ankle and foot bones

Ankle Fusion: 3 essential questions you would ask

For most of us walking or running (except for the elderly) is a given. We usually take it for granted. But at times, because of an ankle injury or arthritis that has taken over the ankle joint…. something as simple as walking to the mailbox or even to your kitchen can become a difficult thing to do.

Pain of the ankle or foot directly affects our mobility and may also restrict our activities of daily living. Severe Arthritis is many a times the cause for this and may require corrective surgery for treating the condition.

When this happens, you can consider a procedure called Ankle Arthrodesis a.k.a. Ankle Fusion, to help get the movement back that you’re used to.

 

What is Ankle Fusion (Ankle Arthrodesis)?

Ankle fusion is a type of surgery done to fuse the bones of your ankle into one piece. This procedure is considered only when your ankle joint has been completely worn down. This could be due to a variety of things including a severe ankle fracture or degenerative arthritis in the joint itself. An ankle injury, several years down the road can wear out the joint and it can become quite difficult to move it freely as you have before.

This procedure basically removes the joint and allows your tibia to grow together with your foot bone. It removes the joint completely providing a remedy for pain relief.

 

What should you expect with this procedure?

You and your doctor will decide if this procedure is right for you. The ankle fusion is a great choice for those who are younger and are very active as it will not wear out like an ankle joint replacement could.

Once you’ve been cleared for surgery your doctor will discuss with you whether an open procedure or arthroscopic procedure is best in your situation. They will also update you of any risks and answer any questions you may have.

Like every surgery, Ankle Fusion also has its fair share of risks involved. Such as –

  • Infection
  • Damage to surrounding nerves
  • Bleeding & Blood clot
  • Misalignment or improper joints during the procedure
  • New Arthritis in nearby joints

 

What happens after Ankle Fusion Surgery?

ankle fusion post surgery
Source: Very Well Health

A stay in the hospital will be likely for a few days depending on your condition. You will leave the hospital in a cast and in around two weeks that one will be changed to a shorter cast.

You cannot put weight on your ankle itself until the bones are fusing properly as they should be. After the procedure, it could take up to 12-weeks afterwards for that to be certain. For the best reduction of pain after Ankle Arthrodesis, it is advised that you keep your ankle elevated above your chest and propped up on pillows to reduce the swelling and throbbing.

Be prepared for rehabilitation time frame to go through and running “normally” will not be possible in the future. However, with inserts available for shoes nowadays and with rehab, you can begin to walk with a normal gait as you did before.

If you’re suffering with a large amount of ankle/foot pain due to arthritis or injury, Ankle Fusion may be an option for pain relief. Consult with your physician to be sure you know the ins and outs of this procedure and to help decide if it’s the route to go for you.

diagnosis of tailbone injury

Tailbone Pain (Coccydynia): Causes, Symptoms & Treatments

Dealing with pain is never an easy situation. And in the unfortunate situation when you are facing with Tailbone Pain (a.k.a. Coccydynia), it can be difficult to do even the most normal daily tasks such as sitting at your desk.

Tailbone pain can come to you for variety of reasons and is more common in women than it is in men. In this post we’ll look at the symptoms of Coccydynia, causes of the pain and how it can be treated to get you back to living life as normal.

The Tailbone

The Tailbone or Coccyx is the triangular bony structure located at the bottom of the vertebral column between the buttocks. Composed of three to five bony segments it is held in place by joints and ligaments. It is the bottom most part of the Spine and helps support the Pelvis

Causes & Symptoms of Tailbone Pain

There are variety of causes that can lead to Tailbone Pain such as –

  • Fall or trauma to the area
  • Loosening of ligaments during pregnancy and childbirth
  • Sitting on hard bench or uncomfortable surface for prolonged duration
  • In some rare cases an infection or tumor in the area.

As mentioned before this is more typical in women than men but men do suffer from it as well. The symptoms are usually pain that is worsened by sitting or putting pressure on the area itself. It may feel worse if you’re constipated or you may feel relief after having a bowel movement. You may also notice worse pain when you go from sitting to standing positions.

Treatment Options

doughnut shaped pillowDealing with tailbone pain can be a difficult process but there are some things to try that will hopefully relieve the pain noninvasively.

  • Your doctor may suggest using NSAID’s to help with the inflammation and swelling in the area.
  • Applying cold packs to the area several times every day to help reduce the swelling. You can also add heat later to help reduce the pain.
  • Changing your sitting posture – Sit with your back against the chair and feet flat on the floor to take the weight off your tailbone or Lean forward when you go to sit down
  • Alternatively, utilize a donut shaped pillow to help reduce the pressure applied on the coccyx area when you’re in a seated position.
  • Make sure not to sit in one position for too long, but get up and walk around to reduce the pressure on the tailbone area

If you notice that constipation or a bowel movement causes or removes pain, then it’s important to be sure to get enough fluid and possibly take a stool softener to help reduce the pain during those times.

Other methods that are non-surgical include gentle stretches, chiropractic manipulation of the area, and injections to block the pain. There are also physical therapy ultrasound techniques that can help to reduce the pain in the area. In severe cases where nothing else has helped after months of treatment, surgery may be required to fully get rid of pain.

Tailbone Pain Treatment in Singapore

At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today for an appointment @ +65 6653 2981 to get a professional assessment of your condition & start your journey toward a better life!

