physiotherapy

What is ACL injury and Does it Require Surgery

June 22, 2020
by Eva Hospital

If you are a soccer player, basketball champion, or football player you are probably familiar with the term ACL.

While playing the game if you hear a popping sound and suddenly your knee is giving out under your body weight, you have most likely incurred an ACL injury.

This will lead to immense pain and swelling in the knee and aches or tenderness in the joint within the next 24 hours.

What is the ACL?

ACL is the acronym for anterior cruciate ligament (ACL). This ligament is positioned in the middle of the knee and connects the thighbone (femur) with the shinbone. It helps stabilize knee joints in the connections.

Basically, ACL provides rotational stability to the knee and prevents the tibia (shinbone) from sliding out in front of the thighbone.

While playing, if you pivot your firmly planted foot, or suddenly change direction, there are chances that you face ACL tear and this may cause damage to the surrounding ligaments and cartilage as well.

According to the best orthopedic and sports injury specialist in Punjab, Dr. Tanveer Bhutani, ACL injuries occur during the game when the player suddenly changes direction or speed or improperly lands while in the game. ACL can be painful and needs immediate medical supervision under an expert.

What are the Causes of an ACL injury?

While playing the game if any one of the following happens and you hear a popping or cracking sound in the knee, you have succumbed to ACL injury:

Direct collision with a jerk with another player during the game can cause an ACL injury.
If you suddenly stop with a thrust, you are likely to sprain the ligaments in the knee.
You may be required to change direction suddenly to accustom to the direction of the ball, and this rapid directional change can cause havoc to the ACL in the knee.
A direct blow in the knee from the force of the ball can be devastating for the knee.
You may land in an odd position from a high jump in the game and this can cause a sprain in the knee.

Dr. Bhutani adds that apart from positioning or speed changes in the game, a few other factors can add to the vulnerability of the ACL tissue.

If you are a woman, relatively weak muscle strength or any hormonal imbalance can add to the tenacity of the damage. Dr. Bhutani checks for arthritis or any other medical conditions that can aggravate the pain or delay the treatment response.

An ACL injury can aggravate the risk of developing osteoarthritis also. The severity of the injury, the positioning of the tissues and ligaments affected and the movement protocol post-surgery can affect the quality of motion and lead to the development of arthritis at later stages. Hence Dr. Bhutani recommends following precautions at all stages of the game.

How can you Prevent ACL Injury?

Dr. Tanveer Bhutani advises the age-old adage to all his patients (of all age brackets)- ‘prevention is better than cure. Sprains or ACL injury affects over 1,50,000 athletes annually and prevention can help mitigate these injuries.

An ACL injury can cause disruption in the range of movement, feeling of instability, and inability to walk without support along with incessant excruciating pain. Dr. Bhutani recommends the sports player abide by the following precautions to avoid ACL injury trap:

Warm-up and Stretches

A physical therapist or a sports medicine practitioner always emphasizes the importance of adequate warm-up and stretches before practices to avoid any type of sports injury.

The relevance of warm-up techniques should not be undermined under any circumstances. Athlete trainers teach and advocate a set of specific warm-up exercises pertaining to the game.

Targeted Strength Training

Athletes or players must focus on strengthening the core muscles. Exercises that help the hips, pelvis, and lower abdomen to gain strength must be done regularly under the supervision of a trained mentor.

You must be adept at knee positioning at all times and focus on exercises that help you gain balance when jumping and landing from jumps.

Proper Footwear and Sports Gear

Proper footwear and padding relevant to the game are quintessential to preventing sports injuries.

Also read: How to prevent sports injuries.

Balance Training

You must focus on exercises that strengthen leg muscles and in particular the hamstring muscles so that the knee can handle the overall body in proper balance.

Is Surgery Required for ACL injury Treatment?

Dr. Tanveer recommends physical examination, X-ray, or maybe an MRI to analyze the extent of the damage. For inactive athletes, the orthopedic may recommend physical therapy or braces to avoid pain and this may lead to slow partial recovery.

However, for young and active athletes and players, arthroscopy or minimally invasive knee surgery is mandatory to be able to resume the game.

During the surgery, a small incision or portal is made in the affected joint. With the help of a camera and fiber optics, the orthopedic can light the internal space, and then the surgery is conducted.

