Subscapularis Inflammation

Posted on February 20, 2018 by Mark

What is Subscapularis Inflammation?

The subscapularis, which belongs to the rotator cuff group of muscles in the body, is a strong muscle that helps in rotating the arm inwards. However, it can be injured easily by throwers and is difficult to treat. The subscapularis muscle starts from the shoulder blade’s underside and inserts at the front of the humerus.

A partial injury to the subscapularis muscle occurs more commonly than a total rupture. Board certified orthopedic surgeons at Thomas & Bigler Knee and Shoulder Institute provide treatments for subscapularis inflammation to patients in Las Vegas, Nevada, and surrounding communities.

Symptoms

The symptoms of an inflamed subscapularis include pain related to shoulder movement, which occurs particularly when the patient tries to raise their arms over the shoulders. A patient can figure out if they have subscapularis inflammation with the help of certain tests that reproduce pain to facilitate in diagnosing the problem.

The surgeon may ask the patient to rotate their arm inwards, against resistance, to see if their subscapularis is inflamed. Pain and tenderness are felt when pressing in on the tendon insertion on the interior of the upper arm.

Treatment for Inflamed Subscapularis

Athletes who have an inflamed subscapularis should rest until the pain subsides. Applying ice at the initial stage can reduce the inflammation and pain. Patients should consult a sports injury professional to get advice on rehabilitation.

Sports injury specialists usually prescribe anti-inflammatory medications like ibuprofen. They also use sports massage techniques to bring about relief, as well as put the patient on a strength training, flexibility, and mobility program.

People who have suffered a partial rupture can get back in training within a few weeks, as long as they look after the injury.

Diagnosis of Subscapularis Tendinitis

An orthopedic surgeon will confirm if a person has subscapularis tendinitis by evaluating the shoulder thoroughly to look for signs of abnormality in the motion range. The patient will be asked to elevate their elbows and rotate the forearms internally.

Treatment for Subscapularis Tendinitis

The treatment of subscapularis tendinitis can vary depending on how severe the inflammation may be. A subscapular tendon that is mildly or moderately inflamed can be treated with anti-inflammatory medication and applying hot or cold therapy.

A patient will be advised to rest for at least one to two weeks during treatment to help prevent further aggravation of the condition. One should be careful as the subscapularis tendon is a very important part of the shoulder joint and rotator cuff.

A tear that is accompanied by tendon inflammation has to be treated surgically, which involves exposing the tendon to identify the torn ligament. Subsequently, the doctor will isolate and remove the torn tendon of the rotator cuff and reattach the adjacent normal tendon to its normal position.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada, and other cities and towns in this section of The Sagebrush State for subscapularis inflammation treatment.

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) 933-9393.

Shoulder Tendonitis

Posted on February 15, 2018 by Mark

Shoulder tendonitis is a degenerative affliction that impacts any of the tendons surrounding the shoulder joint. In general, the condition affects the rotator cuff tendons, but it can also impact the triceps and biceps tendons.

The tendonitis of the shoulder is generally a repetitive or an overuse injury, occurring due to poor posture and shoulder muscle imbalance, which leads to more pressure on a single muscle or tendon than it can bear.

The condition occurs more commonly in people who use the shoulder joint excessively to work their arms overhead, such as manual workers like electricians and carpenters or throwers who participate in field events like javelin or games like baseball.

Board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for shoulder tendonitis to patients in Las Vegas, Nevada, and surrounding locations.

Tenosynovitis

Tendonitis is also known as tenosynovitis, tendinitis, and tendinopathy. Tenosynovitis is a problem associated with the outer sheath that lines the tendon and not with the tendon fibers themselves. However, it is not possible to differentiate between tendonitis and tenosynovitis with an ultrasound scan investigation. The treatment for both the conditions is the same; therefore, in most cases, surgeons do not distinguish between the two afflictions which can also occur together.

