Shoulder Pain Relief: What You Need to Know

Shoulder Pain Relief: What You Need to Know

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The shoulder joint is one of the most complex areas in your body. It allows you to move your arms 360 degrees, and also provides the stability needed for all the bones, muscles, tendons and ligaments in your shoulders and arms to work together. All this range of motion increases the likelihood of shoulder pain and mobility issues, especially as we age.

Check out these top causes of shoulder pain, and what you need to know to start feeling better.

Shoulder Osteoarthritis

Shoulder osteoarthritis is a degenerative joint disease that occurs when the cartilage that lines the sides of the shoulder joint is worn or torn away. It’s seen most often in people over age 50, but can occur in younger people as a result of injury or trauma. It’s time to see a doctor if you’re experiencing:

  • Shoulder weakness or stiffness that seems to come and go
  • Pain with activity that gets better with rest
  • Decreased shoulder movement (range of motion) – especially when reaching back
  • Difficulty sleeping as the condition worsens

Rotator Cuff Tears

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within your shoulder socket. Rotator cuff tears occur most often in people who repeatedly perform overhead motions in their jobs or sports – but can occur as a result of a single injury. It’s time to see a doctor if you’re experiencing:

  • Pain and/or weakness when lifting your arm
  • Pain at rest and at night, particularly if lying on the affected shoulder
  • Pain or weakness when lifting and lowering your arm

Adhesive Capsulitis (Frozen Shoulder)

This condition is just how it sounds —“frozen shoulder” causes pain and stiffness in the shoulder muscles and joints that make it difficult or impossible to move. This condition can last for years and develops in three stages:

  • Freezing: In this stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.
  • Frozen: In this stage, painful symptoms may actually improve, but stiffness remains. During the 4 to 6 months of the “frozen” stage, daily activities may be very difficult.
  • Thawing: Shoulder motion slowly improves during this stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

Chronic Shoulder Instability

Have you ever dislocated your shoulder? Chronic shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket, usually as a result of a sudden injury or from overuse. Once a shoulder has dislocated the chances of it happening again increase – and can be the reason for repeated dislocations. It’s time to see a doctor if you’re experiencing:

  • Pain caused by shoulder injury
  • Repeated shoulder dislocations
  • Repeated instances of the shoulder giving out
  • A persistent sensation of the shoulder feeling loose, slipping in and out of the joint, or just “hanging there”

Wondering what you can do to help relieve shoulder pain right now? Here are 5 tips for feeling better, fast.

We’re here to help! Make an appointment today or visit one of our walk-in clinics.

3 Alternative Non-Surgical Treatments for Head & Neck Pain

5 Alternative Non-Surgical Treatments for Head & Neck Pain

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Head and neck pain can occur for a variety of reasons. Some pain will go away with time, or through a change in lifestyle or behavior. But if you’re dealing with head and neck pain that lasts more than a few days and doesn’t improve with over-the-counter pain medicine, it’s time to make an appointment with one of our pain management specialists for diagnosis and treatment.    

Depending on the cause of your head and neck pain, these five non-surgical treatments might be effective for you. 

1. Physical Therapy

From muscle tenderness, tension and tightness to poor posture – certain types of headaches and neck pain can be relieved through physical therapy treatments. A trained physical therapist can design an exercise plan that strengthens your neck muscles and takes pressure off your spine. They might also apply heat or cold pads during a therapy session to either increase blood flow and range of motion (heat) or decrease blood flow and inflammation (cold). Still other physical therapy treatments could include therapeutic massage, chiropractic treatment and/or neck-strengthening exercises you can do at home.

2. Trigger Point Injections

Trigger points are areas in muscle that are very irritable, and, when pressed, produce a twitch within the affected muscle. A trigger point may produce not only pain in the affected muscle, but in a distant area, including locations in the head and neck, called referred pain. Trigger points may develop because of trauma, injury, inflammation, or other factors. A trigger point injection is a procedure where a medication, usually a local anesthetic, is injected into the painful muscle to provide relief. The pain relief should be experienced not only in the affected muscle, but in the area of referred pain as well.

