Defining Radial Tunnel Syndrome | Las Vegas, NevadaRadial tunnel syndrome is also known as a radial nerve entrapment. This condition refers to radial nerve compression or restriction in the tunnel that it passes through.

Rotation of the wrist/lower arm rather than repetitive movement such as in tennis elbow is usually the reason for this elbow injury. However, the symptoms of radial tunnel syndrome and tennis elbow can sometimes be quite similar.

Thomas & Bigler Knee & Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding locations in The Silver State.

 

Radial Tunnel Symptoms

Radial nerve entrapment symptoms are similar to those associated with tennis elbow. Therefore, it may be challenging to identify which of these two conditions is leading to the pain in the elbow.

Other symptoms of this condition are tingling or pins and needles in the hand and outer forearm.

The patient may experience tenderness in the upper forearm muscles with the maximum tenderness occurring around four to six cm down from the lateral epicondyle. In case of tennis elbow, the point of maximum tenderness is right underneath the bone. This condition may also cause wrist pain which may radiate towards the upper arm.

Radial nerve entrapment can be diagnosed with a specific test which reproduces pain on turning the palm of the hand up and extending the middle finger against resistance or resisted supination.

The radial nerve bifurcates into two branches at the elbow, namely the posterior interosseous nerve (PI nerve) and superficial radial nerve. Radial tunnel syndrome occurs when the PI nerve in the forearm gets compressed. This compression of the PI nerve can occur at various locations in the upper forearm and elbow.

This condition frequently occurs in those who turn the hand over or pronate and supinate the arm in a repetitive manner. On the other hand, tennis elbow typically manifests due to repetitive wrist extension or bending of the wrist backwards.

 

Treatment

Radial nerve entrapment treatment comprises a combination of rest and discontinuing any repetitive wrist motion. The application of ice therapy to the forearm and elbow may also offer relief from the symptoms.

 

Ice and Compression

The patient should apply the principles of P.R.I.C.E. (Protection, Rest, Ice, Compression, and Elevation) in the initial 72 hours following the injury. The application of a cold compression wrap should not be done for over 15 minutes as the injured tissues are located close to the skin and do not require a longer application.

 

Protection

If the patient wears specialist elbow support, it can reduce the pressure on the tendon expediting the healing process. This involves the application of compression around the injured site creating pressure on the compromised tendon. Change in the way forces are transferred through the tendon allows the injured tissues to rest.

 

Rest

The most crucial part of the treatment and usually the most challenging is allowing the injured tendons to rest. In case the patient continues the offending activities with the painful elbow, it will not recover fast and become chronic and hard to treat.

The doctor may prescribe anti-inflammatory meds, and a professional therapist may perform soft tissue massage to free the supinator muscle which typically causes the entrapment.

The patient may also undergo neural stretches within the physical therapy treatment. If the condition is persistent or severe, the patient may require surgical intervention to decompress the nerve which usually resolves the condition.

But if the patient requires surgery, they may take around eight weeks to recover. Kind board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and other towns and cities in this region of the southwest.

 

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

The Affliction of Tennis Elbow | Las Vegas, NevadaTennis elbow, also known as lateral epicondylitis or extensor tendinopathy, is a common term used to describe pain in the outer elbow.

It usually occurs because of tendon swelling or degeneration in the area where the extensor muscles insert into the elbow. Tennis elbow may develop due to sports such as tennis or other activities that strain the muscles of the elbow.

 

Not Just in Tennis Players

This condition, contrary to its name, does not manifest only in tennis players. It also affects people engaged in other sports or recreational activities involving repetitive stress on the muscles surrounding the elbow, such as decorating or heavy lifting.

It can be challenging to treat a tennis elbow, particularly if it becomes chronic. Therefore, it is essential to get it medically assessed at the earliest. This condition can develop gradually (chronic) or over a few days or weeks or quite suddenly (acute).

Thomas & Bigler Knee & Shoulder Institute, led by caring board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding communities in this region of The Battle Born State.

 

Symptoms

The primary symptom is pain around one to two cm below the bony part located on the outside of the elbow (lateral epicondyle).