ACL is reconstructed in the procedure using autograft (grafts from the patient’s own knee) or allograft (donated tissue graft).

Dr. Bhutani advocates arthroscopy for ACL injury as it offers the view and complete insight into the extent of damage that no X-ray or MRI can give.

ACL reconstruction surgery gives the player an undisputed chance to revive the game and part away with the instability or pain in the knee. Surgery also delays or mitigates the chances of occurrence of degenerative arthritis at later stages.

Dr. Bhutani is the most experienced sports injury specialist and has conducted innumerable ACL reconstruction surgeries.

Over to You

ACL cannot heal on its own because of the lack of blood supply to this ligament. If you are a sportsman who is active in the sport or if you have twisted your knee and damaged your ACL, get in touch with the best sports orthopedic in Punjab,

Dr. Tanveer Bhutani at EVA Hospital. Let not the untreated ACL weaken the ligament further and cause instability. Adhere to the precautions and prevent the agonizing ACL injury.

Sports Injuries Treatment

Sports Injuries- What are the Types, Prevention and Treatment

January 14, 2020March 30, 2024
by Eva Hospital

Are you the weekend warrior, a regular sportsman, or a gym freak? If you are either of them, you would understand what adrenaline gush means while you are playing your game or even merely talking about it. The only grim part of games and sports is getting a minor or a major sports injury.

What are the Types of Sports Injuries?

Sports injuries can happen at any time while exercising or while at the game. Sports injuries can happen to anyone-children or adults. You shall be more prone to sports injuries in the following cases:

If you have a sedentary lifestyle
If you avoid proper warm-up before the game
If you play contact sports
If you are not active

Different types of sports injuries have different protocols to follow. Here are the most common types of sports injuries:

Sprains

The injury to ligaments caused due to tearing of ligaments is called a sprain. This is the most common sports injury. The tissues connecting two bones to one another in a joint are ruptured.

Strains

Strains are the over-stretched muscles or the ‘pulled muscles’ which cause tears in the muscle fibers or tendons. Tendons are thick, fibrous cords of tissue that connect bone to the muscle.

Knee Injury

The knee is the most commonly twisted or bent body part while playing. Overstretching, tear in the tissues, ACL tear or the injury resulting from repetitive movement of the knee cap called Patellofemoral Syndrome are all types of knee injuries.

Tennis Elbow

Tennis elbow or Epicondylitis is the pain related to the muscles and tendons of your forearm. There may be a tear in the tendon due to repetitive stress and overuse of the muscles around the elbow. This is also called ‘golfer’s elbow.’

Fractures and Dislocations

Most commonly heard and most prolonged maybe this type of injury-fractures or dislocations. Bone fractures or when a bone is dislocated in the body are both painful injuries and may take a while to heal.

Groin Pull

The side-to-side motion may trigger a push off causing strain of inner thigh muscles or groin. This may sometimes cause significant swelling.

What are the Ways to Prevent Sports Injuries?

Dr. Tanveer Bhutani, a leading orthopedic of Punjab, is a strong advocator of ‘warm-up’ before any workout or game. He says that injuries are likely to happen when your body isn’t conditioned to a particular movement or angle per se.

Every movement or activity must begin with a proper warm-up and you must make sure to be properly dressed and geared up according to the activity you indulge in.

Read through the following pointers and you can prevent the majority of sports injuries:

Learn the proper technique of the game and movements. Different games require different postures and focus on different angles.
Wear proper shoes and equip yourself with proper pads and preventive gear.
Never push yourself beyond the limits suddenly.
Cooldown post the activity is equally important as a warm-up is. Rolling out the muscles using a foam roller is also recommended.

In case you feel pain or overstretch in any of the muscles, do not rush to the activity and give the body a chance to heal.

Dr. Tanveer advocates adequate Rest (R), Ice packs (I), Compression (C), and Elevation (E) as the foremost treatment of any sports injury. If the swelling or the pain or discomfort prolong, you must not delay in contacting an orthopedic immediately.

What are the Treatments of Sports Injuries?

“Some sports injuries will heal with RICE (Rest-Ice-Compression-Elevation) methodology,” says Dr. Tanveer, “however for the severe sprain or strain or a ligament tear, surgery may be recommended”.