3. Anti-Inflammatory Steroid Injections

If your pain is being cause by inflammation around the nerves in your neck, a cervical epidural steroid injection can help by “coating” the nerves in the area. Patients experiencing a herniated disc, a degenerated disc, osteoarthritis or inflammation that reduces the space around the nerves can benefit from this type of treatment. The goal of the injection is to reduce inflammation and associated nerve pain – and the injection itself is given with the patient laying face down under local anesthetic.

4. Botox injections

Think BOTOX® is just for wrinkles? Think again. It can be effective for the treatment of adults with cervical dystonia—a condition that causes the muscles in your neck to tighten or spasm without your control. BOTOX injections can reduce the severity of abnormal head position and neck pain. If you have chronic migraines (≥ 15 days per month) with headache lasting 4 hours a day or longer, this treatment could also be right for you.

 5. Radiofrequency Ablation (Rhizotomy)

Yes, it sounds complicated. But in reality, Radiofrequency Ablation (or RFA) is a non-surgical, outpatient therapy procedure that’s used to help patients with chronic head and neck pain related to spinal arthritis.  As with any non-surgical treatment, this procedure is only recommended after thorough examination and diagnosis. During the RFA procedure, heat is delivered to targeted nerve tissues, preventing pain signals from reaching the brain.

If you or a loved one are experiencing chronic head or neck pain, don’t wait. Learn more about our pain management program and all the options available to you at Orthopedic Institute.

Should You See a Physical Therapist?

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So you know you’ve injured yourself. You’ve got the pain or the swelling to prove it. But with so many varieties of physicians, specialists and therapists from which to choose, how are you to know when is the right time to involve a physical therapist?

Take a look at some of the following common pain points and whether they necessitate a visit to a physical therapist.

Lingering Pain

Immediately after an injury, it’s often best to do what your body is demanding of you: rest. Take a few days off from normal activities, apply ice, and give the injury some time to heal. However, if its been three or four days, and returning to normal activity is still causing you to wince, it may be time to visit a physical therapist. They can figure out the source of the pain and prescribe a plan of action.

Low Mobility

Whatever the reason for it, sometimes your body’s mobility is limited. It can be caused by injury, disease or even simply aging. When it comes to reinvigorating your lost mobility and range of motion, often the best person to see is a physical therapist, as this type of health professional is trained to evaluate and treat matters of movement and flexibility.

Poor Posture

Is your posture suffering? When it comes to sitting for great lengths of the day, you might notice your shoulders hunching over and giving you back pain related to the way you sit up (or don’t). If you’re looking to improve this, a physical therapist may be your first step. He or she can work with your body mechanics to determine the best ways to build up your balance and sitting habits.

Recurring Injuries

When you’re out on the field or at work exerting yourself, you’re bound to encounter a pull, sprain or strain now and again. However, if you’re finding yourself experiencing the same pain over and over again, it may be time to call in the professionals. The best plan when you’re experiencing a moderate to severe level of pain due to a recurring injury is to see a physical therapist. He or she can work with you to determine exactly how you continue to injure yourself, as well as how to avoid pain in the future.

Know your needs

The most important thing to remember is that, if you have pain, address it. Even if you’re unsure to whom you should speak, make sure you’re seen in a timely manner to avoid worsening injury. We’re here to help.

4 Key Benefits of Going to an Orthopedic Walk-In Clinic

4 Key Benefits of Going to an Orthopedic Walk-In Clinic

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Whether it’s scheduling, varying degrees of urgency or fear of price tags, dealing with orthopedic emergencies or non-emergencies can be tricky. Thankfully, orthopedic walk-in clinics provide an option for those acute injuries and pain and they don’t require an appointment.

Here are four key benefits of an orthopedic walk-in clinic, a feature that Orthopedic Institute (OI) happens to offer.

Avoid Unnecessary ER Visits

Not every injury is alike. That’s why some minor, non-emergency injuries that require treatment but may not be urgent enough to foot the bill for an emergency room visit can be dealt with thanks to orthopedic walk-in clinics. Say you experienced a knee sprain or fracture during an evening sporting event—you may be more inclined to take this condition to an orthopedic walk-in clinic than to a potentially pricey emergency wing of a hospital.