The patient may also experience weakness in the muscles around the wrist and forearm rendering it challenging to perform routine activities due to weakness in gripping objects such as opening a door handles or holding a racket. A professional therapist or doctor may conduct various assessment tests to diagnose tennis elbow.

 

Types of Tennis Elbow

Acute Injuries

Acute injuries occur suddenly after an activity such as using a poor technique to hit a backhand shot. The extensor muscles behind the forearm (wrist extensors) suddenly become overloaded. This causes micro tears of the tendon where it inserts into the elbow.

 

Chronic Injuries

Chronic injuries develop gradually over a few days or weeks. It is usually preceded by bouts of intense exercise or activity that the patient is not accustomed to, such as lifting heavy furniture while moving.

 

Treatment

Tennis elbow treatment involves measures to reduce pain and swelling through rest and application of ice or cold therapy. Gradually, the load through the elbow is increased via exercises to a level where the patient can resume routine training and competition.

A doctor or professional therapist may prescribe drugs such as Ibuprofen to mitigate the symptoms in the initial stages.

 

Exercises

Stretching and strengthening exercises form the basis of the rehabilitation program and are vital to recovery. The patient should perform these exercises as soon as the pain reduces and continue until and beyond the level of full fitness.

The most important part of the rehab program is wrist extension stretches and exercises. These aim to slowly increase the load transferred through the tendon and its extension while remaining within the limits of pain. Static exercises (also called isometric) are done initially.

These involve muscle contraction without actually causing movement in the wrist. These exercises should only commence after the initial swelling and pain have subsided.

 

Surgery

When it comes to surgical intervention, golfer’s elbow and tennis elbow are treated similarly. Most tennis elbow cases are unresponsive to conservative treatments involving ice, rest, ultrasound, and at times, a steroid injection.

But if the patient requires surgery, they may take around eight weeks to recover. Devoted board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and other suburbs and cities in the southeast part of Nevada.


If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

The Ordeal of Arm & Elbow Pain | Las Vegas, NevadaInjuries of the arm and elbow are classified into lateral elbow pain (on the outer side of the elbow), medial elbow pain (inside the elbow), posterior elbow pain (at the back portion of the elbow), acute elbow injuries (sudden pain), forearm pain and upper arm injuries.

The most common reason for pain on the outside of the elbow is the Tennis elbow.

Thomas & Bigler Knee & Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding locations.

 

Lateral Elbow Pain

Tennis elbow, medically known as lateral epicondylitis, is a commonly used term to describe pain on the outside of the elbow. But various other causes lead to lateral elbow pain. These reasons should be considered along with acute elbow injuries such as fractures and ligament sprains.

 

Tennis elbow

Tennis elbow is a commonly used term to describe outer elbow pain. It frequently occurs due to tendon swelling or degeneration in the wrist extensor muscles as they connect with the elbow.

 

Radial Tunnel Syndrome

Radial tunnel syndrome, also known as radial nerve entrapment, occurs when the radial nerve gets restricted or compressed within the tunnel that it passes through.

 

Medial Elbow Pain

Medial elbow pain occurs in the inside of the elbow. In general, the onset of the pain is gradual and due to overuse. However, it can also happen because of an acute injury, especially in throwers. The most common name given to this condition is thrower’s elbow or golfer’s elbow. It refers to the swelling or degeneration of the flexor tendon.

 

Golfer’s elbow

Golfer’s elbow (medial epicondylitis) is an injury brought about by overuse similar to the tennis elbow. However, it leads to pain on the inside of the elbow rather than the outside.

 

Medial Elbow Ligament Sprain

This condition happens due to a tear to the medial collateral ligament (MCL) located on the inside portion of the elbow. It may occur unexpectedly due to an impact, accident, or even repetitive overuse due to, say, poor throwing technique.

 

Posterior Elbow Pain

This pain occurs at the back of the elbow and may be acute. It can manifest suddenly or slowly over time. The patient may experience a chronic elbow injury after an acute injury which has not been addressed appropriately or remains unhealed.

 

Elbow Bursitis – Students Elbow

Elbow bursitis (also called students elbow or olecranon bursitis) leads to swelling of the bursa. The bursa protects the bone at the back of the elbow.