Symptoms of Shoulder Tendonitis

The symptoms of shoulder tenosynovitis include pain, which comes gradually with shoulder movement. The exact movement that brings about pain indicates which tendon or tendons are inflamed.

For instance, the occurrence of pain while rotating the shoulders indicate rotator cuff injuries, and pain related to the flexing or upward movement of shoulder shows a problem with the bicep tendonitis. The pain usually becomes worse after rest and starts diminishing when activity warms up the area.

A painful tendon may feel thickened, when the patient presses in to feel the tendon, in comparison with the other side. Furthermore, a patient could also have a creaking feeling, which is referred to as crepitus in the tendon as it moves.

Treatment

Patients who have shoulder tendonitis should take ample rest because the condition can become aggravated by movements and activities. The pain and swelling can be eased by applying ice or other cold therapy treatments for 15 minutes, every three to four hours. An individual who has shoulder tendonitis should also consult a sports injury professional.

An orthopedic surgeon will assess the condition before confirming the diagnosis with the help of ultrasound scans or MRI. They may use electrotherapy treatments such as laser or ultrasound, or sports massage techniques to bring relief to the affected muscles.

A surgeon will also determine the cause of shoulder tendonitis in the patient and address any postural or muscle imbalance issues. Subsequently, they will create a rehabilitation program for improving the shoulder posture and strength of the impacted muscles.

In most cases, the condition can be treated without any invasive procedure, but major degeneration of the tendons may require surgery. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada, and nearby areas for the treatment of shoulder tendonitis.

Proximal Humerus Growth Plate Fracture

Posted on January 20, 2018 by Mark

Proximal Humerus Growth Plate Fracture | Las Vegas Orthopedic Surgery A growth plate fracture in case of children occurs at the end of a bone before the bone has fully matured from cartilage to hard bone. A proximal humerus fracture occurs in the upper arm, close to the shoulder. Most of the young children with proximal humerus fracture can benefit from non-surgical treatment.

In other cases, surgical treatment may be advised to improvement alignment of the fracture and reduce the risk of malunion. Board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder Institute provide treatments for proximal humerus growth plate fracture to patients in Las Vegas, Nevada and surrounding communities in The Silver State.

Symptoms

Symptoms of proximal humerus growth plate fracture include sudden pain in the upper arm and shoulder at the time of injury. This is accompanied by quick swelling in the shoulder. The patient will find it difficult and painful to move the arm. In some cases, the shoulder joint may look deformed after the injury.

Causes

A growth plate fracture is usually caused due to a fall or impact on the arm or shoulder. But in some cases, it may also occur because of overuse of the joint. Long bones such as the humerus typically grow from the ends. At each end there is a growth plate, which is the final part of the bone that hardens from cartilage. That makes it a more vulnerable area to injury.

Growth plate fractures most often occur in children and adolescents, and rarely in adults. The ligaments and other soft tissues surrounding the joint are stronger in a child than the soft bone is. In adults, on the other hand, the soft tissue is more susceptible to injury.

Treatment

If the surgeon suspects a fracture, they will take an x-ray or MRI to confirm the diagnosis and the extent of bone displacement. Conservative treatment may be followed if the injury is non-displaced. The patient will go through a period of immobilization to allow for healing. This will be followed by rehabilitation to regain full movement and strength.

If the two bones are misaligned or separate in a fracture, a surgery may become necessary. The goal of the surgery will be to realign the bones and fix them in the right place using wires or pins. Here again immobilization is essential, which will be followed by rehabilitation.

Surgical Options

Closed reduction surgery may be performed under anesthesia to create an acceptable alignment. But if the fracture continues to be relatively unstable, the surgeon might perform percutaneous pin fixation after a closed reduction. Pins are typically placed retrograde through the metaphysis and enter the humeral epiphysis. The surgeon may use buried smooth or threaded pins to reduce the incidence of pin site infections or pin migration.