Be Seen After Hours

Speaking of time of day, one of the biggest benefits of orthopedic walk-in clinics for daytime workers is the ability to be seen after hours for spur-of-the-moment issues such as flare-up pain, dislocation, fracture or muscle spasm that is causing loss of sleep. Timing may vary from clinic to clinic, but these walk-in-style situations will typically offer hours both after 5 p.m. on weekdays and on weekends for added availability. For example, OI’s own walk-in clinic in Sioux Falls provides weekday hours from 3 to 7 p.m., and Saturday hours from 11 a.m. to 4 p.m.  In Yankton, we see patients Monday to Friday from 9 a.m. to 6 p.m.

Reduce Costs

It can be expensive to see a doctor in an immediate situation. Luckily, walk-in orthopedic clinics often provide flexible hours for more immediate care in cases of injury or sudden pain. Better yet, specialty clinics such as OI have the equipment available for treating these types of injuries—which isn’t always true of a general walk-in clinic. These general clinics may be able to diagnose and offer minimal services and pain relief but will often times require a referral to follow up with a different clinic or physician.

A walk-in clinic at a specialized healthcare provider such as an orthopedic clinic can offer you highly personalized care that a general urgent-care clinic may not be able to provide—not immediately, at least. OI’s walk-in clinic puts you in front of an orthopedic health professional from the get-go to meet your specific needs.

See the Right Healthcare Providers

One of the key benefits of an orthopedic walk-in clinic is that, if you need to be referred to a specialist, such as a hand, foot and ankle, or back specialist, a walk-in clinic healthcare professional can supply you the connection you need to be seen by the appropriate people, often in a timelier manner than you may expect. OI’s team consists of a variety of caregivers, from physical and occupational therapists to interventional pain management services to orthopedic surgeons, so you have comprehensive orthopedic care at your disposal.

Ready to Be Seen?

Click here for details on how to be seen at OI’s walk-in clinics, OI Now.

Hip Replacement Success Stories

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Most people wouldn’t describe getting a hip replacement as a “walk in the park.” Weeks of rehab and struggling to get around can cause many people to put off getting a necessary surgery. However, Lee Goldammer and Tony Bosch had excellent experiences with OI when they decided to pursue anterior hip replacements.

Lee Goldammer

How did you first learn about OI?

My wife worked for OI years ago, and that’s how I got there. I had Dr. Zoellner do my first hip replacement—my niece recommended him.

What was your first experience with OI?

My initial experience was my first hip surgery. They cut most along the side, and I underwent therapy for about a month. Although rehab took a few weeks, I still got along well. That’s just the way it was back then.

How did you decide to get the anterior hip replacement completed?

I heard about this new type of surgery and how Dr. Rothrock would perform the surgery. I knew I would be in the hospital two to three days, and Dr. Rothrock said the amount of therapy I wanted to take on was up to me.

I remember my hip hurt so badly that I couldn’t raise my leg, so I went ahead with the surgery. Afterward, I pulled my leg up immediately, and there wasn’t any pain.

What was therapy like for this surgery?

There was no therapy after that – the doctor simply gave me a few things to do. I used a walker for two or three days, and then I went to a cane. I was easily going up and down steps in about two weeks.

What would you say to someone who is considering this surgery?

I recommend it right away—I recommend it to everybody. I’ve talked to four or five people, and I tell them it’s a piece of cake. There was much less rehab than after my first surgery.

You can be on your way in no time. Everyone has a tendency to put it off. I know it’s hard to do, because no one likes surgery, but they always say they wish they had done it a long time before.

Tony Bosch

How did you first learn about OI?

My wife had some surgery done with Dr. Looby. She had a sciatic nerve problem. I had seen Dr. Looby before—I didn’t know who he was at time – but I went to the fitness center and I saw him, but didn’t realize he was my wife’s doctor until later.

What was your first experience with OI?