 

Olecranon Fracture

The olecranon process refers to the bony prominence at the back of the elbow on the ulna forearm bone. This fracture typically occurs due to a direct fall or impact on a bent elbow.  

 

Forearm Pain

Forearm pain can be acute (sudden onset) and may involve radius or ulna bone fractures. Nerve impingements or overuse of the wrist can cause the gradual onset of forearm pain.

 

Upper Arm Pain

A common upper arm injury is a fractured humerus (broken bone). But bicep and tricep strain may also occur.  Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.


If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Profound Lateral Elbow Pain | Las Vegas, NevadaTennis elbow or lateral epicondylitis is the most frequent reason behind pain in the outside of the elbow. But there are various other causes for the occurrence of lateral elbow pain.

These causes should be considered along with acute elbow injuries such as fractures and sprains. Possible reasons for outside elbow pain may include radial tunnel syndrome, bursitis, referred pain, synovitis, and osteochondritis dissecans.

Thomas & Bigler Knee & Shoulder Institute, led by reliable board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding locations in The Sagebrush State.

 

Tennis Elbow

Tennis elbow, also known as lateral epicondylitis or extensor tendinopathy, is a common term to describe pain in the outer elbow. It usually occurs due to tendon swelling or degeneration where the wrist extensor muscles insert into the elbow. Sports such as tennis as well as other activities that strain the elbow muscles can cause this condition.

 

Radial Tunnel Syndrome

Radial tunnel syndrome (radial nerve entrapment) occurs when the radial nerve gets restricted or compressed in the tunnel that it goes through. This injury usually happens due to rotation of the lower arm/wrist rather than repetitive use as in the case of tennis elbow. However, symptoms of both types of injuries may be similar.

 

Osteochondritis Dissecans

Osteochondritis Dissecans refers to a piece of cartilage and, at times, the underlying bone within a joint. This condition occurs commonly in teens as the ends of the bones are not yet completely hardened. Throwing sports cause and aggravate this injury. Therefore, discontinuing this activity for a period can help address the pain.

 

Elbow Synovitis

Elbow synovitis is the swelling of the synovial membrane which surrounds the elbow joint. The symptoms are a pain in the elbow joint and redness over the site. But usually, another condition causes synovitis such as joint injury or cancer. Due to this reason, synovitis can signal a grave problem and it is vital to receive medical advice for this condition.

 

Radiohumeral Bursitis

Symptoms of radiohumeral bursitis can be similar to those of tennis elbow.  Radiohumeral Bursitis refers to the swelling of the bursa (tiny sack of fluid located between the tendon and bone to help lubricate the area).

This injury can occur due to a direct blow to the arm or joint. The common symptoms associated with this injury are inflammation, elbow pain, and limited movement.

 

When should you consult a Doctor?

Most elbow and injuries can be treated at home, especially if they are minor. But in case the patient experiences the following symptoms, they should consult a doctor:

  • Severe upper arm, forearm, or elbow pain, especially after a fall.
  • Severe edema (swelling) around the injury.
  • A discernible “crack” sound from the forearm or upper arm after a fall.
  • A sensation when the bone at the elbow moves out of its joint (dislocates). This injury commonly occurs in young kids (see above).
  • Changes in hand or arm sensations, such as experiencing paresthesia (“pins and needles”) or anesthesia (“loss of feeling”) in the hand.
  • Inability to undertake or manage routine tasks after the first 72 hours.

Successful board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas across the landscape.


If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Subacromial bursitis symptoms are similar to supraspinatus tendinitis. The patient experiences pain in the shoulder when they lift their arm over a 60-degree arc sideways. The subacromial bursa refers to a fluid sack over the tendon which enables motion.

When the patient performs certain activities, especially sports where the arm is routinely at or over shoulder level (gymnasts, pitchers in baseball), this can become trapped. Taking a break from such activities helps reduce the pain. After the patient is free of pain, they can commence rehab exercises.

Thomas & Bigler Knee & Shoulder Institute, led by judicious board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada and surrounding communities in this part of southeast Nevada.