Here are some common treatment protocols in the most frequent sports injuries:

In the case of Ankle Sprain or Strain:

Complete healing of a hamstring strain may take about one year. It is advised to exercise and revive flexibility so that the chances of re-injury are zilch. The doctor will examine a high ankle sprain to make sure that the bones in the lower leg are intact and not separated.

In the case of Groin Pull:

RICE can help heal a groin pull. However you should not be in a haste to resume the activity, else the problem can be permanent. For persistent swelling, your orthopedic must be consulted immediately.

In case of Knee Injury:

An anterior cruciate ligament (ACL) holds the leg bone to the knee and in case of suspected ACL, an orthopedic may recommend surgery as this is the most common type of injury.

While in games like running, volleyball or basketball repetitive movements of the knee cap against the thigh bone may damage the tissue under the kneecap. This is called Patellofemoral syndrome which may take up to six weeks to recover. The doctor may advise continuing low-impact exercise particularly working out quadriceps for relieving the pain.

In the case of Tennis Elbow:

Epicondylitis or tennis elbow causes irritation and tears in the elbow tendons. You may be advised against playing the game till the pain recovers.

Final Words

Sports injuries can be prevented with precaution and warm-up. Worst cases of sports injuries may not heal with RICE and expert advice of the orthopedics may be needed. Dr. Tanveer Bhutani, at EVA Hospital, is a sports injury specialist and has treated the gravest of sports injuries with precision and care. Stay fit, stay healthy and take care of injuries carefully.

Orthopaedic

How to Treat the Recurrent Shoulder Dislocation

November 12, 2019March 30, 2024
by Eva Hospital

The shoulder is the most mobile joint of the body which is responsible for movement in the arm, swinging the arm, lifting weights, moving the arm to and fro as well as up and down. This greater range of movement may be a cause of instability, especially in the case of a sportsman.

Causes and Effects of Shoulder Instability

Due to shoulder instability, the upper arm bone comes out of the cup-shaped socket that is a part of the shoulder blade and this causes a shoulder dislocation. Following may be the symptoms of shoulder dislocation:

A deformed or misplaced shoulder
Swelling or bruising in the shoulder
Intense recurring pain
Immobile joint

With the movement of the shoulder in just any direction to swing the arm, dislocations are more likely to happen if there is instability in the joint. A strong jerk or a sudden blow may pop the arm ball out of the shoulder socket.

The reasons for shoulder dislocation can be either of the following:

Sports and Work Injuries

In sports like hockey, cricket, soccer, or sports involving falls like gymnastics, skiing, volleyball, etc. Shoulder dislocation can happen frequently. Repetitive strain can cause the shoulder to become unstable. Even some jobs require repetitive work which can traumatize the shoulder.

Sudden Fall

A fall from a certain height, fall from a ladder or stairs, or even tripping from a lopsided carpet or rug may be the cause of severe shoulder pain and shoulder dislocation.

Sudden Jerk

A sudden jerk while exercising or a sudden brake while driving may cause the shoulder to dislocate. Shoulder dislocation or recurrent shoulder dislocation may cause tearing of muscles, ligaments, and tendons that reinforce the shoulder joint. It may lead to shoulder instability which makes shoulder dislocation recurrent.

What are the Treatments for Shoulder Dislocation?

In some cases, non-surgical treatment by just reducing and immobilizing the shoulder may work. This is usually done by your orthopedic surgeon in anesthesia. Post-procedure, applying ice, rest and physical therapy may help.

However, if the tissues that hold the shoulder are ruptured or strained, or if you experience recurrent shoulder dislocations, Dr. Tanveer Bhutani, at Eva Hospital suggests and strongly recommends Shoulder Arthroscopy surgery. If you are a young athlete majorly in sports involving arm movements like throwing or collisions, shoulder arthroscopy is mandatory to resume the game.

What is Shoulder Arthroscopy?

Shoulder arthroscopy is a minimally invasive surgery where the surgeon accesses the shoulder using small incisions and minimal damage to the surrounding tissues.