Visibly displaced finger

What everyone ought to know about Finger Dislocation

We’ve all experienced finger injuries in our lifetime and for a magnitude of reasons…ranging from something as simple as a bruise or cut when preparing a meal in the kitchen, or for a more serious one such as it being crushed in the way of slamming door.

However, a Finger Dislocation is a totally different type of injury. As the word dislocation suggests displacement or dislodgement of the finger bone from the joints. Yes, Finger Dislocation is a much more distressing condition which requires immediate medical intervention and more so by an Orthopaedic Specialist.

In this post, we’ll look at some of the causes, visible symptoms, and the treatment options should you find yourself in the unfortunate circumstance of having a Dislocated Finger.

 

Common Causes of Finger Dislocation

X-ray of dislocated finger boneThe cause of a Finger Dislocation is either “jamming” your finger on the end of the fingertip with an excessive force, or it may be caused if your finger becomes overextended in a particular direction. This can happen when experiencing a fall…landing wrongly on the outstretched hand perhaps trying to desperately get hold of something to avert the fall.

One of the most common cause resulting in Finger Dislocation is a Sports Injury. It can happen when you’re playing a variety of sports such as basketball or baseball and having the ball jam your finger. Finger Dislocation is also common in the game of cricket where hands and wrists are at high risk of impact.

Or it can be getting your finger caught in sports equipment or other type of equipment and pull your finger out of its normal placement.

 

Visible clues of a Dislocated Finger

Typically, when you have dislocated your finger you’re going to know it. It’s visible and not a subtle injury that you may question.

Your finger will look either crooked or bent in an odd shape and it will be quite painful and distressing followed by swelling. You may also experience numbness or tingling in the finger and the finger will start to look pales as well.

In the worst scenarios, depending on how severe the finger injury was, it even may break/rupture the skin when you have a finger dislocation.

 

Treating a Dislocated Finger

treating dislocated fingerAny sign of a finger dislocation calls for a trip to an Orthopaedic or Emergency Room Doctor. You need to have the finger put back into place before any permanent damage is done. The longer you wait to receive treatment, it can make it more difficult to put it back into place or can cause irreversible damage.

Before you get to the doctor, make sure to remove any items of jewelry, watch, etc from the injured finger if you have any on. Travel to the doctor’s office with ice on your hand.

Once you arrive at the medical center or hospital, they will most likely give you a local anaesthetic or some pain medications via IV or mouth so that the doctor can put your finger back into its proper place.

Thereafter, you may receive either a splint or have your finger taped to the healthy one next to it. This will help it to heal and prevent any chance of it slipping back out of place during healing.

Treatment options would vary with the severity of the injury. In cases where torn ligaments and broken bones are involved then surgery and K-wire Fixation may be carried out. At Singapore Sport & Orthopaedic Clinic our specialist team have helped many patients recover from Finger Dislocation conditions. Call us today, we are here to serve you.

Applying pressure for back shoulder pain

Experiencing Muscle Pain? It could be Myofascial Pain Syndrome

Muscle pain of any type can be get difficult to handle. Sometimes the pain may be minor and can be worked through, while other times it can debilitating and hard to handle. One chronic condition that involves muscle pain that many of us may deal with is called the Myofascial Pain Syndrome.

This involves inflammation that is in the soft tissues of the body and cause pain in different areas (referred pain). It could involve one particular muscular area or a group of muscles causing pain.

Here are a few things you should know if you’re dealing with muscle pain or if you think you’re dealing with myofascial pain.

Causes and Symptoms of Myofascial Pain Symptoms

The causes of myofascial pain can be due to an injury or strain of a muscle in the body. It could be due to repetitive motions that injury the muscle groups being used, an excessive strain that is put on the muscle, tendon or even ligaments, or it can be due to inactivity in a group of muscles. This could be due to having an injury to your arm and not being able to move it due to the cast or sling you’re having to wear.

This type of muscle pain originates from what are known as “Trigger Points”. Trigger Points are sensitive areas in the muscle which may under undue pressure. These can cause pain in those specific areas, or it can also produce other problems such as depression, behavioral problems, or fatigue due to the pain the patient is in.

When examined for Myofascial Pain, you may have few types of Trigger Points

  • Active – is very tender can cause the muscle to twitch when manipulated and is the most common type
  • Latent – which do not cause any immediate pain when probed but can get activated where there’s stress or trauma. Basically, waiting to cause future problems
  • Primary – A central trigger point that was activated directly by acute or chronic overload, or repetitive overuse of the muscle in which it occurs.
  • Secondary – painful point in the muscle that becomes active when you stress another muscle.
  • Satellite – This Trigger Point that activates coz its located near to another Trigger Point
example trigger point and referred pain
Source: Mayo Clinic

Treatment Options for Myofascial Pain

  1. There are several options available to treat this type of muscle pain depending on what you’re dealing with at the time.
  2. You can opt for massage therapy to help reduce the trigger points and work out the kinks in the muscles.
  3. Physiotherapy to help you gain movement back in those muscles if you’ve dealt with an injury that restricted your movement.
  4. You may also find that trigger point injection therapy works well for you. This is where the doctor will inject either anaesthetic, saline, or corticosteroids into the trigger point and make it dormant so that it doesn’t cause pain anymore.
  5. One other method that may be used is the “spray and stretch” method. This is where the trigger point is sprayed with a cooling type spray and then it is slowly stretched out.
  6. You can also take anti-inflammatory medications to assist with the pain as well

Myofascial Pain Relief in Singapore

Singapore Sports & Orthopaedic Clinic has been in service for the past 20 years in Singapore helping patients with pain relief and treatments. Our team of doctors (specialists & generalists) have treated Myofascial Pain Syndrome for many patients. Call us today for more info.