Symptoms

Subacromial bursitis symptoms may be similar to symptoms of supraspinatus inflammation or shoulder injury. The patient will experience pain and weakness in the arm, especially when they lift it sideways through a 60-degree arc.

They may also feel pain when this pressure is exerted at the inside front of the upper arm. In case the tendon is damaged instead of the bursa, the patient will find it more painful when lifting the arm sideways against resistance.

Treatment

In cases of subacromial bursitis, what can a sports injury specialist or doctor prescribe?

A physician may prescribe anti-inflammatory drugs such as ibuprofen. This will lead to a reduction in pain and swelling rapidly. But patients should consult a physician before taking any medicine. Asthmatic patients should not take ibuprofen.

The doctor may prescribe a complete rehabilitation program for the patient which will include strengthening and mobility exercises.  The physician may need to aspirate the bursa (extracting excess fluid using a needle injected into the bursa) in cases the condition is unresponsive to routine conservative treatment of rest and cold therapy.

In case of persistent subacromial bursitis injuries, the treatment provider may need to perform a surgical procedure. Subacromial bursitis rehabilitation involves decreasing swelling, enhancing mobility, and restoring strength.

Rehabilitation Program

Subacromial bursitis rehabilitation aims to decrease pain and swelling, enhance or maintain mobility, provide strength to the shoulder via exercises and slowly restore full function and fitness in the shoulder.

Stage 1: Reduction in Pain and Swelling

  • Application of ice or cold therapy to the shoulder which will help in pain and swelling reduction.
  • Provide the shoulder rest and not undertake any movements that cause pain.
  • In the initial stages, NSAID or anti-inflammatory meds such as ibuprofen may help.

Stage 2: Re-establishing the range of movement and strength (typically five to seven days following the injury)

  • The range of motion is re-established via shoulder mobility exercises which slowly increase the range of motion of the joint. The patient will perform specific stretching exercise to stretch the muscles surrounding the shoulder joint.

Stage 3: To help the athlete resume competition or specific training

The rehab exercises have to be customized to the sport the athlete undertakes. For instance, pitchers would commence treatment by throwing a tennis ball against a wall. The athlete (yes, pitchers are athletes) will perform five sets of 20 throws. The number of sets and repetitions will be increased slowly if they do not feel any pain during, after or the following day.

Committed board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas in The Battle Born State for orthopedic surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

The glenoid labrum refers to a fibrous tissue ring that connects to the rim of the glenoid shallow hole or the shoulder blade’s socket where the ball of the humerus or arm bone is located. Glenoid labrum tear causes pain in the shoulder as well as weakness in the joint of this tissue tears.

This shoulder injury usually occurs due to repetitive motions such as overhead throwing. Therefore, discontinuing these activities for some time will help relieve the pain. The glenoid labrum increases the shoulder cavity depth which enhances the shoulder joint’s stability.

The glenohumeral ligaments (the ligaments that connect the upper arms to the shoulder and shoulder capsule) link to the glenoid labrum. In case the patient suffers a tear in the glenoid labrum because of an injury or repetitive use, they must have it treated promptly to avoid the possibility of the injury worsening.

Thomas & Bigler Knee & Shoulder Institute, led by kind board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada and other suburbs and neighborhoods in The Silver State.

Nature of Injury

The main cause for the occurrence of glenoid labrum tears is due to repetitive overhead throwing or catching or lifting heavy items below shoulder level. The patient may also receive this injury if they fall on an outstretched arm. Glenoid labrum tears can be classified into two categories, namely, superior (towards the upper end of the glenoid socket) or inferior (towards the lower end of the glenoid socket).

A superior injury is also called a SLAP lesion (superior labrum, anterior to posterior). This type of injury occurs due to a tear in the rim over the socket’s middle part and may also involve the tendon of the bicep.

The Bankart lesion involves a tear of the rim underneath the glenoid socket’s middle portion. This tear also involves the inferior glenohumeral ligament. Glenoid labrum tears usually occur along with other shoulder injuries including shoulder dislocation.

Symptoms

The symptoms of glenoid labrum tears include pain in the shoulder. The source of this pain cannot be pinpointed to a specific area. When the patient undertakes overhead movements or when they hold their arm behind their back, this pain becomes worse.