After my wife’s surgery, Dr. Looby came into the consultation room and we got to visiting. So I knew him when my hip started hurting. Next thing you know I have this hip causing me trouble. Dr. Looby said Dr. Adler was really good with hips. So I went in for an appointment, had the X-rays, and Dr. Adler told me my hip was full of arthritis. I asked him if we could do it soon, and he was able to make it happen for me the very next day.

I never missed one day of work after the surgery. I went to work after the surgery, set my walker off to the side, and I never used the walker, a cane or anything. The hardest part was training my head not to limp! Someone saw me afterwards and asked, “Didn’t you just have hip surgery? You’re limping pretty bad.” But my hip didn’t hurt at all. I was limping just because I was used to limping for so long because of my hip pain. So I took about a week for me to learn to stop limping.

What was your experience with the doctors like?

Dr. Adler is just one fabulous human being. Orthopedic Institute is very lucky to have him, Dr. Adler and Dr. Mitch Johnson. We are blessed to have this kind of medical facility, Orthopedic Institute, in Sioux Falls.

What was therapy like for this surgery?

I didn’t need any therapy. I mean, I had a total hip replacement. No therapy. Zero! You just knew when it started hurting that you needed to take a break.

What would you say to someone who is considering this surgery?

I wouldn’t look any further. Dr. Adler is the best there is as far as I am concerned. He’s not only a great surgeon but a great human being. He has patient charisma, he’s the whole package.

How to Tell When Your Child's Elbow Injury Is Serious

How To Tell When Your Child’s Elbow Injury Is Serious

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Kids have a way of getting into all kinds of mishaps. Whether it’s a fall from the monkey bars or trampoline, a collision playing sports or simply wrestling with the dog – elbow injuries are common with children. They can involve three bones: the humerus (upper arm), the radius and the ulna (forearm). Unfortunately,  injuries that occur near the elbow may often require surgery.

Here’s how to tell if your child’s elbow injury is serious.

Home treatment with RICE (rest, ice, compression and elevation) plus over-the-counter pain medication can relieve minor aches and pains for a strained or “bumped” elbow. 

However, serious elbow injuries will present much differently. If you child complains of elbow pain after a fall and/or experiences any of these symptoms, it’s time to see an orthopedic physician immediately.  

  • Visible deformity in the area 
  • Pain in the elbow and forearm 
  • Tenderness, swelling or bruising  
  • Discoloration of the elbow or hand (signs that circulation is affected) 
  • Limited range of motion/ In children, change of normal use (won’t use the hand or arm to play with toys or bring food to mouth) 
  • Numbness, a “tight” sensation or cool sensation of the forearm, hand or fingers (signs of nerve injury)

During the visit, expect your doctor to order X-rays to evaluate if a fracture has occurred. Because a child’s bones are still forming, your doctor may request X-rays of both arms for comparison. Soft tissue injuries such as ligament strains, sprains or tears can also occur particularly in “hanging” injuries commonly seen in playground accidents. No matter the injury, skilled evaluation can assist you in helping your child to heal as quickly as possible.

Childhood elbow injuries are all-too common and nearly always occur as a result of a fall. In other words, there’s no time to waste. Learn more about our convenient walk-in clinics.

Outpatient Joint Replacement Surgery: The Benefits & How to Prepare

Outpatient Joint Replacement Surgery: The Benefits & How to Prepare

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The idea of an outpatient procedure is always an attractive one—the ability to have your surgery and return home the same day can be valuable. In fact, at Orthopedic Institute (OI), joint replacement surgeries can often be performed outpatient—as much as 90 percent of such surgeries at OI are outpatient for select scenarios.

From total shoulder replacements to knee and hip procedures, why does outpatient matter—and how should you prepare?

The Benefits

Among the obvious benefit of being in the comfort of your own home post-surgery, outpatient procedures can have other marked benefits. Without the expense of a hospital stay, outpatient surgery will typically save money on your final bill. It has also been shown anecdotally to be less stressful—the familiarity of home often makes a great recovery space. It also means less of a time strain on your schedule—you can book your appointment on an ideal day and keep any unnecessary time off from work or other commitments to a minimum.