Why Referred Shoulder Pain should be a cause of concern to you

Feeling pain in any body part is never a desirable situation to be in. And when we do experience it the obvious reaction is treating that part of the body with remedies at our disposal. Perhaps followed by deliberating what could be the possible cause of it.

But sometimes pain in one area of the body can be a sign of an issue in another area. Human Body is strange. For example, you may have shoulder pain and at first think it’s something to do with your arm or shoulder, however it may not have anything to do with your shoulder at all! It could be something called referred shoulder pain instead.

What is Referred Shoulder Pain?

Referred shoulder pain is actually pain that shows up in the shoulder but could be an indication of gallstones, heart blood vessel problems, lung infection such as pneumonia, or a variety of other problems. Yes! the pain you’re feeling in your shoulder could be might as well be from another area instead of your actual shoulder. If you’re noticing pain in that area and it doesn’t change when you move your arm or neck, it could be what is known as Referred Shoulder Pain.

source: anatomynotes.blogspot.com

Signs of Referred Shoulder Pain

While in the case of local topical shoulder pain it can be from an injury to the shoulder such as a fall or sports injury but if its Referred Shoulder Pain then it can also be caused by something entirely different. Things to look out for include:

  • Pain that is felt not only in the shoulder but in your shoulder blade areas, neck, armpit, or even in the chest
  • Intense pain that comes on quickly
  • Swelling in the area
  • Inability to use your arm or move the shoulder joint

These are signs that you should be watching out for to make sure you seek medical attention when it’s needed. But if you’re having shoulder pain and you have shortness of breath or tightening of your chest, call for emergency medical help to assist you. It could be signs that something dangerous is on the horizon.

Causes of Referred Shoulder Pain

It is always best to have your doctor check you out when you’re feeling pain, whether it’s in your shoulder or in some other area. Pain is a sign that something is not quite as it should be and should not be ignored.

In the case of Referred Shoulder Pain, possible causes could be –

  • Abdominal related problems like Gallstones, Pancreatitis, etc
  • Result of Lung problems which result in pain in your upper torso
  • Left arm and shoulder pain could be because of serious problem such as inflammation around the heart or a heart attack
  • If you’ve had a procedure done recently it could be air pressure or gas that was used in the process causing the pain

If you know what your referred shoulder pain is from, such as a recent medical procedure or you’ve had a diagnosis, you can use some of these tips to help with the pain. Be sure to rest the shoulder and use ice to help relieve the inflammation. Over the counter pain relievers can also be a huge help to reduce the pain and swelling.

Of course, it’s always advisable to reach out to a clinic in your area for proper diagnosis and remedial treatment. We at Singapore Sports and Orthopaedic Clinic, conveniently located at the Gleneagles Medical Centre are always at your service.

treatment for ankle injury

An uncomplicated Guide to Ankle Ligament Surgery

Ankle Sprains & Foot injuries are a common occurrence that can result while playing your favourite sport or maybe from a fall you experienced climbing down a flight of steps. It may also result passively on account of inherent foot deformities.

Torn or injured ankle ligaments can cause a lot of discomfort and pain given that foot and ankle bear weight of our body.

In such situations, experienced Foot & Ankle Specialists are the best persons equipped to prescribe the right treatment. Sometimes one can get away with rest and change of habits, or with non-invasive therapies. And at times it may need Ankle Ligament Surgery to correct the issue.

So, in this post we’ll touch more upon Ankle Ligament Surgery, its Pros & Cons and the alternatives. Read on…

What do Ankle Ligament Procedures entail?

lateral collateral ligaments surgerySurgery is what your physician will do to help repair a torn ligament due to an injury to the ankle area. This is used to help treat your ankle when you’ve had a serious sprain or if you’ve had instability in the ankle due to an injury.

Ankle ligaments that are most commonly injured are the ones on the outside. They are Ateral calcaneofibular, anterior and posterior talofibular, and the anterior and posterior tibiofibular ligaments. Ankle ligament procedures may involve repair/reconstruction or by drilling small holes in the bones and rerouting the tendons to take the place of the ligaments. But the complexity of procedure really depends on the seriousness of the ligament tear

Common Ankle Ligament Surgeries

Lateral Ankle Ligament Reconstruction

Also known as the Brostrom procedure, this is where the physician will repair one or more of your ligaments in the ankle. It is because you’ve had multiple sprains in your ankle, your ankle has become weak over time due to injury, or there may be a defect in the ankle area that this can help to correct.

If you’ve dealt with problems such as hindfoot Varus, midfoot cavus, or a disease such as Ehlers-Danlos where your ligaments are very loose, this is the surgery that can help you to get some stability back in your ankles. There are some risks involved but you should consult with your physician on your personal risks.

The procedure will involve you being put under general anesthesia or just some local anesthesia depending on the severity of the surgery. The surgeon makes a small incision and uses instruments to carry out the procedure if the surgery is a minimally invasive one. In some situations, the doctor will need to make a longer incision for severe cases.