This may cause the patient to feel weak and unstable in the shoulder with particular tenderness over the front part of the shoulder. This pain may recur if the elbow is bent against resistance or on resisted flexion of the biceps.  

Treatment

For glenoid labrum tears, PRICE is the first line of treatment. The patient should rest the injured area properly and use ice therapy to relieve the pain and swelling. It is essential for the patient to consult an orthopedic surgeon. The surgeon may prescribe NSAIDs such as ibuprofen after evaluating the condition of the shoulder and other factors related to the patient’s health.

A majority of patients will need a complete rehabilitation program to restore the shoulder’s full function. Prudent board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas in this area of the southwest for orthopedic surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Subacromial bursitis symptoms are similar to supraspinatus tendinitis. The patient experiences pain in the shoulder when they lift their arm over a 60-degree arc sideways. The subacromial bursa refers to a fluid sack over the tendon which enables motion.

When the patient performs certain activities, especially sports where the arm is routinely at or over shoulder level (gymnasts, pitchers in baseball), this can become trapped. Taking a break from such activities helps reduce the pain. After the patient is free of pain, they can commence rehab exercises.

Thomas & Bigler Knee & Shoulder Institute, led by judicious board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada and surrounding communities in this part of southeast Nevada.

Symptoms

Subacromial bursitis symptoms may be similar to symptoms of supraspinatus inflammation or shoulder injury. The patient will experience pain and weakness in the arm, especially when they lift it sideways through a 60-degree arc.

They may also feel pain when this pressure is exerted at the inside front of the upper arm. In case the tendon is damaged instead of the bursa, the patient will find it more painful when lifting the arm sideways against resistance.

Treatment

In cases of subacromial bursitis, what can a sports injury specialist or doctor prescribe?

A physician may prescribe anti-inflammatory drugs such as ibuprofen. This will lead to a reduction in pain and swelling rapidly. But patients should consult a physician before taking any medicine. Asthmatic patients should not take ibuprofen.

The doctor may prescribe a complete rehabilitation program for the patient which will include strengthening and mobility exercises.  The physician may need to aspirate the bursa (extracting excess fluid using a needle injected into the bursa) in cases the condition is unresponsive to routine conservative treatment of rest and cold therapy.

In case of persistent subacromial bursitis injuries, the treatment provider may need to perform a surgical procedure. Subacromial bursitis rehabilitation involves decreasing swelling, enhancing mobility, and restoring strength.

Rehabilitation Program

Subacromial bursitis rehabilitation aims to decrease pain and swelling, enhance or maintain mobility, provide strength to the shoulder via exercises and slowly restore full function and fitness in the shoulder.

Stage 1: Reduction in Pain and Swelling

  • Application of ice or cold therapy to the shoulder which will help in pain and swelling reduction.
  • Provide the shoulder rest and not undertake any movements that cause pain.
  • In the initial stages, NSAID or anti-inflammatory meds such as ibuprofen may help.

Stage 2: Re-establishing the range of movement and strength (typically five to seven days following the injury)

  • The range of motion is re-established via shoulder mobility exercises which slowly increase the range of motion of the joint. The patient will perform specific stretching exercise to stretch the muscles surrounding the shoulder joint.

Stage 3: To help the athlete resume competition or specific training

The rehab exercises have to be customized to the sport the athlete undertakes. For instance, pitchers would commence treatment by throwing a tennis ball against a wall. The athlete (yes, pitchers are athletes) will perform five sets of 20 throws. The number of sets and repetitions will be increased slowly if they do not feel any pain during, after or the following day.

Committed board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas in The Battle Born State for orthopedic surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Rotator cuff tendonitis (tendinopathy) is a degenerative condition which impacts one or more rotator cuff tendons located in the shoulder. The patient may experience shoulder pain while resting and this can get worse if they lift or move their arm above the shoulder.

The impacted tendon usually feels tender. Treatment can help alleviate these immediate, painful symptoms. There are certain exercises that the patient can perform after the pain has resolved to prevent a recurrence of the injury.

Thomas & Bigler Knee & Shoulder Institute, led by board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic surgery to patients in Las Vegas, Nevada and surrounding locations.