Preparing for Surgery

Informing Your Team

One of the first steps of prepping for an outpatient joint replacement surgery is informing your team of physicians about what medications you’re currently taking regularly. Some medications may need to be halted in advance of your surgery day, including over-the-counter medicine such as ibuprofen or aspirin. Make sure to provide honest answers to medical history questions—these will play an important role in clearing you for the procedure.

Getting Tested

Your doctor may order some tests prior to the procedure—these pre-op examinations may include X-rays, blood tests and EKGs to determine your readiness for surgery. Your physician should also provide you with materials you may need to help you better understand what the surgery entails—including what to bring on the day of, what will be the goal of the surgery and joint exercises to try leading up to the date.

Post-Surgical Recovery

Upon leaving the clinic, your surgeon or physician will offer you advice on how to care for yourself from home. For starters, you should plan on having someone to drive you—post-surgery, it’s recommended you don’t operate a vehicle due to drowsy or dizzy conditions. You should use medication as prescribed or recommended by your doctor—and make sure you have a phone number handy to call a qualified nurse or physician if you have any questions about medications or other elements of the recovery process.

3 Common Causes of Thumb Pain

3 Common Causes of Thumb Pain

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Years of working hard and participating in your favorite hobbies can potentially take a toll on your body, especially your fingers. Think about how much strain you likely place on your hands over your lifetime. It’s no surprise, then, that many people start to feel aches and pains in their thumbs.

Are you starting to feel pain or stiffness in your thumbs? Read into these three common causes of thumb pain. 

1. Trigger Thumb

Trigger thumb occurs when your thumb remains stuck in a bent position, as if squeezing a trigger. This occurs when tendons become irritated and swollen and can’t move easily. Sometimes a bump may form on the tendon, adding to movement difficulty. Farmers, musicians or people in industrial occupations commonly experience trigger thumb due to the heavy reliance and strain on their fingers.

Signs of trigger thumb include:

  • Snapping/popping sensation when moving the thumb
  • Swelling or bump in the palm
  • Inability to fully flex the thumb
  • Locking in the bent position, requiring help from the other hand to straighten
  • Pain and stiffness when bending
  • Soreness at the base of the thumb

2. De Quervain’s Tendinosis

When tendons at the base of the thumb become swollen or constricted, they may cause pain along the thumb side of the wrist.  De Quervain’s tendinosis may occur from overuse, but it’s also associated with pregnancy and rheumatoid disease.

Signs of De Quervain’s tendinosis include:

  • Primarily pain felt over the thumb side of the wrist, along with swelling
  • A snapping sensation when moving the thumb
  • Difficulty moving the thumb and wrist

3. Thumb Arthritis

There are several types of arthritis, but the type most often affecting the joint at the thumb’s base is osteoarthritis, a.k.a. “wear-and-tear” arthritis. This is found more often in women than men and tends to occur after 40 years of age. The most prominent symptom is pain at the base of the thumb when you grasp an object or apply force with your thumb.

Signs of thumb arthritis include:

  • Enlarged appearance at the joint of your thumb
  • Decreased range of motion
  • Decreased grasping or pinching strength
  • Swelling or stiffness at your thumb’s base

Experiencing thumb pain?

We want to help. Contact us today at (605) 331-5890 or set up an appointment.

6 Tips for Reversing Your Shoulder Pain

6 Tips for Reversing Your Shoulder Pain

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Shoulder pain—for many of us it’s just a fact of life. But when it’s keeping you from enjoying your daily activities, it may be time to try some useful remedies.

Try out some of these options for reversing shoulder pain.

Stretch

If you have soreness in your shoulder that you suspect was brought on from exercise or physical activity, an inflammation or swelling may have occurred. One way to reduce mild, exercise-related shoulder pain is through stretches. These may include chest expansions by meeting your hands behind your back or across-the-chest stretches, bringing your arm across your chest and pulling your elbow toward it with your spare hand. These are exercises that should be recommended by someone who specializes in functional assessment, such as a physical therapist or athletic trainer.