The Foot/Ankle Surgeon may either shorten your ligaments, remove them, and attach your ankle differently (re-route) to help give it stability, or do other constructive means to help give the ankle the strength it needs.  Harvesting a tendon to replace your damaged ligament is generally involved in such procedures

Peroneus Brevis Tendon Rerouting / Loop / Split

In Rerouting procedure, the tendon is transected above the ankle, rerouted in a distal-to-proximal direction through a surgically created tunnel in the fibula, and then reattached at the initial transection site.

In Loop Procedure the tendon is transected above the ankle and rerouted through the fibula but is not reattached at the initial transection site

In Split Procedure the tendon is split longitudinally, with half of the tendon separated proximally from the intact peroneus brevis muscle-tendon unit followed by rerouting.

Conclusion

Surgeries & procedure such as ligament reconstruction, tendon rerouting or splitting can assist you in getting back on your feet. Once you’ve gone through the rest period of about six weeks after surgery, you can start to bear weight on your ankle and getting back to life.

The Foot and Ankle Specialists at the Singapore Sports & Orthopaedic Clinic supported by a qualified medical team have helped patients with treated and recovery from Ankle Ligament conditions. Book your appointment today and be on the path to good health and active life again.

hip joint x-ray

A Primer on Arthroplasty Surgery

Our hips and knees undergo a lot of stress throughout our lives. These joints absorb substantial force and weight when we walk, jump, and move. With wear and tear over time, the cartilage in our joints breakdown causing pain during weight-bearing activities.

Other than Cartilage wear out limb/joint misalignment, joint space narrowing, stiff joints, disease, or traumatic conditions may inflict pain and limit movement and mobility

Arthroplasty surgery can lead to restored function of these joints and an improved overall quality of life. The new joint can last up to 15-20 years. Trends in Singapore continue towards most individuals having at least one arthroplasty procedure in their lifetime

The most common Arthroplasty Surgeries in Singapore replace the hip or knee joint. It is one of the most effective and affordable surgeries in Singapore.

What Are the Benefits of an Arthroplasty?

With technological improvements, joint replacement surgery continually gets better, fast and cheaper. Undergoing an Arthroplasty surgery can benefit individuals by

  • Pain Relief
  • Improved mobility
  • Decreased risk of depression
  • An increased quality of life

The overall outcome of these procedures are high, with almost all experiencing decreased pain levels and improved functioning. However, as with any surgery, the procedure does not come without its risks. Risks include:

  • Infection
  • Bleeding
  • Blood clots
  • Loosening of replacement parts

These risks are often higher in those that suffer from pre-existing conditions beforehand.

Why Undergo an Arthroplasty?

Source: Johns Hopkins Medicine

Degenerative diseases, such as osteoarthritis, are the most common reasons for undergoing an Arthroplasty Surgery.

Osteoarthritis is the most common form of arthritis. Over time, wear and tear causes the protective cartilage in between bones to breakdown. This creates painful bone-on-bone grinding. Other reasons for undergoing an Arthroplasty procedure include injury or damage to the joint, necrosis, or rheumatoid arthritis.

While physiotherapy and chiropractic care methods may help ease the pain via strengthening of the surrounding muscles, pain may still persist. When the pain begins to interfere with one’s quality of life and daily activities, an Arthroplasty procedure is often recommended.

What Does a Arthroplasty Procedure Involve?

In short, the affected joint is either replaced or partially reconstructed. Since the 2 most common procedures involve the hip or knee, the following outlines hip and knee arthroplasty surgeries in a step-by-step process.

Hip Replacement Surgery:

  1. A general anesthesia is administered. This will allow you to sleep during the surgery and allow your muscles to relax making the operation easier for the surgical team to perform. You will also feel no pain during the procedure.
  2.  An incision is made on the side of the hip.
  3. The ball portion of the femur bone is removed and replaced with an artificial part.
  4. Damaged portions of hip bone, such as cartilage, are removed.
  5. The replaced ball portion of the femur bone is then inserted into the hip.
  6. Tissue, such as muscle, is reattached, and the incision is, then, closed.
required elements in knee arthroplasty
Image Source: New England Journal of Medicine

Knee Replacement Surgery:

  1. A general anesthesia is administered. This will allow you to sleep during the surgery and allow your muscles to relax making the operation easier for the surgical team to perform. You will also feel no pain during the procedure.
  2. An incision is made vertically in the front of the kneecap.
  3. The kneecap is moved out of the way to make room to perform the surgery directly on the joint.
  4. Damage to the femur bone is removed. It is, then, resurfaced to fit the artificial piece.
  5. An artificial piece is attached to the end of the femur bone.
  6. The top of the shin bone is treated in a similar fashion. Damaged portions are removed and the top of the shin bone is fitted with an artificial piece.
  7. A plastic piece is snapped into the top of the shin bone’s new part to help the knee bend properly.
  8. The patella is adjusted. A plastic piece may also be added to the patella to allow it to fit properly in the new knee joint.
  9. The joint is moved to ensure each piece is functioning properly. Then, the incision is closed.

Pre-Surgery Care

Before surgery, the appropriate examinations and tests are carried out to minimize risks. Your surgeon will fully explain the procedure and answer any questions you may have. You will also be advised not to consume any food for a set time before the procedure.

If you are on a waitlist for surgery or have months in advance to plan, it is recommended to begin strengthening around the area before undergoing the procedure. Strengthening these muscles beforehand will help with the recovery process. Discuss your options with your surgeon or your chiropractor and physiotherapist.

