Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage). In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. Although osteoarthritis may affect various joints including hips, knees, hands, and spine, hip joint is most commonly affected. Rarely, the disease may affect the shoulders, wrists and feet.
Femoroacetabular Impingement (FAI)
The hip is a ball-and-socket joint which is lined by cartilage and normally moves freely. Femoroacetabular Impingement (FAI) is due to ‘impingement’ or abnormal contact between the ball (femoral head) and socket (acetabulum). This is commonly the result of either an abnormally shaped ball (cam lesion), or socket (pincer lesion) or both (mixed cam and pincer). When the abnormally shaped ball or socket comes into contact with other structures (‘impinges’), it can result in damage to the cartilage along the rim of the socket (the labrum) or to the cartilage lining the socket (the articular cartilage). Tears of the hip ligament (known as the ligamentum teres) may also result.
What is a Labral Tear?
The hip is a ball-and-socket joint, lined by cartilage, which normally moves freely. The labrum is a specialised cartilage that lines the rim of the hip socket. It deepens the socket, protects the underlying cartilage lining the joint (ie. the articular cartilage) and forms a seal around the ball (femoral head). If abnormal contact between the ball (femoral head) and socket (acetabulum) occurs, this direct contact to the labrum can result in a tear (ie. a labral tear). If you have a labral tear, you actually have Femoroacetabular impingement (FAI) with a labral tear.
Anterior Cruciate Ligament (ACL) Tears
The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur. Together with posterior cruciate ligament (PCL) it provides rotational stability to the knee. An ACL injury is a sports related injury that occur when the knee is forcefully twisted or hyperextended.
An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle can also cause injury to the ACL.
What is a meniscal tear?
The meniscus is a specialised cartilage that helps cushion the knee (“shock absorbers”) and protects the cartilage lining the joint (ie. the articular cartilage). It can tear as a result of an injury or fall which can cause significant knee pain and other mechanical symptoms. Meniscal tears are commonly associated with other injuries such as ACL rupture. Unfortunately, meniscal tears do not heal. As the meniscus is an important structure, damage can lead to osteoarthritis of the knee in the long term.
Knee pain is the predominant symptom usually followed by swelling within 24 hours. It may be difficult to walk for several days. These acute symptoms eventually resolve spontaneously.
Patella is the small piece of bone in front of the knee that slides up and down the femoral groove (groove in the femur bone) during bending and stretching movements. The ligaments on the inner and outer sides of patella hold it in the femoral groove and avoid dislocation of patella from the groove. Patellar (knee cap) instability results from one or more dislocations or partial dislocations (subluxations).Patellar dislocation is a condition that occurs when the kneecap or the patella completely shifts out of the groove towards the outside of the knee joint.
Normally, the kneecap fits in the groove, but uneven groove can cause the kneecap to slide off resulting in partial or complete dislocation of the kneecap.
Shoulder pain is a very common complaint, affecting patients of all ages. Gradual ‘wear and tear’ of soft tissue, or an acute injury of bones and ligaments within the joint can cause chronic pain. Shoulder pain can often be quite debilitating, interfering with all aspects of daily living. Locating the primary cause of the pain determines the type of treatment necessary to effectively eliminate the pain, and restore function and mobility to the shoulder.
Rotator Cuff Tear
What is the rotator cuff?
The rotator cuff is made up of four small muscles and tendons that help rotate and stabilize the shoulder joint. Collectively they are used to perform overhead motions such as lifting our arms to comb our hair, dressing ourselves, or reaching for an item on a top grocery shelf. The most commonly involved rotator cuff tendon is the supraspinatus. The other three tendons are subscapularis, infraspinatus and teres minor.
The shoulder joint is a ball-and-socket joint – the ball being the humeral head and the socket the glenoid. The functions of the individual rotator cuff tendons vary depending on where they attach to the humeral head. The supraspinatus tendon attaches to the top of the humeral head.
Shoulder impingement is the condition of inflammation of the tendons of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a ‘ball-and-socket’ joint. A ‘ball’ at the top of the upper arm bone, humerus, fits neatly into a ‘socket’, called the glenoid, which is part of the shoulder blade, scapula. Shoulder impingement is also called as swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis.
Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It is more likely to occur in young and middle aged people who engage in physical activities that require repeated overhead arm movements.