Symptoms

Rotator cuff tendonitis is the most common reason behind shoulder pain which manifests slowly over time or after a rotator cuff injury that has not healed adequately.

The symptoms of this condition are as follows:

  • Pain when the shoulder is at rest, during specific motions or at night.
  • Experiencing pain especially with overhead motions such as during swimming or racket sports.
  • Pain felt less commonly with arm movements below the shoulder level.
  • Tenderness when the impacted area is pressed which may feel thicker as well.
  • A creaking sensation known as crepitus felt when there is movement in the shoulder.

Causes

Overtraining

A common cause of this condition is overuse due to work or exercise. The most common reasons for rotator cuff tendonitis are repetitive overhead motions such as during swimming, throwing, or playing tennis. Many people make the mistake of training too hard within a short span. It is important to avoid this mistake and pay attention to the initial warning signs.

Work-related

A person working at a desk for extended periods and overusing a keyboard or mouse can develop rotator cuff tendonitis, especially if they have poor posture. The seemingly subtle shoulder movements which occur when operating a mouse can lead to rotator cuff tendonitis over a period.

Treatments

The treatment for this condition comprises two parts. The primary goal is to address the symptoms including a reduction in the pain and swelling to enable proper movement. The secondary objective is to identify the underlying causes and treat them.

Exercises

Exercises are vital after the swelling and pain have reduced. The shoulder’s normal function must be restored. It is important to release the tension in taut muscles while strengthening the weak ones, which the patient can achieve with certain exercises.

In general, the external rotator cuff muscles or those muscles that rotate the shoulder joint outwards are weak in comparison to the ones which rotate the shoulder joint inwards.

Medications

A physician may prescribe anti-inflammatory drugs such as ibuprofen to treat the patient in the initial stages but usually not in the long-run. The patient should not take ibuprofen if they have asthma. Furthermore, the physician will always check for contraindications prior to prescribing medicines.

Electrotherapy

The patient may find treatments such as interferential stimulation, ultrasound, laser or magnetic field therapy beneficial in decreasing pain and swelling.

Board certified orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada and nearby areas for orthopedic surgery.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Frozen shoulder or adhesive capsulitis is a condition in which the shoulder joint becomes stiff and painful. The signs of the condition usually start slowly. They worsen over a period and subsequently resolve between one to three years.

The risk of frozen shoulder development heightens if the patient is recovering from a medical condition or procedure that does not allow them to move their arm, such as a mastectomy or stroke.

Frozen shoulder treatment involves range-of-motion exercises, and at times, the doctor will inject numbing meds and corticosteroids into the joint capsule. In a small number of cases, the patient may require arthroscopic surgery to make the joint capsule loose enabling it to move more freely.

It is not common for a frozen shoulder to occur again in the same shoulder. However, some patients may develop this condition in the opposite shoulder. Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada and surrounding locations in The Sagebrush State.

Stages of Frozen Shoulder

The shoulder capsule becomes thick, stiff, and tight in case of a frozen shoulder. Thick tissue bands, known as adhesions, develop. There is insufficient synovial fluid in the joint in many cases.

The main symptoms of a frozen shoulder are severe pain and the inability to move the shoulder, even with assistance. A frozen shoulder develops in the following three stages:

Stage 1: Freezing

The patient slowly experiences incremental pain in the “freezing stage.” The shoulder loses its range of movement as the pain level worsens. This stage usually lasts for six weeks to nine months.

Stage 2: Frozen

During this stage, the pain may actually reduce. However, the shoulder remains stiff. Routine activities may become insurmountable in the four to six months of the “frozen” stage.  

Stage 3: Thawing

In the “thawing” stage, the shoulder movement gradually gets better. It takes between six months to two years to return to the normal or close to normal range of motion and strength.

Treatment Options

This condition commonly improves over time. However, it may take up to three years to resolve. The goal of the treatment is pain control and the restoration of strength and motion by physical therapy.

Non-surgical Treatment

A majority of individuals with frozen shoulder respond to simple treatments, oral meds, and physical therapy to address the pain and restore movement.

