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Irritation and injury of the rotator cuff are the most common shoulder problems encountered the sports medicine community. While these problems can occur after a specific traumatic injury, they are more commonly associated with repetitive use. "Wear and tear" over time leads to the development of rotator cuff symptoms in a large portion of the population as they enter their 40's and 50's. We will briefly attempt to review the main principles involved in rotator cuff disease and to outline treatment options.
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Muscle tissue makes up approximately 40% of the body weight of the average person. It is the contraction of muscular tissue that allows our joints to move. Muscle tissue is composed of many fibers, which in turn are composed of many sarcomeres. The sarcomere is the smallest contractile unit, and it is through the contraction of countless numbers of these tiny contractile units that contraction of the muscle occurs.
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Heel pain is a common complaint in both the athletic and non-athletic populations. Causes of pain include stress fractures, S1 radiculopathy (nerve compression in the back) and nerve entrapment syndromes. However, one of the most common causes of heel pain is inflammation of the plantar fascia, plantar fasciitis.
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Osteochondral fractures of the talus are commonly associated with ankle sprains. Berndt and Harty classified osteochondral lesions into four stages.
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The ankle is an excellent example of interplay between bone and ligamentous structures and their protective relationship upon one another. The ankle joint is maintained by the shape of the talus (first bone of the foot) and its tight fit between the tibia and fibula. In the neutral position, there are strong bony constraints.
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Spontaneous rupture of the achilles tendon generally occurs in patients in their third to fifth decade. Most patients are men and most injuries occur during sporting activities. The most common mechanism of injury is pushing off forcefully with the affected foot while extending the knee.
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The ankle is an excellent example of interplay between bone and ligamentous structures and their protective relationship upon one another. The ankle joint is maintained by the shape of the talus (first bone of the foot) and its tight fit between the tibia and fibula. In the neutral position, there are strong bony constraints. With increasing plantar flexion, the bony constraints are decreased and the ligaments are more susceptible to strain and injury. The three major ligament groups that support the ankle include the tibiofibular ligaments, the deltoid ligament complex medially and the lateral ligament complex.
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Osteochondritis dissecans (OCD) is a condition in which a fragment of subchondral bone and its overlying articular cartilage becomes separate from the underlying bone.
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The primary functions of articular cartilage (covering of the bone) are to distribute forces to the bone and provide a low friction surface for the joint.
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Arthroscopic treatment of meniscal injuries is one of the most common orthopedic surgical procedures. Although our knowledge and understanding of the anatomy) function, and treatment of meniscal pathology has evolved, meniscal tears continue to cause significant symptoms and long-term impairment of the knee.
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The posterior cruciate ligament, the largest and strongest ligament in the knee, prevents posterior displacement of the tibia on the femur.
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Five Phase rehabilitation program for Torn ACL Ligaments.
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The incidence of ACL injuries has increased dramatically over the last 2 decades. More than 200,000 new ACL injuries occur in the United States annually. These injuries are important because of the extent of disability associated with ACL tears.
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Anterior knee pain in the athlete can be a difficult problem for the sports medicine physician given the numerous causes and refractory nature.
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Chondromalacia is a descriptive term, which literally means softening of cartilage.
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The treatment of ACL injuries should be tailored to the individual patient. Risk factors that may be used to determine treatment include age, activity level, willingness to modify activities, laxity of the joint, number of giving way episodes, and presence of associated ligament, articular cartilage, or meniscal injuries.
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Injuries to the knee are very common. The anatomy of the knee has been studied extensively. This section will attempt to cover major aspects of knee anatomy.
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Post Surgical Rehabilitation Protocol, Type Two - Rotator Cuff Repair (Deltoid Splitting), Medium to Large Tear - Greater than 1 cm and Less than 5 c.
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Cuff tear arthropathy is a term which is used to describe the changes which occur in patients who have suffered a large tear of the rotator cuff which has gone untreated. In many of these patients, repeated corticosteroid injections have been given over the years. They may have been told repeatedly that they simply had bursitis and no further evaluation may have been given.
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The shape of the acromion can be seen on a specific X-ray view known as an outlet view. The acromion has been described as having three general confirmations: (Type I) flat, (Type II) curved, (Type III) hooked.
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The patient with multidirectional instability usually has a large element of inferior (downward) instability in addition to anterior or posterior instability. Many of these patients have generalized laxity of their joints. Often, they have complaints involving both shoulders.
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