An open reduction may be performed if an acceptable closed reduction is not possible. This is often performed using a standard axillary approach. Other possible approaches include a deltoid split and a deltopectoral approach. Most surgeons favor percutaneous pin fixation, or occasionally internal fixation, after open reduction to minimize future displacement.

Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas for proximal humerus fracture treatment.

Shoulder Subluxation

Posted on January 10, 2018 by Mark

Shoulder Subluxation | Las Vegas Orthopedic Surgeons | Shoulder Surgery When the shoulder partially dislocates, shoulder subluxation or shoulder instability may occur. The large range of movement in the shoulder makes it vulnerable to dislocation. Shoulder subluxation may be associated with pain or dead arm sensation. In some cases, the subluxation may not be painful, but may hamper the performance of certain daily activities or sports.

Shoulder subluxation can happen in one direction, such as anterior instability or posterior instability, or even in multiple directions. Anterior instability is the most common form in shoulder subluxation because the joint capsule is at its weakest at the front of the joint.

Board certified orthopedic surgeons at the Thomas & Bigler Shoulder & Knee Institute provide treatments for shoulder instability to patients in Las Vegas, Nevada and other suburbs and cities in the southeast part of the state.

Causes

Shoulder subluxation may occur due to a number of reasons. If the joint surfaces are shaped slightly differently, the joint may not be as stable compared to people who have normal joint anatomy. Shoulder instability may be caused due to:

Trauma (traumatic instability): This often occurs because of a specific accident or injury which damages the structures that provide stability
Old injury: Sometimes an old injury that weakens the capsule may cause instability, which is called post traumatic instability
Joint Laxity (atraumatic instability): This may occur because of anatomical abnormalities, hyper mobility, or muscle weakness certain conditions, including pregnancy
Acute or chronic instability: A traumatic injury occurring on an already lax joint may create chronic instability

Diagnosis

The orthopedic surgeon will perform several tests to determine the exact type of shoulder instability that the patient may have. They will evaluate the patient’s detailed medical history to try to understand the reasons behind this occurrence. The surgeon will also determine whether the patient has a condition that caused them to have lax ligaments throughout the body, which is known as hyper mobility.

Treatment

The surgeon will usually recommend a strengthening program to help the patient develop the muscles around the shoulder which are responsible for stabilizing the joint. A specific type of electrotherapy may be performed to help identify the muscles that are not functioning correctly. A tiny electric current to make the muscle tingle will help the patient to train the muscles more efficiently.

In some cases of shoulder instability, such as traumatic instability, if conservative treatment approaches do not work, the surgeon may have no other option but to perform a surgery. The surgeon will have several techniques available to improve the joint laxity at the shoulder. But this will have to be followed by a comprehensive rehabilitation program to ensure that the patient does not lose any joint movement.

Arthroscopy is nowadays more commonly used to determine the precise cause of shoulder subluxation. This is a minimally invasive procedure where the patient is administered an anaesthetic, and a small fiber optic camera is introduced to the joint to examine the underlying structures and assess the damage that could be repaired with surgery in a less invasive and targeted manner.

Judicious, responsible, and board certified plastic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas for shoulder subluxation treatment.

Bruised Collarbone

Posted on January 6, 2018 by Mark

Bruised Collarbone | Las Vegas Orthopedic Surgeons | Shoulder Surgery A bruised collarbone, clinically known as a clavicle contusion, occurs following a direct impact to the collar bone at the front of the shoulder or chest.

The condition involves bruising of the skin and the underlying tissue at the collarbone or the clavicle due to direct trauma. The contusions cause bleeding, and the blood infiltrates the soft tissue, tendons, and muscles.

A bruised collarbone often occurs along with an injury to the sternum or the breastbone and shoulder joint. Fabulous, perspicacious, and board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder Institute provide treatments for bruised collarbone to patients in Las Vegas, Nevada and surrounding locations.