Sleep Differently

One common cause of shoulder pain, particularly when it’s experienced first thing in the morning, is sleeping habits. A potential way to reduce this pain is to try out a new sleeping position. If you favor one side over the other, it might be an indication of where your pain is coming from. Use pillows or remove pillows to determine the best amount of cushion to avoid pain if you favor sleeping on your back or stomach. According to our experts, it’s best to sleep on your back with your hands below chest height. AVOID SLEEPING ON YOUR STOMACH. This can cause even more shoulder pain when you wake up.

Diversify Your Exercises

Another frequent reason for shoulder pain is found in athletes or otherwise physically fit people—especially when they tend to exercise or engage in sports with highly repetitive shoulder movements. The best way to combat this is to keep your regimen diverse. Select a variety of exercises that don’t put undue strain on your shoulders as compared to the workout your other joints are receiving.

Try Massage

Massage therapy can very often be beneficial for shoulder pain, because it can release muscle tension and increase range of motion in the joint – which in turn can improve function and help reduce pain. Best of all, you can give yourself a neck and shoulder massage almost anywhere and at anytime for temporary relief. If you still feel stiff and sore, talk to your doctor about other therapy options.

Apply Heat or Cold

Just like when you’re nursing an injury, applying heat or cold can go a long way toward reversing your shoulder pain. Use heat to soothe stiff joints and relax muscles after a strain or when recovering from an injury. Ice packs are typically used to numb sharp pain and reduce inflammation immediately following an injury. Whichever option you need, remember to protect your skin – and only apply the hot or cold therapy as directed.

Obtain Physical Therapy

There’s perhaps no better way to reverse your shoulder pain, particularly when it’s ongoing or chronic, than being seen by a physical therapist or orthopedic physician. It’s the best way to determine if your condition is diagnosable and how best to treat it.  Contacting Orthopedic Institute for an appointment is a good place to start.

4 Everyday Tips for Fighting Off Foot & Ankle Pain

4 Everyday Tips for Fighting Off Foot & Ankle Pain

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 Are your “dogs” barking? You’re not alone! Every day, we take thousands of steps. So it’s no surprise that foot and ankle pain can occasionally be part  of our days, too – especially as we age. See your doctor for serious pain that interferes with daily life. But when it comes to occasional foot pain or discomfort, there are a few simple steps you can take for quick relief. 

Here are 4 tips to give foot and ankle pain the boot. 

1. Wear the Right Shoes

One of the best things you can do to relieve foot and ankle pain today – and prevent it from happening tomorrow – is to wear properly fitted, well-cushioned shoes. Have your feet measured at a shoe store at least once a year to make sure you’re wearing the correct size and width, and replace older shoes that no longer fit. This doesn’t mean you can’t be stylish, it just means you need to know what to look for when buying new footwear.

2. Support Your Arches

Arch support isn’t just for people with flat feet – it’s important for all of us! If you’ve been experiencing foot and ankle pain, especially from wearing flat-soled shoes, try adding Powerstep inserts to your shoes. Our pedorthist, Reid Herrboldt, swears by them. They can be tough to find, but good news … we carry multiple sizes! Stop by OI to pick up a pair. Or better yet, make an appointment with Reid for a professional fitting. Your legs and feet will feel better, because proper arch support helps reduce weakness and soreness all day long.    

3. Stretch Often

Muscles can become stiff and painful whether you’re standing and walking all day, or simply sitting at a desk or table. Every hour or so, remind yourself to stretch, relax and lengthen the muscles in your feet and ankles. Start by pointing your toes down to stretch the top of the foot and ankle. Then, roll your feet in circles (clockwise and counter-clockwise) to loosen up your ankle. Finally, point your toes straight up to stretch the back of your calf. Our physicians and therapists like these six stretches from Prevention Magazine.

4. Baby Your Feet

You can help your feet recover from carrying you around all day with simple foot care techniques. Do the bottoms of your feet hurt? Try rolling them from heel to toe over a frozen water bottle, tennis ball or baseball. The gentle massage stretches muscles and helps your feet recover from the day. Pain on the top of your foot can be an indication of arthritis. Most people with plantar fascitis have very tight calf muscles. You can use the six stretches noted above for relief.

If your foot and ankle pain persists, it’s time to see a specialist at Orthopedic Institute.