Post-Surgery Care

Following an Arthroplasty surgery in Singapore, your surgical team may require that you move your joint the right away. For hip replacement surgery, you may be required to walk right after surgery. This will ensure proper healing and mobility of the new joint. Your doctor will also prescribe pain medication to help you deal with the initial stages of recovery including how to take proper care of the incision while it heals.

It is also important to take extra care not to fall after surgery as this could cause damage to the newly replaced joint. Use handrails and supports when necessary. Often, a rehab program through a registered physiotherapist or chiropractor is recommended during the post-surgery stage.

Orthopaedic Care after Arthroplasty

Before joint replacement surgery, exercise may help decrease and manage your pain levels. Following an Arthroplasty Surgery, exercise in the rehabilitation process can help:

  • Decrease swelling
  • Improve range of motion and mobility
  • Improve gait and help retrain gait mechanics

Your physician will work with you to help you gain back your confidence and get you back to your regular activities. Initially, heat or ice application may be used to help reduce the swelling and pain. They will prescribe and help you perform stretches and strengthening exercises to help promote movement of the joint and provide support to the new joint.

Having a qualified healthcare professional guide you through the rehabilitation process can help determine the success of your Arthroplasty surgery. It also ensure you complete your exercises correctly which is essential to proper function of the new joint.

For the knee joint, post-surgery exercises focus on strengthening the quad and achieving full range of flexion. For the hip joint, post-surgery exercises will focus on the gluteal muscles, the major muscles of the leg, and core strengthening.

At the Singapore Sports and Orthopaedic Clinic, our team of doctors and surgeons can guide you through the entire process. Our experts provide the best treatment and care during the pre-surgery, surgery, and post-surgery stages. Our experienced team can help you get back to living your life, free of pain.

Call and book your consultation today. Get back to your regular activities and get back to enjoying your life.

Knee injury during workout

Everything you need to know about Ligament Tears

Ligament Tears are a common injury people experience, especially with those who are active in sports. Yet, many of us are quite clueless while trying to imagine which of portion of the body it is that actually gets affected.

And rightly so, coz Ligaments aren’t a prominent body organ nor is it something that visible externally to the human eye. So, ignorance on this subject can be quite rational.

In this post lets learn more about Ligaments, get a bit well-versed in appreciating its functions and gain some understanding of what happens on someone has torn ligament injury.

What are Ligaments

Ligaments are fibrous and flexible tissues that connect our bones to other bones. They help to support the joints and allow a normal range of motion for the joints. Ligaments have high tensile strength due to the high density of collagen present. Ligaments also provide proprioceptive inputs to the brain and allow the body to perform complex activities required in sports.

Common Ligament Injuries

Injuries to the ligament are common in high impact (such as Badminton), high speed sports (especially athletics) with the knee and ankle being the most vulnerable. A structural damage to the ligaments is known as ligament sprains. There are some ligament injuries that are much more common than others and let’s take a look at them.

ACL Tears

Anterior Cruciate Ligament (ACL) injuries are common is high impact sports like football, soccer, rugby and basketball. The ACL is one of the 4 main ligaments in the knee which joins the femur to the tibia. Nearly 50% of patients who experience ACL injuries suffer it in combination with injuries to other parts of the knee such as the meniscus and medial collateral ligament.

ACL injuries occur most commonly from sudden twisting motion when the foot is still firmly planted on the ground while the knee is trying to change direction, causing the ACL to rupture. An ACL reconstruction will be the most viable option after injury as ligaments cannot heal by themselves.

MCL Injuries

The medial collateral ligament (MCL) is another main ligament of the knee which provides stability to the knee. The MCL is located from the end of the femur to the top of the tibia and it prevents the knee from opening up. Due to its preventive features, it is commonly injured when there is an impact on the outside of the knee joint which causes the knee to buckle and the knee to open up.

MCL injuries are also mostly in conjunction with ACL and meniscus injuries. If it is a standalone MCL injury, surgery is often not required and patients can get on with their lives pretty well with the help of a knee brace to provide stability.

GHL Tears

The Glenohumeral joint ligaments (GHL) are located in the shoulders at the Glenohumeral joint which provides stability to the shoulder. The Glenohumeral joint connects the upper arm bone to the humerus and the shoulder blade. Injuries to the Glenohumeral joint occurs due to a fall and the patient landing on an outstretched arm, sudden twisting of the arm to beyond the normal motion range and a sudden impact on the shoulder, causing the ligaments to tear.

Above are 3 of the common ligament injuries that are experienced by many. Although ligaments are strong fibrous tissues, they can rupture if a sudden impact or twisting motion is applied on it. Ligaments are important in ensuring stability of the specific part of the body so extreme care should be taken to protect it.

Symptoms & Treatments for Knee Ligament Tear

Our knee is supported by 4 main ligaments – anterior cruciate ligament (ACL), medial collateral ligament (MCL), lateral collateral ligament (LCL) and the posterior cruciate ligament (PCL). Each of the ligament plays a different role in ensuring the stability of the knee.

illustration of ACL, PCL, MCL
Image Source: pt Health

However, due to various reasons, the ligaments can be torn. Rupture of the ligament can be a partial one or a full one and this will affect the treatment administered. A ligament tear will also bring about instability in the knee and the inability for it to bear weight, causing problems when walking. In this article, we will look at some of the symptoms and treatments for ligament tears.

