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Joint Mechanics

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Anterior cruciate ligament (ACL) tears are probably the most commonly known knee injury requiring surgical repair.

Tony Buoncristiani, M.D., of Sawtooth Orthopedics & Sports Medicine, explains that ACL surgery “is currently experiencing a ‘rebirth’ whereby two ‘bundles’ of tissue associated with the ACL are being reconstructed via a ‘double-bundle’ technique to provide more stability and improve outcome. This is especially important for those individuals who participate in rotationally demanding sports (i.e., skiing, hockey, football, soccer, basketball, etc.)”

Some people may find temporary pain relief from homeopathic remedies, acupuncture or foot reflexology, but as a PT, I find that the underlying mechanical injury also needs to be addressed to achieve lasting improvement.

Rehab involves techniques that improve blood flow to the tendons, since they receive only about 16 percent of the flow received by the muscles. I also use massage to relieve trigger points and tightness in the shoulder blade muscles, and mobilization to the joints of the shoulder and neck/upper back, since they too strongly influence mechanics. Rehab exercises are different from what someone would do with standard gym equipment, because PTs help athletes train movements and muscle groups together in a way that will mimic the demands placed on the shoulder during a specific sport.

If conservative treatment fails, surgery may be indicated. According to Dr. Buoncristiani, rotator tears are predominantly being repaired arthroscopically, with new techniques being used to restore the original anatomical attachment of the rotator cuff via a “double-row.” Of course, as with many orthopedic problems, corrective surgery is just the first step in the healing process. A rehabilitation program and strict adherence to the program is crucial to recovery. Dr Shapiro states that, “Most patients have a hard time accepting that it will be six to nine months after a rotator cuff reconstruction before they’re able do things that require power from the shoulder muscles. You just can’t rush Mother Nature.”

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