pain. Ibuprofen, aspirin, or another anti-inflammatory drug may be prescribed for a few weeks to provide relief from pain and swelling.

The patient will be required to give rest to the affected area for a few days to a few weeks to enable the body to repair itself. For instance, a patient with a golfer’s elbow will typically need to rest the painful elbow for at least four weeks. Antibiotics may be prescribed if the tendonitis has occurred due to an infection.

Depending on the severity and location of tendonitis, the patient may require temporary bracing, splinting, or a sling. In any case, they will be advised to regularly and gently move the joint to keep it flexible and avoid a frozen joint. This is especially important for shoulder tendonitis.

Treatment for Serious Tendonitis

For more serious conditions of non-infectious tendonitis, the surgeon may inject a local anesthetic or a corticosteroid drug into the affected tendon. They may also refer the patient to a physical therapist for more focused, localized treatments. These may include friction massage, water therapy or deep heat treatments involving ultrasound to increase joint mobility.

The treatment provider will also help the patient through a rehabilitation program that will enable them to regain function, motion, and strength. The length of the program will vary according to the severity and type of tendonitis. For instance, tennis elbow and Achilles tendonitis may require several months of treatment.

Surgical repair may be required only in rare cases of tendonitis. If the patient’s condition does not improve or fails to respond to other types of treatment, or when significant tendon damage has occurred that is unlikely to improve with less invasive treatments, the treatment provider may recommend surgery.

Hot and Cold Therapy

In less serious cases of tendonitis, the treatment provider may recommend hot and cold therapy as a part of the treatment regimen. A cold compress can help mitigate the initial pain and swelling. Cold therapy is typically most useful when it is applied within the first 48 hours after injury or overuse, or when the swelling just begins to appear.

After the first 48 hours, or for cases of long term or chronic pain, dry or moist heat therapy, such as a warm bath, may be more effective than cold compresses. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and other communities in the region for tendonitis treatments.

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. call (702) 933-9393; Physical Therapy (702) 933-9394

Tendonitis is mostly an inflammation or irritation of the tendon. Tendons are thick, ropelike cords that attach the muscles to the bones. Tendons perform the role of a pulley to help muscles move a joint. Tendonitis typically affects the biceps, shoulders, hands, wrists, thumbs, and calves.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide safe, prove and effective treatments for various forms of tendonitis. Patients in Las Vegas, Nevada, and surrounding locations have an opportunity to receive these treatments from Dr. Thomas and Dr. Bigler.

Common Causes     

Tendonitis is most commonly caused due to sports related injuries or repetitive movements. Sports activities typically involve repetition of a particular movement each time. Certain types of jobs of hobbies also involve repetitive motions, which places stress on the tendons needed to perform those activities. In a few cases, tendonitis may occur due to a sudden injury.

Therefore, when performing repetitive job related activities or play a sport that involves repetitive movements, it is especially important to use the proper techniques. Improper techniques can result in overload on the tendon, which may eventually lead to tendonitis. Appropriate physical exercises can also help to prevent the occurrence of tendonitis in people who engage in sports or jobs involving repetitive movements.

Other Causes

Tendonitis may also be caused in a few cases due to one or more of the following reasons:

• Poor walking habits
• Bad posture while sitting or standing
• Some types of arthritis and related conditions
• Conditions related to metabolism, such as diabetes
• Stress on soft tissues from a poorly positioned or abnormal bone or joint, such as leg length differences or joint deformities
• Side effects from certain types of antibiotics

Patients in Las Vegas, Nevada and nearby areas have an opportunity to receive cutting edge procedures for the treatment of tendonitis from board certified orthopedic surgeons Dr. Thomas and Dr. Bigler. They will carefully evaluate the causes behind the occurrence of the condition and then suggest a customized treatment approach.

Risk Factors

Risk factors for developing tendonitis include age, participating in certain types of sports, and working in particular jobs.

Age

The tendons will become stiffer as a person gets older, which will make them more vulnerable to injuries.

Occupations

If a person’s job involves one or more of the following attributes, they are more likely to be affected by tendonitis:

• Repetitive motions
• Awkward positions
• Frequent overhead reaching
• Vibration
• Forceful exertion
• Sports

Certain types of sports activities involving repetitive motions increase the risk of developing tendonitis, particularly when the technique is not optimal. This may occur with:

• Tennis
• Golf
• Running
• Baseball
• Basketball
• Bowling
• Swimming
• Riding a bicycle

In absence of timely treatment, tendonitis can increase the risk of tendon rupture, which is a more serious condition and may require surgical repair. If the condition remains untreated for several weeks or months, it may also cause tendinosis, which involves degenerative changes in the tendon, along with abnormal growth of new blood vessels.

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. call (702) 933-9393; Physical Therapy (702) 933-9394

Tendons are fibrous tissue bands that connect muscles to bones. When the tendon becomes irritated, inflamed or suffers tiny tears, the condition is known as tendonitis. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provider treatments for tendonitis to patients in Las Vegas, Nevada, and surrounding locations.

Causes

The cause of tendonitis is usually hard to determine. But the condition typically occurs for one of the two reasons:

• Overuse: The patient repeats a particular body motion too often.
• Overload: The level of a specific physical activity, such as weight lifting, is increased too rapidly.

For unknown reasons, tendonitis is also common in diabetics, and in recent years, the use of certain antibiotics has been related to the occurrence of tendonitis. The condition occurs most commonly in the elbow, shoulder, knee, heel and wrist, although it may happen in any area of the body.

Shoulder Tendonitis

Rotator cuff tendonitis is the most common form of tendonitis in the shoulder. It involves the tendon of the muscle that attaches the upper part of the humerus at the shoulder joint. In most cases, this tendon is injured due to overuse, typically in a sport or an occupation that requires the arm to be repeatedly elevated.

Elbow Tendonitis

Two forms of elbow tendonitis that commonly occur as overuse injuries among athletes include:

Lateral Epicondylitis (Tennis Elbow)

This causes pain on the external part of the elbow joint. Nearly half of all adult athletes who play racquet sports are likely to be affected by this condition. It may also caused by any other activity that flexes and twists the wrist repeatedly.

Medial Epicondylitis (Golfer’s Elbow)

This causes pain on the inner side of the elbow. Despite its name, this type of injury is less common than tennis elbow. It typically occurs to individuals in occupations that involve repeated elbow movements, such as construction work. Sportspersons are less commonly affected by golfer’s elbow.

Knee Tendonitis

Jumper’s knee is the most common form of knee tendonitis. This will involve either the quadriceps tendon at the upper edge of the kneecap or the patellar tendon at the lower edge of the kneecap. Particularly in basketball players and distance runners, this is a common overuse injury.

Wrist Tendonitis

Tendonitis in the wrist commonly occurs in the form of de Quervain’s disease. This is a condition that causes pain in the back of the wrist at the thumb’s base. Although this disease typically occurs in people who engage in repetitive pinching or grasping motion with the thumb, it may sometimes occur during pregnancy for unknown reasons.

Achilles Tendonitis

This condition affects the Achilles tendon, which is the large tendon attached to the heel bone at the back of the foot. The condition usually results from overuse, particularly in sports that involve running or repeated jumping. It accounts for nearly 15 percent of all running injuries.

Poorly fitting shoes or faulty running technique may also sometimes cause Achilles tendonitis. Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients for tendonitis from Las Vegas, Nevada, and other nearby cities and neighborhoods.  

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. call (702) 933-9393; Physical Therapy (702) 933-9394