Causes

In many cases, the bruised collarbone occurs due to a direct trauma to the clavicle. The injury is typically seen in contact sports such as football, hockey, wrestling, and basketball. While the injury commonly occurs during sports activities, it can also occur in other cases involving a fall. It can also develop due to a heavy object falling directly on to the shoulder area.

Symptoms

Common symptoms of a bruised collarbone include:

Swelling at the site of injury
Palpable tenderness in the injured tissue
A sensation of firmness when pressure is applied over the injured area
Skin discoloration at the injured site
In cases of severe injury, restriction of shoulder motion could be in play

If the patient experiences any of these symptoms, they should promptly seek medical attention. Early diagnosis and treatment will prevent the collarbone injury from worsening.

Diagnosis

To diagnose a clavicle contusion, the orthopedic surgeon will evaluate the patient’s history and perform a thorough physical exam of the injured area. They may also perform imaging studies in the form of x-rays of the collarbone to assess the extent of damage.

Treatment

A bruised collarbone is usually treated with a conservative approach starting with PRICE therapy. The patient should take sufficient rest and refrain from engaging in any form of sport activity. Frequent application of ice will help to calm down the pain and inflammation in the first one to two days.

It is beneficial to immobilize the arm with the use of a sling because it will take any type of pressure off the collarbone. The surgeon may also prescribe pain meds and NSAIDs to provide relief from the pain. If the surgeon suspects a fracture, they will take an x-ray to make the correct diagnosis. In case of a simple clavicle contusion, complete healing will usually occur in about two weeks.

When a fracture is suspected, the surgeon may also check the AC joint along with the collarbone to determine if any disruption of ligaments has occurred in that area. The surgeon will ensure that the pulse in the injured hand is strong and there is no change of sensation to rule out blood vessel or nerve injury.

Patients in Las Vegas, Nevada and other communities and towns in this region of the southwest have an opportunity to receive treatments for a bruised collarbone from board certified plastic surgeons Dr. Steven Thomas and Dr. Gregory Bigler.

Deltoid Muscle Strain

Posted on December 16, 2017 by Mark

What is a Deltoid Muscle Strain?

Image result for Deltoid Muscle Strain The deltoid muscle is the large muscle on the shoulder and has three parts: the anterior, posterior and the middle. The muscle performs the role of lifting the arm up sideways. The front part helps to lift the arm up forward, which is called shoulder flexion. The back part helps to lift the arm up backward, which is called shoulder extension.

If the deltoid muscle is strained or injured, it can cause pain at the front, side or back of the shoulder. Salient, committed, and board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder Institute provide treatments for deltoid muscle strain to patients in Las Vegas, Nevada, and other neighborhoods and towns in The Sagebrush State.

Symptoms

One of the common symptoms of deltoid muscle strain is sudden pain in the muscle at the front of the shoulder. When the patient lifts the art from the side to the front keeping it straight against resistance, the pain is reproduced.

Where the muscle is torn, visible swelling and tenderness may develop. Bruising may occur in more severe injuries. Symptoms of a deltoid strain are similar to that of a rotator cuff injury, which is much more common. Therefore, both possibilities should be considered.

Treatment

Grade 1 Deltoid Strain

Frequently apply ice therapy and compression wrap, 15 minutes at a time, for the first 24 hours. Perform light exercises as suggested by the orthopedic surgeon to gradually build up weight and strengthen the muscle. Professional sports massage or ultrasound therapy may be used to expedite recovery.

Grade 2 Deltoid Strain

Apply ice for three to five days. Thereafter, apply heat through hot water bottle, hot baths or ultrasound therapy. A sports injury specialist can help create a proper rehabilitation plan. After the first week, the patient will be required to perform light pain free exercises.

Cycling and stretching exercises may also be advised. A sports therapist may perform sports massage techniques to speed up recovery. After two weeks, the patient can gradually return to sports activities.