Common Symptoms

  • As a general rule of thumb, a partially torn ligament will not bring about a pop sound while a fully ruptured one will produce a pop sound. A fully torn one can create instant instability and the knee may give way.
  • Swelling occurs and the injured knee may start to turn purple due to the lack of proper blood flow to the area. Swelling occurs due to a build-up of blood from the injured ligament.
  • The knee is unable to function properly, and you may feel that you are unable to control it.
  • Tenderness will onset when you touch the knee.

Quick Care Options (for minor injuries)

  • Protect the knee from further movements
  • Resting the knee immediately following injury for at least 48 hours. If you need to move around, consider using crutches or walkers to prevent bearing weight on the injured knee.
  • Ice will bring down swelling and reduce inflammation. Always try to ice the area every hour by using a cold compress or simply by wrapping knee in a towel and applying it locally.
  • Compress the knee with a bandage to reduce swelling and prevent excessive movements.
  • Elevate the knee to above your heart level to reduce swelling. This will cause excessive blood to flow away due to gravity towards your heart.

Treatment Options for Torn Ligaments

Here are the common treatment options for recovery from torn or ruptured Ligaments. The intensity of treatment needed and estimated knee sprain recovery time are dependent upon the severity of the injury.

  • Physical Therapy: Strengthening the knee and its surrounding muscles, tendons, and ligaments can help to repair ligament injuries. Specific knee ligament injury treatment exercises can help to repair ligament damage and restore full function to the knee.
  • Bracing: Wearing a knee brace or using crutches can help stabilize the knee and prevent sideways movements that may increase ligament damage and prevent healing and increase knee sprain recovery time.
  • Surgery: For serious injuries or tears associated with other injuries normal healing may not help, in such cases your doctor will most likely recommend a surgical solution.

 

Nutrition Tips for Ligament Tear Recovery

The ligament is a fibrous tissue and its main function is to connect bones to another bone and prevent abnormal joint motions. Injuries to ligaments will take a long time to heal. However, good nutrition can help to speed up the recovery process. The vitamins and minerals in food can help to facilitate healing.

Proteolytic Enzymes: The first step of any injury is to reduce inflammation in the region and foods that contain Proteolytic enzymes are especially useful due to its anti-inflammatory properties which help to eliminate protein from the injured region. Foods that are rich in proteolytic enzymes include pineapples and ginger roots.

Zinc: Zinc is another mineral that is excellent in combating inflammation. The way our body works is fascinating. When one part of the body is injured, it will divert all the zinc in the body to the injured part to counter inflammation. As such, other parts of the body will have a zinc deficiency. In order to prevent zinc deficiency, it is important to consume foods that are rich in zinc such as oysters, wheat germ and veal liver.

Vitamin C: Vitamin C has excellent anti-inflammatory properties as well and when worked together with Proteolytic enzymes, it provides an even better result. Vitamin C is not a vitamin that they body can self synthesize. As such, patients will need to consume it in order for the body to possess it. Vitamin C is also required to produce collagen in the body and this is important in ligament healing. Foods that are rich in Vitamin C include citrus fruits, broccoli and tomatoes.

Protein: Protein is the building block of our body and it is required by the body for any healing process. Protein can easily be obtained from foods such as tofu, meat, eggs and soy products. Protein deficiency will lead to various ailments in the body.

Calories: Although the body’s metabolism is low during injury, there is still a need to consume sufficient calories on a daily basis. Calories are required in the healing process and if patients decide to cut down severely on their calorie intake, this will slow down the recovery process.

Ligament injuries will require physical therapy, surgery and proper nutrition to ensure a speedy recovery. Proper nutrition is not difficult to achieve. Although your movements will be severely limited, you can always ask a dear one to help you out in ensuring you receive sufficient nutrition daily.

 

Torn Ligament Treatment in Singapore

At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today for an appointment @ +65 6653 2981 to get a professional assessment of your condition & start your journey toward a better life!

 

Bunion Deformity Correction: What you ought to know

Bunions & Bunionettes are a common cause of painful toes. A bunion is a misalignment of the bones in the foot, occurring when something causes the big toe to turn inward or in case of bunionettes this is a bone growth on the outside of your foot near your pinky, or 5th, toe.

While these can result from heredity, arthritis, or misalignment of the foot; a common cause is wearing shoes that squeeze the toes into pointy or narrow toe boxes, forcing the toes to fold over one another to fit in.

So if you are experiencing this condition what are the options available to overcome this deformity, read on…

Common Symptoms

Medically it is known as hallux valgus deformity. The symptoms for Bunion conditions are quite visible and clear, common ones include –

  • a bony protrusion at base of big toe (for bunion) or fifth toe (for bunionette)
  • pain, especially when wearing shoes that press against the bump

While you may not even notice a bump or growth there to start with, over time as the bunion/bunionette continues to grow, it can become quite painful. It’s also called a Tailor’s bunion in some circles.

 

Preventing Bunions

Yes prevention is better than cure. And in cases when its not hereditary…simply wearing shoes that provide sufficient room in the toe boxes is the best strategy for preventing bunions and bunionettes from developing. Look for shoes with blunt toes rather than pointy ones, and allow for about a quarter-inch to a half-inch of space between your longest toe and the front of the shoe. Selecting a functional shoes that are good to your feet over ones that are just aesthetically pleasing would be a wise choice.

