Shoulder painis

a typical and expected part of many athlete’s lives. Those that spend most of their time throwing a ball are the most susceptible to shoulder injury. By the nature of their sports, baseball and softball pitchers, tennis players, javelin, and handball players put a great deal of stress on their shoulders. Their role in the game is to rapidly accelerate and decelerate their throwing arm while pushing an object from their hands. This causes the shoulder to possibly become overextended, overused, and vulnerable to tears and injuries.
The shoulder is one of the most mobile joints on the body. There are four joints in the shoulder which, if injured, can cause a number of problems and pain. It is often difficult to discern which part of the shoulder is affected by injury, as certain types of pain can be caused by different causes. For example, weakness in the shoulder and aching could be due to a labral tear, which is a tear in the tissue around the arm socket, or it could be due to a rotator cuff injury, which are the muscles and tendons around the shoulder joint itself. Both are similarly painful, but completely different injuries.
Shoulder injuries can happen to pitchers and players of any age. It is common for a young pitcher to have an injury to the growth plate located in the shoulder due to overuse and often untrained throwing styles. Those on traveling teams, who have more games than in a regular season will often find themselves sporting sore and overextended shoulders.
For mild shoulder injuries, over the counter treatment should suffice. Ice, along with ibuprofen and NSAIDs (nonsteroidal anti-inflammatory drugs) will help to keep the swelling of the injury down, along with decreasing pain. Rehabilitation and physical therapy can be helpful to get the shoulder back in full use again. Rest will help, too, but there is a fine line of when rest becomes too much and the shoulder can lose its mobility and need to be retrained. This can cause problems when an overeager adolescent wants to get back on the field quickly and pushes himself too hard.
Sometimes shoulder injuries to too extreme for ice and Motrin and surgery is needed for repair. Arthroscopy is a common surgical procedure for shoulder injuries. It is minimally invasive and allows the orthopedist to view the problems through an arthroscopic camera, and fix the problems at the same time. Arthroscopic surgery takes less time to heal due to the small incisions that are made, and a large percentage of players are able to return to the field afterwards.
One way pitchers ages 7-18 to decrease the potential for shoulder injury is to strictly adhere to pitch limits set by Little League Baseball, which takes into consideration the age of the player and the number of pitches per day that is deemed safe to throw. Those ages 7-8 are allowed 50 pitches per day, while 17-18 year olds are allowed 105 per day.
If you or your child suffer from shoulder pain, contact our sports medicine specialists at Orthopedic Surgery San Diego to undergo an evaluation.  Our specialists provide the best orthopedic and medical care available.

The Efficacy of Platelet-Rich Plasma in the Treatment of Symptomatic Knee Osteoarthritis: A Systematic Review With Quantitative Synthesis
Osteoarthritis is wear and tear of the joint that occurs over time. It is a condition that causes worsening pain and complications over time. Osteoarthritis can impair a person’s quality of life, cause pain and limit him/her in the activities that they can do. Sports medicine doctors can help reduce or treat osteoarthritis with medications, physical therapy, and also with operations such as knee replacements. Platelet-rich plasma (PRP) has been used to help treat or reduce pain from osteoarthritis. The effectiveness of PRP is still being studied; studies performed to date have shown conflicting results.
A review of the results of the many studies evaluating the efficacy of PRP for the treatment of painful knee arthritis was performed. The data from the different studies were combined and examined. Multiple databases, including Medline, Embase, Cochrane Central Register of Controlled Trials, Pubmed, and www.clinicaltrials.gov were searched to locate prospective studies and clinical trials that have evaluated the effectiveness of PRP.
Six studies were included in this review. Among these six studies, a total of 577 patients were included, with 264 patients (45.8%) in the treatment group (those that received PRP) and 313 patients who did not. The average age of patients receiving PRP was 56.1 years old (51.5% of them were male) compared with 57.1 years (49.5% male patients) who did not receive PRP. Combining the data from the multiple studies showed that patients who used PRP for osteoarthritis had significant improvement (reduction of symptoms) compared to those that did not use it (average difference, using the Western Ontario and McMaster Universities Arthritis Index scale was -18.0, 95% confidence interval (-28.8 to -8.3), p < 0.001). There was also a significant improvement noted with use of PRP when the International Knee Documentation Committee score was used (average difference, 7.9, 95% confidence interval, 3.7 to 12.1, p < 0.001). Adverse events such as pain, stiffness, syncope, dizziness, headache, nausea, gastritis, sweating, fast heart rate and pain and swelling at the injection site occurred more commonly in patients treated with PRP (8.4% v. 3.8%, p=0.002).
In conclusion, intra-articular PRP injections may aid in the treatment of adult patients who have mild to moderate knee osteoarthritis at approximately 6 months. There seems to be an increased incidence of adverse events amongst patients treated with PRP.
If you are faced with knee arthritis or hip arthritis, contact our orthopedic specialists at Orthopedic Surgery San Diego to undergo an evaluation.