Grade 3 Deltoid Strain

The patient should seek immediate medical attention and apply PRICE therapy. From the second week, the patient can perform pain free static contractions. Heat can be applied through hot water bottle, hot bath or ultrasound. The third week can include all these activities and additionally an increase in the static contraction intensity.

From the fourth week, the patient can perform light lateral raises and rotator cuff exercises, cycling and stretching exercises as advised by the surgeon. Week five will include build up exercises. Thereafter, the patient can gradually move to sports specific exercises. Recovery can be faster if the orthopedic surgeon or sports therapist makes use of sports massage as well as ultrasound or electrical stimulation.

Surgery may be required in a few cases, if the conservative treatments fail to achieve proper healing of the deltoid muscle. If the patient suspects grade two or three injury, they should promptly seek medical attention. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas for deltoid strain treatment.

Winged Scapula

Posted on December 15, 2017 by Mark

What is a Winged Scapula?

Image result for Winged Scapula Winged scapula is not an injury in itself, but a symptom of another condition. It occurs where the shoulder blade protrudes out on the back, rather than laying flat against the back of the chest wall.

Board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder institute provide treatments for winged scapula and various others conditions to patients in Las Vegas, Nevada and surrounding locations in The Sagebrush State.

Symptoms

A winged scapula is often easily noticed as the scapular or shoulder blade protrudes outwards sticking out of the back. The patient may experience pain in the shoulder blade with pressure on the scapular from a chair while sitting. In some cases, the condition may occur due to an injury resulting in nerve damage. Such patients may have limited shoulder elevation and may also experience shoulder blade pain.

Causes

Winged scapula is a fairly common dysfunction of the shoulder because it may also occur due to a poor posture. It is called winged scapula because the medial or inner border of the scapula may appear to be wing-like on the back.

A winged scapula is associated with a contusion or damage to the long thoracic nerve of the shoulder as well as weakness in the Serratus Anterior muscle. If the long thoracic nerve gets bruised or damaged, it can lead to paralysis of the serratus anterior muscle and winging of the scapular or shoulder blade.

Nerve damage can occur due to a contusion or blunt trauma of the shoulder, traction of the neck, and can also sometimes result from a viral illness.

Treatment

Application of ice therapy can help mitigate the pain in the shoulder blade. However, the back can be a difficult play to apply an ice pack, and the patient will require assistance. It is important for the patient to undergo a complete rehabilitation and strengthening program that will include winged scapular exercises as well as a range of other exercises for the shoulder.

The vital muscle to strengthen in this case is the serratus anterior muscle, which performs the role of holding the shoulder blade in place. The serratus anterior, which is also known as the punching muscle, can be strengthened with the help of punching type exercises.

The patient should seek professional medical treatment from an orthopedic surgeon, especially when the shoulder fails to respond to muscle strengthening exercises. Initial treatment is usually conservative but in a few cases where the condition is caused by nerve entrapment or if other treatments fail, surgery may have to be performed.

Winged Scapula Exercises

To target the Serratus Anterior directly, the best exercises will involve scapula protraction along with serratus press exercises. Any movement that allows the shoulder to protract forwards at the end range of movement will target the serratus anterior. Punching a punch bag will also help to improve the resilience of this muscle.

The exercise regimen should only be performed under the guidance of a qualified professional. Stellar, committed, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients for winged scapula from Las Vegas, Nevada and nearby areas.

Shoulder Impingement Syndrome

Posted on December 14, 2017 by Mark

What is Shoulder Impingement Syndrome (swimmer’s shoulder)?

Image result for Shoulder Impingement Syndrome Shoulder impingement syndrome, commonly known as a swimmer’s shoulder or thrower’s shoulder occurs when the tendons of the rotator cuff become impinged as they pass through the shoulder joint. The condition may occur gradually through overuse or follow a partial tear of a rotator cuff tendon.