 

Treatment for Bunions & Bunionettes

While some people can do well with the deformity by getting shoes that are roomier on their feet. For others treatment some of the treatment options would be –

Image Source: John Hopkins Medicine

Custom Inserts

Padding the affected area to protect it from rubbing on the shoes, and even custom inserts (Bunion Correctors) to help protect the area can be tried.

Another helpful aid is a shoe stretcher. A plastic fixture or plug that can be placed in the shoe to stretch the narrow area, which relieves pressure on the foot at that point. A shoe inserts (orthosis) can redistribute your weight so the bunion doesn’t constantly rub against your shoe.

While this may help some, it doesn’t always work and the next step would be a surgical procedure.

Orthopaedic Correction Surgery

surgery option for bunion
Image Source: Harvard Medical School

First, those who may benefit from surgery are the patients who have not gained any relief from the other methods already tried. Surgery is not the first line of defense for this ailment but it can relieve pain in those who do not receive relief in any other form.

This is an outpatient procedure so unless there are other complications to deal with, you’re going to be in and out in the same day. The surgeon you work with will go into detail on their plans, but generally the bunionette surgery entails the tissue on your outside of the foot and sometimes an incision is made into the bone itself. There are several different methods to help rid the foot of the bony growth and straighten out the curve that may have developed. Once your surgeon has looked over you records, they will go over the best options.

People who have a cut on their foot, lost circulation in the foot area, or that have an infection in the foot will not be good candidates for the procedure. Your doctor will advise the best route of dealing with the deformity correction to help relieve your pain and get you walking again.

If you have the surgery you can expect recovery to vary depending on your specific case. Most people are in a boot or splint to help the foot stay in place for anywhere from three weeks up to twelve. Be sure to follow all of your doctor’s orders afterwards so that you can make sure it heals properly and you can get back to business as usual.

Bunion Correction in Singapore

For Orthopaedic help and surgeries reach out to Singapore Sports & Orthopaedic Clinic at the Gleneagles Medical Center. Our team of orthopaedic specialists and doctors will advise you on the best possible way to treat Bunion Deformity Conditions. Call us or fill in the appointment form and we’ll get in touch with you.

Gout Treatment (Medication) in Singapore

Surprisingly, gout (podagra) affects about 1 in 40 individuals. It is a form of arthritis that causes stiffness, tenderness, and pain in the joints. It can make movement difficult and very painful. Luckily, gout treatment can help you manage your symptoms. Orthopaedic care offers a holistic approach to treating gout.

At the Singapore Sports and Orthopaedic Clinic, our qualified experts can help find the best solution and gout treatment in Singapore, for you and your lifestyle.

What is Gout?

Gout (podagra) is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints.

Gout - Anatomy of Feet

When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones (nephrolithiasis).

What Causes Gout?

  • Intake of alcholic beverages
  • Hereditary
  • Increase in level of uric acid
  • Starvation and dehydration
  • Trauma

Thousands of years ago, gout was considered the ‘disease of kings.’ Why? Certain foods with a high purine content, such as shellfish and red meat, and alcohol trigger gout attacks. During this era, these foods and alcohol were limited to royalty and the extremely wealthy. Thus, middle and lower class civilians rarely experienced the disease.

Today, the prevalence and incidences of gout have steadily increased. Our diets have changed. And with technology, we can detect and diagnose gout much easier than ever before.

Gout is caused by a buildup of uric acid in the body. Usually, the kidneys filter and then excrete uric acid through the urine. In certain circumstances, the body may produce uric acid at a higher rate than it can expel it. When uric acid levels in the blood become too high, the body deposits monosodium urate crystals in the joints. These crystals irritate our joints, and cause the symptoms commonly associated with gout including:

  • Tenderness
  • Pain
  • Stiffness
  • Redness
  • Inflammation

The body may be unable to keep up with uric acid levels for a number of reasons. Our body breaks purine down into uric acid. Purine is found in alcohol beverages, various meats, and seafood. When we consume foods high in purine, our bodies may lack the ability to keep up with the production of uric acid. This results in hyperuricemia, or high uric acid levels, in the blood.

In other cases, kidney impairment may cause higher uric acid levels. If the kidneys are unable to excrete uric acid, it builds in the blood. Impaired kidney function may occur due to diabetes, cancer, high blood pressure, thyroid disorders, or kidney failure.

Genetics and certain medications are also thought to play a role in the development of gout. For example, diuretic medication used to treat high blood pressure can lead to gout. Diuretics increase your fluid output. Yet, the fluid left in the body may become highly concentrated with uric acid. Doctors advise drinking plenty of fluids when taking diuretics and avoiding foods high in purine to reduce the risk of gout.

How is Gout Diagnosed?

Prior to gout treatment in Singapore, a proper diagnosis must be made by a physician. Your doctor may take into account a number of factors. They may assess and ask questions relating to the following:

  • Are you overweight?
  • Do you consume a diet high in purine foods?
  • Do you regularly consume alcoholic beverages in high amounts?
  • Are you on certain medications, such as diuretics?

A joint fluid test and blood test will confirm a gout diagnosis.

In a joint fluid test, fluid is taken from the inflamed and painful joint via a needle. If crystals are present in the fluid, a gout diagnosis is made. Your doctor may further order an x-ray to ensure the pain is not caused by other problems.

