IBJI Blog

Adolescent Athlete Knee Pain, is it Osgood-Schlatter Disease?

Osgood-Schlatter is a painful disease that occurs on the tibial tubercule, which is right under the knee on the upper portion of the shinbone on adolescent’s who are going through growth spurts. Physicians believe that it is caused by small, but frequent injuries to an area of the body that is a already under great stress from growing. The quadriceps muscle is one of the primary muscles used for running, jumping, and climbing. When it is overused, the quadriceps can become inflamed, swollen, and very painful. In Osgood-Schlatter Disease cases this swelling occurs on the tibial tubercule.

Symptoms of Osgood-Schlatter Disease

There are some specific warning signs of Osgood Schlatter Disease to watch for, including:

• Swelling on the bump right below the knee
• Pain or tenderness around the knee
• Pain in one or both legs
• Running, jumping and climbing may cause increased pain
• Mild to sever swelling

Trigger Finger Disease Isn't What Clint Eastwood Thinks It Is

Stenosing tenosynovitis is the medical name of a fairly common condition that is widely known as trigger finger. This condition causes one or more fingers to get locked into a curled position and suddenly release, almost snapping back.  Its name derives from its similarity to the motion of a shooters finger when they pull the trigger of a gun. In the worst cases of trigger finger the finger can get stuck in a curl and not straighten out. Despite some similarities, trigger finger is not related to Dupuytren's contracture.

Symptoms Of Trigger Finger (They Aren't Usually Itchy)

The symptoms of stenosing tenosynovitis can vary widely from almost non-existent to very severe. In many cases the severity progresses, becoming more and more severe as time goes on. The symptoms of trigger finger are:

• A finger stuck in a curled, or bent, position
• Occasionally the finger gets stuck and locked into a curl
• May involve one finger, multiple fingers, and both hands
• Usually occurs on the thumb, ring, and middle fingers
• A finger that makes a click or pop when moved
• Mornings tend to be the worst for stiffness
• A bump near the hand that may be tender
• Grabbing an object may cause the finger to get stuck
• An inflammation in the joint on the affected finger

For Immediate Press Release
March 21, 2012

14 IL Bone & Joint Institute Providers Certified in the AMA 6th edition

Fourteen physicians and two physical therapists at Illinois Bone and Joint Institute (IBJI) are now certified in the AMA Guides to Impairment, 6th edition. IBJI providers serve workers’ compensation patients at locations in Chicago, Gurnee, Libertyville, Glenview, Bannockburn, Arlington Heights, Lincolnwood and Morton Grove. At least a dozen additional IBJI physicians will participate in training and take the certification exam at the end of March 2012.

The providers currently certified in the 6th edition include: Medical Doctors James C. Cohen; Robert C. Dugan, Thomas F. Gleason, Peter Hoepfner, Ira Kornblatt, Alan League, Michael Lewis, Edward J. Logue, Steven Mardjetko, Tomas Nemickas, Rhutav Parikh, Charles Slack, Jeffrey Visotsky, Craig Williams. Complete information about each physician, including their areas of expertise, can be found at www.ibji.com/physicians. Doctors of Physical Therapy Joseph Castronovo and Richard Talenti also became certified in impairment ratings on March 3, 2012.

To make an appointment for a work comp patient, please contact the physicians at locations listed on www.ibji.com. To make an appointment for an IME, with or without impairment ratings, you can call 877-385-8755. Contact IBJI’s Industrial Rehabilitation Program to connect with the therapists named above at jcastronov@ibji.com.

This information is not intended to provide advise or treatment for a specific situation. Consult your physician and medical team for information and treatment plans on your specific condition(s).

Rotator Cuffs: Revolving Around The Shoulder Joint

A common misconception is that the rotator cuff is the entire shoulder joint. In actuality the rotator cuff is only a part of the shoulder joint. There are four muscles and tendons that surround the shoulder joint. These muscles and tendons help hold the upper arm in place by attaching it to the shoulder blade and holding the ball end of the bone into the socket of the joint. This complicated structure allows for a wide range of motion that is not seen in any other joint of the body. This expansive range of motion allows for people to accomplish many tasks, but it also leaves the rotator cuff susceptible to injury.

Rotator Cuff Symptoms Can Make You Feel Shackled

The rotator cuff is open to a lot of different potential injuries. Typical symptoms of injury to the rotator cuff is weakness in the shoulder, a decreased range of motion, a desire to keep your shoulder still, and of course shoulder pain or tenderness. Pain is sometimes felt more acutely when pulling or lifting an object, reaching for something over your head or behind you, and even possibly when lying on the shoulder.