health insurance

A large health insurance company has announced that it will pay its employees for getting more exercise. Depending upon how many steps are recorded while walking or running, a worker could receive as much as $240 in Amazon.com gift cards, Reuters reported.
Multiple studies have shown that people who regularly engage in strenuous physical activity are less likely to suffer pain in their knees or hips. Exercising keeps joints fit and strong, making them less vulnerable to injury and degenerative conditions like osteoarthritis.

The company, Oscar Health Insurance, apparently understands the value of keeping its employees healthy. People who run, jog or walk are at much lower risk of obesity, heart disease, stroke, diabetes and high blood pressure. They also have fewer cases of  breast, lung, colon and endometrial cancer. Running and brisk walking are forms of aerobic, as well as cardio, exercise. Such workouts boost the immune system, making the body more resilient to ailments.
Paying workers to exercise may a relatively new idea, but employer-sponsored health plans have long offered incentives like lower premiums for participating in “workplace wellness” programs, Reuters noted.
The news agency reported that Oscar, which operates health-insurance exchanges in New York and New Jersey under the Affordable Care Act, has enrolled 17,000 members. The New York-based company plans to expand to California in 2016.
Oscar recently started paying its employees to stay healthy by giving them $20 gift cards for getting flu shots. That worked so well that company executives decided to establish the walking-exercise program.
Workers are given Misfit fitness tracking devices, worn on the wrist, to measure the number of steps they take while walking or running. Other data, like the number of calories people burn and the amount of sleep they get, also can be recorded. The devices send the information to company computers with software that tracks individuals’ progress and sets their daily goals.

 The goals are determined according to each employee’s ability and exercise level. Most people start with about 2,000 steps, while some take as many as 10,000, Oscar co-CEO Mario Schlosser told Reuters. He said researchers have detected measurable improvement in the health of study participants who walked about 6,000 steps per day.
At Oscar, some employees began experiencing benefits soon after starting the program. Others did not report positive changes, like weight loss, until later.
The program “is a big carrot hanging in front of you,” Schlosser told CNBC.com. “The original motivation was certainly that we want to give people a nudge to stay healthy.”
The company also plans to offer as many as 20,000 of its customers a Misfit app they can download onto smartphones. Wristband fitness trackers will be shipped to the customers, who can activate the devices to automatically sync to the app and individuals’ insurance plan accounts, CNBC explained. Customers earn daily gift-card rewards of $1, up to $20 per month, if they exceed their exercise goals.
“We think it can be a very powerful tool to getting people out on the street and being more active,” Schlosser said. He pointed out that giving away the devices, which retail for about $60 each, is worth the cost because healthy customers cost Oscar less money. Walkers and runners are less likely to need the doctors, hospitals and medications that their insurance plans cover.
“It will pay off, at best, in the medium term, if not the short term,” Schlosser told CNBC. “It’s potentially revolutionary, potentially incredibly impactful. If we were able to get everybody to do that, that would be a fantastic, fantastic outcome.”
Studies have proven that people who use fitness tracking devices and set goals get more exercise than others. Getting started on a walking or running regimen as early in life as possible can help prevent knee and hip pain, as well as osteoarthritis and other such conditions.
If you are experiencing joint pain, or suspect that you might be developing a degenerative condition, you need to know what is wrong and how you can address the problem. Schedule an appointment for an evaluation by the nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to learn about your options.