Exploring the Relationship Between Gout & Joint Pain

Gout can cause sudden intense painful attacks at the joints, causing swelling and redness of the joint tissues. It usually attacks the joint of the big toe but this does not rule out the attacks on other joints. Gout usually affects men with 9 out of 10 patients being men. Once gout starts to attack other joints, it leads to inflammatory arthritis. Let’s look at the relationship between Gout and Joint pain here.

Gout happens due to an excessive accumulation of uric acid. Uric acid is formed when the body breaks down an aromatic organic compound called purines. Purines are found in foods such as livers, beans, mackerel and beer. Overconsumption of such foods will lead to a high level of purines, resulting in too much uric acid. The body’s natural mechanism of dealing with uric acid is by passing them out through urination but when this urination process is less efficient, hyperuricemia occurs, leading to gout.

Gout happens through 3 basic stages:

Asymptomatic Hyperuricemia

This is the onset of gout. In this first stage, the patient starts to have an excessive accumulation of uric acid in the body but no other symptoms or problems are present. It is also in this stage that the problem can easily be reversed by significantly reducing the amount of purine-rich foods.

Acute Gouty Arthritis

When no actions were performed to limit the consumption of purine-rich foods, the uric acid levels will increased and lead to the formation of uric crystals in the spaces between the joint. Due to the crystals and high acidity, sudden onset of intense pain will occur and this can lead to swelling in the joints. Attacks will be infrequent and can be spaced weeks or even months apart from each, but as time passes, the attacks will become more and more common.

Chronic Tophaceous Gout

This stage is the most serious and will only happen after 10 years. A patient will only reach this stage when he makes no attempt to seek treatment and gout has caused a permanent damage to the joints and kidneys.

There is an exponential relationship between gout and joint pain, leading to sudden onsets of pain attack and swelling. However, reaching from one stage to the other takes time and during the periods, it can be treated by medication and reduction in consumption of purine-rich foods. Gout will cause a lot of trauma and severely affect patients.

How is Gout Treated?

In some cases, gout is very dehabiliting. It can happen suddenly and be very painful. The most common spot for gout to occur is in the big toe. Although, it may spread to the ankles, feet, and knees.

Fortunately, gout is a very treatable condition. And we offer a variety of ways to treat the disease. When a gout attack occurs, it will often resolve on its own in about a week. Thus, many health professions focus on relieving the symptoms and preventing future incidents.

Medications are the most common go-to. NSAIDs, nonsteroidal anti-inflammatory drugs, may alleviate swelling and pain. Your doctor may also prescribe stronger pain medication if over-the-counter drugs aren’t helping. Medications that help lower uric acid levels may also be considered. These type of medications help to prevent attacks by reducing the production of uric acid.

However, long-term use of most of these drugs is not recommended. Surprisingly, NSAIDs can have fairly dangerous side effects. With chronic use, heart problems may arise. Prescription NSAIDs are particularly problematic for this. You may experience gastro-intestinal issues. These medications may cause bleeding and ulcers when used for long-periods or at high dosages. Such medication may also lead to further impaired kidney function, which not only doesn’t help the problem but can amplify gout occurrences and symptoms. When using any medication, make sure to follow the direction on the label and read the warnings prior to consumption.

Your healthcare provider may also consider the medication you are currently taking and make modifications where it is necessary.

If your diet is the main problem, your healthcare provider may discuss other dietary options that do not increase your risk of gout. They will advise you to avoid foods high in purine and to drink plenty of water throughout your day.

In short..

The treatment of an acute attack of gouty arthritis involves measures and medications that reduce inflammation. Preventing future acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to lower the uric acid level in the blood.

Maintaining adequate fluid intake helps prevent acute gout attacks. Adequate fluid intake also decreases the risk of kidney stone formation in patients with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism to cause hyperuricemia. Therefore, alcohol has two major effects that worsen gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, both of which contribute to the precipitation of uric acid crystals in the joints.

Orthopaedic Care & Gout Treatment in Singapore

At the Singapore Sports and Orthopaedic Clinic, our experts can diagnose, treat, and prevent joint, neuro, and muscular disorders, such as gout. They can provide exercise and nutritional advice to help treat gout.

Your doctor will address your nutritional and lifestyle choices, in combination with manual manipulation of the joints to eliminate your pain, improve mobility, reduce the incidences of gout attacks, and help increase your overall quality of life.

Your healthcare provider may recommend the following foods to replace high-purine content foods in your diet:

  • Low fat dairy products
  • Vegetables
  • Legumes
  • Whole grains
  • Nuts
  • Water

Surgery is a rare option for treating gout. However, in cases where there is a lack of draining, the area has become infected, or movement is severely impacted, surgery may provide the best option.

Your healthcare provider may also recommend specific exercises to reduce joint pain and increase support to the commonly affected areas. Weaknesses in the body may lead to pain and conditions such as gout. Strengthening around these areas can lessen the pain symptoms associated with the condition. Weight management is also important to limit the stress placed on the joints that are prone to gout attacks. Your treatment will likely involve an exercise program tailored to your specific needs, including strengthening exercises and possible weight loss strategies.

Get the advice you need and the proper care and treatment for your condition. Frequent and painful gout attacks do not have to be your normal.

At the Singapore Sports and Orthopaedic Clinic, our qualified doctors will find the appropriate gout treatment in Singapore for you. Our team of doctors are experienced in treating orthopaedic problems, sport injuries, and degenerative changes. Start your life free of pain. Get back to the activities you know and love. Call and book your appointment, today.