Twisting & Turning: Causes of Rotator Cuff Injury

While most people focus on rotator cuff tears, there are a number of potential injuries and ailments for pain to be felt in the rotator cuff. These include:

• Strains & Tears – This can occur suddenly following a sudden movement or over time as the tendons deteriorate.
• Tendinitis – Occasionally people who work or take part in sports that involve raising their arms over their heads, lifting heavy loads, or repeatedly moving the shoulder can cause the tendons to become inflamed.
• Bursitis – In the shoulder joint is a liquid filled sack called the bursa that sits between the shoulder and the rotator cuff. In some cases the bursa can become inflamed.

The Tendon Named After Achilles

Commonly called the Achilles tendon, it is known in medical terms as the calcaneal tendon. It is usually the strongest tendon in a person’s body, attaching the 2 muscles in the lower leg to the back of the heel. It is integral in allowing people to walk and move because it facilitates the extension of the foot and pointing of toes.  It received its name from Greek mythology. Achilles was mystically protected from harm with only one weak point in his body; the tendon which would eventually bear his name. On the myth, Achilles died after a poisoned arrow fired by an enemy named Paris struck this tendon. Nowadays, most of us thankfully do not need to dodge poison arrows. Injuries to the Achilles tendon, while still potentially painful and debilitating, are not as dire as they were in the days of Zeus.

Common Achilles Tendon Injuries

While this tendon is the thickest and strongest tendon in the body, it is also one of the most frequently injured.  Tendonitis, or swelling, is one of the more common causes of Achilles tendon injury⁽¹⁾. Of course this tendon can be damaged in more traumatic ways.  A complete or partial tear is usually found after an excessive amount of force is placed on the heel. It takes a large amount of force to damage the tendon as it routinely receives 4 to 8 times the weight of a persons body when walking and running. These increased loads are most often seen in athletes. ⁽²⁾   This mean that in some cases a severely injured Achilles tendon can be career ending.

Non-Arrow Causes Of Achilles Tendon Injuries

There are a few causes of injury in the Achilles tendon. Some causes are things that can be changed and others are unfortunately unavoidable.

Common causes of tendon injury that aren’t caused by fighting:

• Improper, or ignored, stretching before starting exercise.
• Increased loads placed on the tendon by wearing high-heeled shoes.
• Beginning a new, or increasing an existing, overly strenuous activity.
• Medical conditions like fallen arches or flat feet, making every impact more forceful than usual.
• Overly tight tendons and muscles, which are not relieved by stretching.
• No different the other tendons, the Achilles tendon can be damaged by overuse and repetitive motion.

Congratulations To Dr. Steven Mardjetko

On March 7^th one of the Illinois Bone and Joint Institutes spine specialists, Dr. Mardjetko was named as one of the 207 Spine Surgeons and Specialists to know by Becker’s Orthopedic, Spine & Pain Management Review. Dr. Mardjetko was selected for the list based on his research into spine care, his professional accomplishments, and his leadership in IBJI's spine care. With thousands of spine specialists currently working in the country, being named as one of the top 207 is quite an honor.

Dr. Mardjetko's Many Accomplishments

At IBJI Dr. Steven Mardjetko is a specialist in spinal deformities in adults and children, pediatric orthopedics, and spinal surgery. He has focused closely on cervical spine disorders, injuries to the spinal cord, and scoliosis and other general disorders of the spine. He is a fellow at the AAP (American Academy of Pediatrics), the American Academy of Orthopedic Surgeons, and the Scoliosis Research Society. Dr. Mardjetko has a medical degree from the University of Illinois Medical School where he graduated with Honors. He has also completed two fellowships in pediatric orthopedics and spinal deformity and reconstruction at the Rush-Presbyterian-St Luke's Medical Center right here in Chicago.

Osteoarthritis In A Nutshell

Arthritis can take many forms, but the most commonly diagnosed is osteoarthritis (OA). (1) Caused by the gradual breakdown of cartilage in almost any joint it can result in arthritis related pain, stiffness, decreased range of motion, a feeling of grating in the affected joint, and point tenderness. Worldwide, millions of people are affected by OA; in the US almost 27 million people live with its effects. Osteoarthritis does not discriminate based on race or ethnicity however it is most common in people under 45. Men are typically affected more than women when they are under 55 years old, but after the age of 55 that changes to women being more likely to feel the discomfort of osteoarthritis. (2)

Risk Factors For Osteoarthritis

A few OA risk factors you cannot avoid are:

• Genetics – Joints that are misshapen and have a family history of osteoarthritis
• Prior Joint Problems – Previous joint injuries, surgical procedures, infections and a history of other types of arthritis
• Buildup Of Elements – An overabundance of calcium, iron, or copper due to endocrine or metabolic issues
• Nerve Damage – Poorly functioning nerves can lead to changes in your posture, which in turn can cause joint damage
• Age – As years pass, wear and tear on the joints increases
• You can decrease some of the risks, including:
• Physical Activity – A lack of exercise causing weak muscles and stiff joints
• Weight – The more pressure put on the joints, the more damage is done
• Injury – Major injuries can seriously damage the joint’s cartilage
• Repetitive Motions – An activity that requires a motion to consistently be repeated will wear the cartilage down much quicker

Overuse and Abuse Leading To Hip Osteoarthritis

Hip osteoarthritis can be painful and even completely debilitating in some cases. After years of motion and abuse, all of that wear and tear can cause damage to a hip, potentially leading to osteoarthritis. This degenerative joint disease is a result of the cartilage in the hip being damaged and worn away over the years. After the cartilage has disappeared, the bones are allowed to rub against each other, resulting in inflammation and pain.

Risks Associated With Osteoarthritis In The Hip

Due to genetics almost anyone can be affected by hip osteoarthritis, though there are some things that can increase the likelihood of developing this disease.  Since this disease is caused by damaged bone over a long period of time, people over 50 are typically the most affected. If the hips are forced to bear more weight than normal more damage is done to the cartilage which means that people who are overweight have an increased potential for developing hip osteoarthritis. A previous injury, like a broken bone or dislocation, is often seen in cases of osteoarthritis in the hip. Joint deformation, like hip dysplasia, can cause the cartilage to be worn abnormally and quicker than usual leading to potential for earlier onsets of arthritis.

When the muscles in the hip place pressure on the sciatic nerve it can cause excruciating pain called sciatica. The sciatic nerve is a major nerve the travels the full length of the body, following the lumbar region of the back and down the leg all the way to the foot. Typically this nerve does not trouble people, but it is vulnerable to pressure due to its path though the hip. In many cases physical therapy, when prescribed by an orthopedic physician, will result in effective and long lasting pain relief.

Type of Physical Therapy For Sciatica

There are a variety of physical therapy options available to pain management doctors in the treatment of sciatica. The types of treatments usually fall into two categories; active therapy and more passive treatments. Active treatments may include aerobics exercise, strength training, and stretching. The more passive treatment options can consist of massage, Transcutaneous Electrical Nerve Stimulation (TENS), and Ultrasound. All of these have the potential for temporary, and in some cases more permanent, sciatica relief.

Get Active!

The three main types of physical therapy that involve movement and activity all have different benefits.

• Aerobics– As mentioned in our arthritis pain relief through exercise article, aerobic exercise, including long walks or swimming laps, releases natural pain relieving endorphins into your body.
• Strength Training – To decrease the chances of injury and creating proper back alignment sciatica strength training usually focus on the lumbar region in the back, the gluteal muscles, and the thigh muscles.
• Stretching – Relaxing the muscles that have become resistant to movement and are causing the impingement of the sciatic nerve is a very common method of sciatica pain relief.

Definition of Degenerative Disc Disease

As every person ages they will begin to damage their spinal discs but most people will never know the pain of degenerative disc disease (DDD). The name is potentially misleading though. It is actually a condition, not a disease, which usually affects either the lumbar or cervical regions in the back. It is a result of the normal movement over a lifetime that causes deterioration of the discs in the spine. Those discs hold the vertebrae together while allowing for movement and functioning like cushions or shock absorbers.  Disc degeneration itself is not usually painful; however, when those discs are no longer providing the cushion they once did, then the patient may experience back pain from the pressure put on the spinal cord and the adjacent nerves.

From Discomfort to Disabling - The Difficulties of DDD

The symptoms of degenerative disc disease can vary from patient to patient. Differing amounts of degeneration as well as the location of the degeneration in the back can all affect the severity and types of symptoms the patient experiences.

• The levels of pain can go from irritating to devastating.
• The pain may appear one day and then disappear a few days, or even months, later.
• There may be a numb or tingly feeling in the legs, arms, feet or hands.
• While seated the pain becomes more intense.
• Long walks or runs may lessen the discomfort.
• While sleeping a change of position possibly brings relief.
• Increasing pain when picking up an object, bending over, or rotating.
• The lumbar region, thighs, and cervical regions may be impacted by pain.
• Potentially, damaged nerves may make the patient’s legs feel weak.