 Almost 92% of Americans own a cell phone in 2014, with almost 60% owning smartphones. One does not have to have to have a lot of money to own a smartphone as almost 50% of Americans with an income of $30,000 and lower also own one.  Smartphones function like a mini-computer and allows access to email, internet, browsing, surfing the web, texting, games, pictures, and applications, also known as apps.
Apps are what make the smartphone more useful than mobile phones, which also have many of the same features as a smartphone.  There are over a million apps each for Android and iPhone users, and the ideas are seemingly endless from apps for games, weather, and sports, to music, movies, and migraines. Apps that are geared to health and fitness are growing in popularity, and are called “m-health” (mobile health) apps.
Technology has recently been seen as a way to help low-income and at-risk groups better manage their health. A study was done at UCLA that used an m-health app to help teach 40 African American women better health habits. Black women are more susceptible to heart disease, and the women chosen for the study ranged in ages 25-45 and had to have at least two heart disease triggers. Poor eating habits and lack of exercise along with stress was a common factor for these women.

These women had fallen into an unhealthy pattern. When we gain weight but do not exercise, the added pounds can weaken our joints. This leads to a vicious cycle of pain, such as knee pain, back pain, shoulder pain, shoulder injury and the need to seek out an orthopedist. Because of the pain, the inclination to exercise diminishes more, we eat more, we have more pain, and the cycle continues. This adds to the problem of heart disease, high blood pressure, high cholesterol and a myriad of health problems.

The women were taught in four sessions about healthy lifestyles, how to reduce stress, and eat more healthy. They were then given an Android phone that was loaded with the m-health app that was developed at UCLA. The phone could be used to text other members in the group, but to not call out. The app is an interactive one that sends daily messages to the users reminding them to eat fruits and vegetables and tracks their exercise. In order to track their movement, the phone had to be worn when they were awake, at all times, via a passport pouch. They also took blood pressure readings once a week with a Bluetooth-blood pressure cuff that sent the numbers to the study lead.

The researchers were able to see when blood pressure would spike over the Fourth of July, when salty foods are consumed. It was also able to tell when a member of the study group was faking the exercise by shaking the phone instead. In the end the women had improvement in blood pressure, cholesterol, decreased stress, better eating habits, and were exercising more.
If you have sustained shoulder pain or knee pain while exercising, contact our sports medicine specialists at Orthopedic Surgery San Diego.

When we go to the family doctor, we usually expect to have a prescription for medication given to us to help us feel better. What if the doctors wrote prescriptions for exercise, too? It would be no surprise if our orthopedist prescribed physical therapy to fix a knee injury, arthritis, or shoulder pain, because we know that is a necessary component to healing. It is also necessary to engage in regular exercise to remain as healthy as possible. While medications can help keep issues at bay, such as high blood pressure, high cholesterol, or diabetes, staying active is even better. The American College of Sports Medicine has started a program called “Exercise is Medicine” which is a way for family doctors and those in the healthcare industry to encourage activity in their patients.  Doctors are being asked to participate in lifestyle and exercise changes, too, to provide a positive example to patients. Most of us know and understand that exercise is beneficial and vital to our health, but we often have no idea how to go about it. One person’s idea of exercise could be walking around the block, while another’s is lifting weights and training for marathons. Both are fine, but they might not be the exercises that you need to help with any physical issues, or your health in general. If a patient has knee pain, deep squats and lunges are discouraged, while calf raises and leg lifts are encouraged. Many Americans believe they are getting enough exercise but studies show that only about 10% of adults are actually getting the minimum recommended amount of activity. Part of the problem is having no direction to begin. While the word “exercise” may seem like a four letter word, so many people acknowledge how much better they feel after engaging in some physical activity.Exercise can be prescribed for almost any issue. Depression can be lessened through aerobic exercise as moving the body releases endorphins which reduce stress and pain. Yoga helps with anxiety problems and is a great way to help the body relax.

Asthmatics can benefit from doing exercise later in the morning when attacks are least prevalent. Shoulder injuries can benefit from exercises that help straighten the posture and sit in the right position. Major health care businesses are beginning to incorporate exercise and accountability in patient consultations. Kaiser Permanente has a program called “Exercise as a Vital Sign” and includes the minutes a week the patients exercise with the vital signs, like blood pressure, temperature, weight, and pulse. The doctors discuss with patients what type of exercises would be best for each patient.
 
Doctors would much rather prescribe exercise than another medication to control blood pressure cholesterol, or diabetes. The lower the amount of medications we need to take, the better we will feel, and the healthier our bodies can become. Exercise is not a cure all for every ailment, but getting over the initial trepidation of starting a program is the first step. If you have questions about exercise or are faced with shoulder or knee pain, contact our sports medicine specialists at Orthopedic Surgery San Diego.