Board certified orthopedic surgeons at Thomas & Bigler Knee & Shoulder Institute provide treatments for shoulder impingement syndrome to patients in Las Vegas, Nevada, and other cities and towns in The Silver State.

Symptoms

Symptoms of this condition may include pain which develops over a period of time. There will be pain at the front and side of the shoulder joint, particularly when the patient makes overhead movements such as in throwing, racket sports and swimming.

When the arm is held out to the side turned outwards, the patient may experience pain in the shoulder. If the pain occurs in arc from about 70 degrees to 130 degrees when the patient raises the arm out sideways and up above the shoulder, it is another sign of shoulder impingement.

Causes

Shoulder impingement syndrome is caused by the rotator cuff tendons becoming impinged as they pass through the subacromial space. With repetitive pinching, the tendons become irritated and inflamed. This can result in thickening of the tendon, which may lead to additional problems because there is very little free space.

As the tendons become bigger, they are further impinged due to the shoulder joint structures and the muscles themselves. There are various different causes of shoulder impingement syndrome which include bone spurs, rotator cuff injury, labral injury, shoulder instability, biceps tendinopathy and scapula dysfunction.

The condition can develop into a rotator cuff tear if left untreated. The muscle most commonly involved in this syndrome is the

supraspinatus. Shoulder impingement will be categorized as internal or external on the basis of its cause. External impingement is divided into primary impingement, which is caused by a bony spur, and secondary impingement, which occurs due to poor stabilization of the shoulder joint.

Treatment

Shoulder impingement treatment is based on the goals of mitigating pain and inflammation, improving mobility and strength while diagnosing and addressing the possible causes to ensure it does not recur. As a first step, the patient should apply the PRICE principles of protection, rest, ice, compression and elevation.

The shoulder should be rested from any painful activities or movements. The patient must apply ice therapy and compression wrap to the painful area for about 15 minutes per hour initially. As the symptoms reduce, the frequency of therapy should be reduced to three to four times a day.

Anti-inflammatory medications may be prescribed to reduce pain and inflammation. A professional therapist may use electrotherapy such as ultrasound as well as recommend a customized rehabilitation and exercise program. Steroid injections into the subacromial space to reduce inflammation may be used in exceptional cases.

Steroids are not an early option and are typically recommended after a period of at least six to 12 months of therapy. Remarkable, perspicacious, and board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide shoulder impingement syndrome treatments to patients in Las Vegas, Nevada and other towns and cities in this part of the southwest.

Frozen Shoulder

Posted on November 20, 2017 by Mark

Adhesive capsulitis, commonly known as frozen shoulder, is condition that restricts the shoulder joint movement and causes pain. A frozen shoulder will go through three phases: a freezing phase, where the joint becomes tight; a stiff phase, where shoulder movement gets significantly curtailed; and a thawing phase, where mobility improves and pain begins to subside.

Board certified orthopedic surgeons at the Thomas & Bigler Knee & Shoulder Institute provide treatments for frozen shoulder to patients in Las Vegas, Nevada and towns and suburbs in this section of The Battle Born State.

Symptoms

Painful (Freezing) Phase

In this phase, a gradual start of aching in the shoulder will occur. The pain will be diffused and is likely to worsen at night, making it difficult for the patient to lie down on the affected side. This painful phase may last from two to nine months.

Stiffening (Frozen) Phase

Stiffening will start happening in the shoulder joint in this phase. The shoulder pain may continue, and the patient may find it difficult to perform normal daily tasks. If treatment is neglected, shoulder muscles may begin to waste away. The symptoms in this phase may persist for about four months to a year.

Thawing Phase

In this phase, the frozen shoulder symptoms will start improving. Patient will be able to extend their range of movement and experience gradual pain reduction. Stiffness can ease for some time, but pain may re-emerge later. The thawing phase may last for about five months to a year.