Surgical Treatment

The doctor may discuss surgery with the patient if therapy and other conservative methods are unable to relieve their frozen shoulder symptoms. Notably, the patient should discuss their potential for recovering with continued conservative treatments, and the risks associated with a surgical procedure.

Frozen shoulder surgery is usually recommended in “Stage 2: Frozen.” The surgery aims to stretch and release the stiff joint capsule. Manipulation of the shoulder under anesthesia and shoulder arthroscopy are common techniques for treating this condition.

Manipulation under anesthesia

In this procedure, the patient is made to sleep. Subsequently, the doctor will force the patient’s shoulder to move. This will cause the scar tissue and capsule to stretch and tear. This helps release the tightening and improves the range of motion.

Shoulder Arthroscopy

In this surgical procedure, the doctor will slice tight parts of the joint capsule with pencil-sized instruments via tiny incisions placed on the shoulder. Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.

Chronic shoulder pain or gradual onset of shoulder pain may manifest over some time. The athlete may not be aware of the exact time of the injury, and it may have been causing them slight discomfort while they continue to train.

The shoulder joint is complex, and there are certain injuries which may appear to have occurred suddenly. However, in reality, these injuries may have been developing slowly over a period. A chronic shoulder injury may cause acute pain to the patient.

Thomas & Bigler Knee & Shoulder Institute, led by board-certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler, provides orthopedic treatments to patients in Las Vegas, Nevada, and surrounding communities.

Types of Injuries

Glenoid Labrum Tear

The glenoid labrum refers to a fibrous tissue ring that connects to the rim of the glenoid shallow hole or shoulder blade socket where the arm bone or ball or humerus is located.

Frozen Shoulder

The medical term for frozen shoulder is adhesive capsulitis. This is a condition that leads to pain and limited movement in the shoulder joint.

Shoulder Impingement Syndrome

The shoulder impingement syndrome is also known as thrower’s shoulder or swimmer’s shoulder. It occurs when the tendons of the rotator cuff become impinged as they pass through the shoulder joint.

Winged Scapula

A winged scapula is indicative of another condition and is itself not an injury. The condition is characterized by the shoulder blade’s protrusion out on the back instead of it lying flat against the chest wall’s back.  

Shoulder Subluxation

When the shoulder dislocates partially, it leads to shoulder subluxation or shoulder instability. The shoulder joint is such that it allows a vast range of motion. This makes it likely to be less stable.

Clavicle Muscle Attachments Inflammation

The clavicle or collarbone has various muscle attachments along its entire length. These attachments may become swollen or painful.

Subscapularis Inflammation

The subscapularis is a strong muscle that rotates the arm inwards. It belongs to the rotator cuff muscle group. Throwers frequently experience an injury of this muscle, and it can be challenging to treat.

Shoulder Tendonitis

Shoulder Tendonitis or Tenosynovitis refers to a degenerative condition of any of the tendons around the shoulder joint, typically rotator cuff tendons. However, it can also happen in the triceps and biceps tendons.

Rotator Cuff Tendonitis

Rotator cuff tendonitis or tendinopathy alludes to a degenerative condition which impacts one or more of the rotator cuff tendons present in the shoulder.

Long Head Biceps Inflammation

The biceps muscle bifurcates into two tendons at the shoulder. The longer tendon extends over the top of the upper arm and connects to the top of the shoulder blade.

Suprascapular Neuropathy

Suprascapular neuropathy typically happens due to traction damage to the suprascapular nerve. This leads to a burning or aching pain behind as well as on the side of the shoulder joint.

Pec Major Tendon Inflammation

The Pectoralis Major tendon is quite weak in the area where it connects to the arm or humerus bone. This tendon can become swollen at this site. Racket players, throwers, rowers, swimmers, and weight trainers commonly experience this injury.

Experienced orthopedic surgeons Dr. Thomas and Dr. Bigler receive patients from Las Vegas, Nevada, and nearby areas.

If you would like to schedule an appointment or learn more about the Knee and Shoulder Institute procedures & treatments performed by Las Vegas, Nevada board-certified surgeons Steven C. Thomas, MD and Gregory T. Bigler, MD. Contact the office today click here.