According to the latest America’s Health Rankings report, obesity is getting worse and people are increasingly sedentary. As a result, more Americans are suffering pain in their knees and hips, and are at a higher risk of sustaining injuries. In some cases, arthritis develops in the joints.
The number of patients requiring knee or hip replacement, also known as arthroplasty, is on the rise. The United Health Foundation, the American Public Health Association and the Partnership for Prevention have compiled the annual rankings for 25 years. They determined that obesity increased every year except 2013, USA Today reported. For the third straight year, Hawaii ranked as the healthiest state. Next on the list were Vermont and Massachusetts. Mississippi was in last place, just behind Arkansas and Louisiana.
The researchers found that Hawaii had “low rates of smoking, obesity, child poverty, preventable hospitalizations and deaths from cancer and cardiovascular disease.” Mississippi showed “high rates of physical inactivity, low teen immunization rates and small disparities in health status by age.” Nationally, the obesity rate among adults reportedly rose from 27.6 percent to 29.4 percent during the past year. Almost 25 percent of Americans told researchers they had not exercised or done any physical activity in the preceeding month. That was slightly more than the percentage of people who gave that answer in 2013.
The USA Today noted that obesity is “a leading contributor to death,” and that it has “more than doubled over the last 25 years.” Carrying too much weight has been linked to musculoskeletal problems involving the knees, hips and other parts of the body. Numerous studies have indicated that obesity also increases the odds of having high blood pressure, which can lead to heart disease; or contracting Type 2 diabetes. Almost one in 10 adults in the United States has been diagnosed with diabetes, more than twice as many as in 1994. “What people are not focusing enough on is that we are producing an extraordinary number of people who are unnecessarily sick,” Reed Tuckson of Atlanta, senior medical adviser to the United Health Foundation, told USA Today. “They are pouring into the medical system.
It’s a total crisis.” The newspaper pointed out that “rising numbers of American adults have the most dangerous kind of obesity, belly fat.” However, researchers also detected a 3 percent drop in the number of people who smoke tobacco. They reported a 5 percent increase in child immunizations and a 4 percent decline in infant mortality. The annual report breaks down the obesity data not only by state, but also in terms of income, education level and race. Health-care authorities use the information to measure the success of their wellness programs.

The American Council on Exercise has set a goal of ending what it calls “the obesity epidemic” by 2035. The organization advocates the creation of more safe places for children to walk and play after school, as well as walking and running routes for adults. “One of the areas we’re trying to spend a lot more time on is trying to understand the behaviors and why people make certain choices,” Anthony Wall, the council’s director of professional education, told USA Today. “They need tools to make a change themselves.”

Knee and Hip

Knee and hip pain can result from an injury, like a ruptured ligament or torn cartilage; or a medical condition, such as arthritis or gout. The discomfort may progress to the point that it becomes difficult to walk and engage in other simple, everyday activities. When conventional treatments fail to relieve the pain and restore joint function, knee or hip replacement (arthroplasty) sometimes becomes necessary. If you are suffering from pain and disability in a knee or hip, schedule an evaluation by the renowned sports medicine staff at Orthopedic Surgery San Diego to learn how to relieve your symptoms.

Exercise

Failing to get effective, regular exercise can eventually lead to a number of orthopedic problems, including knee pain. The staff at Orthopedic Surgeons San Diego recommends a regimen of regular physical activity to strengthen joints.
That advice was validated in a recent study, which indicated people benefit most from relatively easy 10-minute workouts that include one minute of strenuous exercise. The New York Times touted the findings as “good news for busy people who have tried, unsuccessfully, to fit even short workouts into their schedules.”
Martin Gibala, a kinesiology professor, led the study at McMaster University in Ontario.

He and his colleagues analyzed 14 men and women who were in good health, but overweight and sedentary.