Treatment

An orthopedic surgeon can provide timely treatment to ensure that severe stiffness is avoided. The patient should be prepared to follow the surgeon’s recommendation for a rehab program. Shoulder movements should be continued, even though the small and pendular. Mobility exercises and movement activity should only be done under the supervision of a qualified therapist.

Orthopedic surgeon’s first goal will be to try and manage frozen shoulder with conservative treatments. Surgery should only be a last option. The patient should arrange for physical therapy and a scientifically designed course of exercises in order to help maintain mobility and flexibility in the shoulder.

NSAIDs or steroidal drugs may be prescribed to treat inflammation in the shoulder joint. If the pain is acute, the surgeon may perform a steroidal injection directly into the joint. However, if inflammation does not diminish, surgery may be the last option left.

Once a conservative treatment or a surgery is completed, the rehabilitation efforts will begin. The patient should take care to pursue rehab only under professional supervision and guidance.

Surgery

Arthroscopic capsular release is the most common technique to perform surgery to treat a frozen shoulder. This procedure is performed using the keyhole surgery technique. The thickened shoulder capsule gets divided with this treatment for easy release.

Patients should note that a surgical procedure will have to be followed by a scientific rehabilitation program. The patient should be prepared to follow it well. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler receive patients from Las Vegas, Nevada and nearby areas.

AC Joint Separation

Posted on November 15, 2017 by Mark

An AC joint separation is an injury to the ligament that holds the acromioclavicular (AC) joint together at the top of the shoulder. A common cause of this injury is a fall onto an outstretched arm. The severity of this joint sprain can from grade 1 to grade 6. Timely treatment and support to the joint is vital to avoid shoulder deformity and other long term problems.

Symptoms may include pain at the end of the collar bone on the top of the shoulder. Pain will worsen when trying to move the arm overhead and there is often swelling. A deformity may be noticed in more severe injuries in the form of an obvious lump on top of the shoulder joint.

Sagacious, profound, and board certified orthopedic surgeons at the Thomas & Bigler Knee and Shoulder Institute provide treatments for AC joint separation to patients in Las Vegas, Nevada, and surrounding locations.

Treatment

In case of an AC joint injury, the immediate step should be to provide first aid and apply the PRICE principles of rest, ice, compression and elevation. It is important to apply ice therapy and compression wrap as soon as possible to mitigate pain and swelling. The shoulder should be immobilized by wearing a sling to take the weight of the arm.

The surgeon may prescribe NSAIDs to treat pain and inflammation, while they evaluate the extent of injury. Ultrasound for minor injuries or TENS for pain relief may be used in more severe cases.

AC Joint Taping

An AC joint can fix and support the joint into the correct position to assist with healing. Taping may be needed for two to three weeks. The first step should be to apply two or three strips of 2.5 cm zinc oxide tape over the shoulder top that covers the AC joint. This will create an anchor for the support strip.

The surgeon would then pass a support strip of tape from the front of the shoulder, down the side of the arm applying tension to the tape. Thereafter, they will pass it below the elbow and back up to the top. This support strip will help pull the AC joint down. The support strip will then be secured with an elastic adhesive bandage. Finally, they will trim the lower part of the support taping away to finish.

The patient should gradually perform shoulder exercises recommended for AC joint sprain rehabilitation as pain improves.

Surgery

If the AC joint injury is graded as grade 1, 2 or 3, surgery is often avoided and more conservative treatment approaches can be adopted. However, if a grade 3 sprain fails to respond to conservative treatment, or the injury is of grade 4, 5 or 6, the patient will typically require surgery.

If the patient does not seek timely treatment for AC joint separation, or allows the healing to occur out of place, it could increase the wear and tear on the joint, causing future problems. Board certified orthopedic surgeons Dr. Steven Thomas and Dr. Gregory Bigler provide AC Joint injury treatments to patients in Las Vegas, Nevada, and other towns and neighborhoods in this region of the southwest.

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702.933.9393

9499 West Charleston, Suite 200
Las Vegas, NV 89117