A slim, pencil-sized instrument called an arthroscope is inserted into the joints through a small incision. With a keyhole light and a keyhole video camera, on the other hand, the details of bones, tendons, ligaments, and labrum are highlighted and magnified.

The torn ligament or labrum is repositioned, the ring of cartilage that surrounds the shoulder socket is repaired and the humerus is stabilized.

It is usually outpatient surgery and you can leave the hospital within a couple of hours post the surgery. This may, however, be contingent on the patient’s health status and age.

Dr. Tanveer Bhutani, the best orthopedic surgeon in North India describes this surgery for shoulder dislocation as very effective and says that with proper follow-up and medications, and physical therapy, the patient will be able to resume sports activities within 8-14 weeks.

Last words

Why suffer from pain and discomfort of recurrent shoulder dislocations when shoulder arthroscopy can heal the dislocated shoulder! The surgeon’s level of experience and knowledge is vital for a genuine diagnosis.

For any kind of pain in the shoulder and neck or any visible signs of lumps in the back, contact Dr. Tanveer Bhutani. He is a specialist in shoulder arthroscopy in Punjab. Resume your sports and games and live your life pain-free!

Knee Surgery

Hip Replacement- Tips for Effective Recovery

October 31, 2019March 30, 2024
by Eva Hospital

Have you been experiencing hip pain that interferes with your sleep or pain that is worsening with walking even with the help of a cane or walker? Has the hip pain affected your ability to climb up or down the stairs? Have you been facing an acute problem in rising up from a sitting position? It may be arthritis of the hip

The reason for hip damage could be any- Osteoarthritis or Rheumatoid Arthritis or it could even be Osteonecrosis (inadequate blood supply). Irrespective of the reason you need to contact the best orthopedic surgeon of your area and discuss your deteriorating health.

Technically called Total Hip Arthroplasty or Hip Replacement surgery, this has been performed successfully for years. This is the procedure when the doctor surgically removes a painful hip joint (due to acute arthritis) and replaces it with an artificial joint made from either metal or plastic components. The hip replacement surgery makes walking easier and facilitates mobility.

The hip replacement surgery may be performed using the standard procedure (where the incision is 5-8 inches long) or the latest minimally invasive technique.

The surgery definitely makes movement much easier. But there are certain dos and don’ts to be followed to make it a complete success. Dr. Tanveer Bhutani is the best orthopedic surgeon in Punjab and recommends that physical therapy should be continued for a couple of months to enable better recovery and mobility. Certain activities like pivoting or twisting the leg should strictly be avoided. Even bending forward at the waist and squatting must be avoided.

Dr. Tanveer Bhutani has curated a list of activities that can be done easily at home and you will recover quickly post hip replacement surgery.

Certain rearrangements at home can go a long way in helping you recover.

Place the utility items like remote controls, phone, glasses pitcher, and medicines on a high table within your reach. This will prevent unnecessary bending forward.
Stay away from enthusiastic and active pets till you fully recover.
Get all the carpets and rugs removed so that the chances of tripping over are minimized.
The bathroom should have a shower chair, gripping bar, anti-slip mat, and a raised toilet seat.

Take the medication prescription from the surgeon and understand the directions.
Discuss with your surgeon about over-the-counter drugs, supplements, and vitamins.
Make sure you take antibiotics before any dental work (after consulting your orthopedic surgeon). This will prevent any bacterial infection from creeping in.
Keep your medical card handy so that in case of any medical emergency it is easily known to the doctor that you have an artificial hip.

To reduce the swelling, keep your leg elevated and prefer applying ice packs.
Wear compression stockings to reduce swelling.
The wound has to be kept clean and dry, so the surgeon will tell you at length about the bathe and shower protocol.
Watch for any signs of redness or drain from the wound.

Any kind of blood-thinning medicines vitamin K supplements or foods rich in Vitamin K like spinach, beans, lentils, etc. have to be avoided for a while.
The surgeon will recommend iron and vitamin supplements along with a normal diet.

After the hip replacement surgery your life would be much more active than before. Adhere to the list of instructions given by the surgeon and you will lead a hassle-free life. Dr. Tanveer is the most renowned surgeon in Ludhiana and gives a customized recovery module to each patient depending on their age, weight, and health status. Contact Dr. Bhutani and get free from the hip pain forever.

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