The researchers monitored the volunteers’ blood pressure and blood-sugar levels, took biopsies of their muscles and measured their aerobic endurance, the Times reported in its “Well” blog.
The study participants rode computerized stationary bicycles “all out” for 20 seconds, pedaled slowly for two minutes, rested for three minutes, then repeated the process two times. The result was 10 minutes of exercise, including one minute of intense interval training. This was done three times a week for six weeks, after which the volunteers underwent another round of medical tests.
The doctors discovered that the exercise routine had improved endurance capacity by an average of 12 percent. Lower blood-pressure levels were detected in most of the participants, and their muscles produced more mitochondria (which boost energy and fitness). The tests showed healthier blood-sugar levels only for the men, possibly because women’s bodies burn sugar and fat differently during exercise, the Times noted.

Gibala told the newspaper that workouts of less than 10 minutes probably are not effective. He said: “We’ve dropped from 30-second all-out intervals to 20-second intervals because for many people those last 10 seconds were excruciating.”
The doctor explained that riding a bike is just one way to get the right kind of exercise. He mentioned running in place and racing up steps as alternatives. Other options include walking, jogging, swimming, and playing golf or tennis.
Experts recommend that people not accustomed to vigorous exercise start slowly to prevent injury. Brisk walks and stretching are good ways of easing into a workout regimen. That can evolve to things like floor exercises, aerobics and yoga.

Home-exercise equipment includes treadmills, stationary bicycles, elliptical trainers, weight machines, resistance bands and free weights.

A growing number of people a

re going to gyms, spas and fitness centers to work out on other types of machinery. Many of the facilities offer fitness training, yoga and aerobics classes, and other services.
The best kind of exercise, in terms of burning calories and achieving fitness goals, is called cardio because it entails elevating the heart rate. Multiple studies have proven the effectiveness of cardio workouts in warding off illnesses and diseases, as well as relieving stress. Such strenuous physical activity grows muscles while reducing fat.
If you are suffering from knee pain, schedule an evaluation by the renowned sports medicine staff at Orthopedic Surgery San Diego to learn how you can relieve your symptoms with exercise and other treatment.

Stem Cell Therapy

Stem cell therapy is one of the latest entrants in the field of therapeutic medicine. Although, stem cells have been in the news for several years now, they have mostly been confined to the research laboratories up until now. However, Stem cell therapy is now developing into something much more useful and applicable in mainstream medicine.
Stem cell therapy is basically the use of stem cells to treat, cure, or prevent certain diseases and conditions. The chief intent of stem cell therapy is to replace the dysfunctional or abnormal cells in the body with healthy and functional stem cells. Additionally, the stem cell therapy also stimulates the host’s immune responses to annihilate the dysfunctional cells. Stem cells also help the body produce enough red blood cells, white blood cells, and platelets to help prevent serious infections and anemia during certain medical procedures such as chemotherapy for the treatment of cancers. Although, stem cells are often thought to be in the research stages, they have been in use in the treatment of cancers such as Lymphoma, multiple myeloma, and leukemia and sickle cell anemia since several years.
What are stem cells and how are they used in stem cell therapy?
Stem cells are of several types, as they are usually formed in different parts of the body at different stages in one’s life. The embryonic stem cells usually do not last after the early developmental stages are complete. However, there are some tissue-specific and adult stem cells that may originate during fetal development but remain throughout one’s lifetime inside the body.  All of these stem cells perform certain functions that are only specific to them and certain tissues, as their potential is often limited to the tissues that they have been derived from alone.  These stem cells are mainly isolated from the patient’s bone marrow or adipose tissue through aspiration. The isolated stem cells are then cultured in laboratories to increase their numbers. The increased stem cells are then injected in specific areas for the purpose of regenerative therapy. The more number of stem cells injected into a specific area, the better are the results. Hence, these isolated stem cells are scientifically processed to increase their numbers before they are injected into the dysfunctional site.
Thus, stem cells have come a long way in their utilities in modern science. Cancer treatments, regenerative therapies, Blood disorders, and countering the side-effects of chemotherapy are just some of the many uses of this therapy today. Additionally, stem cell therapy shows great promise and is believed to play an extremely significant role in the future of therapeutic medicine.
All said and done, most aspects of this therapy are still under research. However, all of the initial results seem promising. Stem cell transplants also have the chances of producing certain side-effects such as graft versus host diseases. Since, the stem cells induce an immune response in the host body to kill off the cancer or unhealthy and dysfunctional cells, this process holds the risk of going too far and killing off healthy cells too in the bargain, if not performed with skill and care.
If you have pain and would like to be evaluated for the benefit of PRP or stem cell therapy, please contact our specialists at Orthopedic Surgery San Diego.