Morton Neuroma refers to the interdigital nerve entrapment in the third webspace (occasionally the second webspace) of the foot.
Archives: FAQs
What does zone II mean in reference to my hand?
The hand was broken down into a classification scheme based on the flexor tendon along five anatomic zones. Zone II occurs between the distal crease of the palm and the middle crease in the finger.
I am having surgery on my injured pointer finger flexor tendon. When will I start rehabilitation?
You may have your first visit with your therapist prior to surgery to allow for education on the postoperative plan and possible fabrication of your splint. Otherwise rehabilitation will likely occur between four and seven days after surgery.
What presentation does an acute anterior shoulder dislocation typically have?
They will often present with their arm held fixed and slightly internally rotated and abducted out to the side.
I just dislocated my shoulder playing basketball and had it reduced at the local ER? How long will I be in this sling?
This will be addressed on a case-by-case basis with your orthopedic physician. However, typically your arm will be immobilized for a minimum of three to four weeks.
My MRI demonstrates a rotator cuff tear will I need surgery or can it be treated non-operatively?
Every patient will present differently and thus must be treated on a case by case basis. That being said, usually a course of nonoperative treatment including rehabilitation will be utilized prior to deciding if surgery is part of the plan of care.
What is the Rotator Cuff Quality-of-Life Index?
The RC-QOL is an encompassing patient-derived questionnaire that addresses not only physical symptoms but also work, recreational, social, lifestyle and emotional components.
I have calcific tendonitis and have been going to physical therapy for 2 months. How long should I be going to therapy before I seek other options? This seems to be taking awhile.
A recent review of the literature suggests you should give conservative treatment, like physical therapy, up to six months prior to seeking more invasive options like surgery. It is important to remember that the most pain and inflammation associated with calcific tendonitis occurs right before the calcium deposit is reabsorbed into the body and the tendon repairs itself.
I am a 56 year-old female and have had nagging shoulder pain for about a year now and have gotten to the point where it’s hard to put on my coat. My physician says it is calcific tendonitis. Is there something that can be done for me?
Calcific tendonitis is best treated conservatively by anti-inflammatories and physical therapy. Conservative treatment has proven to be best for this condition and you should give it three to six months prior to seeking more invasive types of procedures.
I am considering a direct anterior approach for my hip replacement. I have heard that it is important to have an experienced surgeon for this procedure. Why is this the case and how much experience should I look for in my surgeon?
In a report out recently by Post et al., the direct anterior approach for total hip replacement has been described and reported on. These authors describe a technique which has the advantage of decreased muscle injury and the possibility of faster and less painful recovery. One issue they discuss is the steep learning curve and the need for surgical expertise for the most optimal outcomes. This is due to the complicated anatomy and the challenge in determining the appropriate location for dissection. The positioning and use of the tools to perform the replacement is also improved with experience. This report describes improvements in outcomes with experienced surgeons and reports that studies have found that complications decrease when the surgeon experience is greater than one hundred cases.
What are some of the common complications associated with Direct Anterior Approach for total hip replacement?
According to a recent study presented by Post et al. there are a few possible complications with a direct anterior approach for total hip replacement As with all hip replacement, dislocation is a risk and is reported between one and one and a half percent. Another complication is damage to the lateral femoral cutaneous nerve which is reported to range from less than one percent to as high at sixty seven percent. Fortunately most parathesias from damage to this nerve often resolve and do not commonly present with a functional limitation. Fractures of the greater trochanter have been described as a complication. Fractures of the ankle have been associated with use of a fracture table during surgery with the direct anterior approach for hip replacement. Local wound complications are also a possibility due to the moist nature of the groin area. All of these complications have been reported to decrease in frequency with increased surgeon experience.
How long is the recovery for a radial fracture and what can I expect during my recovery time? I recently fell while skiing and have to have an “ORIF with a fixed volar angle plate.” I am a golfer and want to get back to my game this summer.
Typical recovery from this type of injury does take awhile but you can expect near to full recovery with the proper rehabilitation. A recent study found quicker return to normal function and decrease in pain with early motion and strengthening following the surgery versus the standard protocol of waiting for motion until two weeks after surgery and waiting to strengthening until six weeks after surgery. You might look into the accelerated rehabilitation program and a physical therapist that can guide you in your recovery. Also, this is a good discussion to have with your surgeon since recovery does also depend on the extent of damage and how well the surgery goes.
I had an ORIF with a volar fixed angle plate placed 2 days ago. I am supposed to keep my wrist in a splint for 2 weeks before I am allowed to do anything. Is this normal? I would think that my muscles would waste away in that time.
The protocol that your surgeon gave you sounds like the standard protocol– no movement for two weeks and no strengthening until week six. A recent article has found it to be more beneficial, however, to begin passive motion fairly immediately and strengthening as soon as two weeks. This would be a good discussion to have with your surgeon.
I am part of a return to work focused rehabilitation program. What might this entail?
This will vary from program to program. There will likely be an evaluation by a primary physician and an interdisciplinary component that may include physical therapy, social work, and counseling services.
I have been suffering from neck pain and out of work for one month secondary to this condition. Would becoming involved in a specific return to work program be beneficial in getting me back to work?
This is a conversation that you first and foremost should be had with your treating physician. They will have the knowledge of what interdisciplinary care is available in your area.
Does the presence of DISH mean that my existing kyphosis will worsen over time?
We are unable to answer this at this time as further investigation needs to occur through longitudinal studies.
My doctor informed me my recent x-rays demonstrated DISH, what is DISH?
DISH stands for diffuse idiopathic skeletal hyperostosis. This means there is a presence of ossification of your soft tissue along the front and side portion of your spine in the lower thoracic and upper lumbar region. Usually this occurs between four continuous segments.
What are some of the biggest challenges when recovering from an Achilles tendon rupture?
The biggest challenges or complications occurring after an Achilles tendon rupture include possibility of re-rupture, decreased quality of life during initial immobilization phase especially if this includes limited weight bearing, time off work, difficulty regaining full strength, and difficulty with full return to previous level of sport participation.
What is the rehab like following an Achilles tendon rupture being treated without surgery?
The initial treatment protocol includes immobilization in a walking boot and, according to Weisskirchner Barfod et al, this period lasts eight weeks. During this time you may be instructed to stay off the injured leg fully, and comply with a weight bearing restriction, however this study has shown that full weight bearing during this period causes no setbacks and can improve quality of life. (Be sure to ask your physician and follow their protocol.) During this eight week immobilization phase there will be use of multiple heel wedges, and they will be slowly removed over the course of this time. There may also be instructions for gentle range of motion exercises. After the initial eight weeks the patient will be released from use of the walking good and will begin progressive strengthening. This may include referral to a physical therapist to lead this phase, which can last several months depending on individual progress.
What is the difference between an “extramedullary sliding hip screw” and an “intramedullary nail” and why would I want one over the other? My surgeon says that the type of hip fracture that I have needs an intramedullary nail and I think this is excessive.
An intramedullary nail is a rod that is placed in the bone shaft itself and screwed in place. It is used in cases where the bone is not easily screwed together with plates on the outside of the bone, or a “extramedullary sliding hip screw.” Depending on the type and extent of your hip fracture, an intramedullary nail might be necessary. This is something that you should discuss with your surgeon.