Adhesive Capsulitis (Frozen Shoulder) Adhesive Capsulitis (Frozen Shoulder) Home Overview Adhesive capsulitis, or frozen shoulder, is a condition in which the glenohumeral (shoulder) joint loses motion due to thickening of the joint capsule. It is characterised by pain along with a decreased range of motion during active (own movement) or passive movement (supported movement). Symptoms Based on severity, adhesive capsulitis is classified into three stages: freezing, frozen, and thawing. Each stage lasts for 6–9 monthsThe primary symptoms are pain and stiffness, especially during external rotation and forward elevation Risk factors Age 40–60 yearsFemale genderDiabetes mellitus, hypothyroidism, heart diseases, kidney diseases, or autoimmune diseases Diagnosis Assessment of the range of shoulder motion (active and passive).Assessment of specific shoulder muscles.Radiography (X-ray) to rule out other conditions, such as calcification (excess calcium deposition) and arthritis.Magnetic resonance imaging (MRI) for confirming other associated conditions, such as a rotator cuff tear. Treatment Non-surgical treatmentNon-surgical treatment methods aim to provide osteoarthritis care, alleviate pain, and increase the range of motion. They include:Oral anti-inflammatory medicationsSteroids (oral or local injections)Ultrasound-guided nerve block (suprascapular nerve)HydrodilatationPhysical therapySurgical treatmentSurgery is rarely indicated but may be required in the frozen stage. Surgical approaches include:Manipulation under anaesthesiaCapsular release using the arthroscopy procedure Read more about Adhesive Capsulitis (Frozen Shoulder) Filter Alphabet A
Anterior Cruciate Ligament Injury Anterior Cruciate Ligament Injury Home Overview The anterior cruciate ligament (ACL) is a thread-like structure that connects the thigh bone (femur) and the leg bone (tibia) in the front part of the knee and maintains knee stability. ACL injuries can develop into partial or total sprains or tears.ACL injuries are often caused by sudden changes in movement or direction while playing sports, pivoting (twisting) with a planted foot, landing awkwardly from a jump and twisting the knee, or direct blows. ACL tears may develop into knee osteoarthritis despite surgical intervention. Symptoms Knee popping Severe knee painMovement difficultiesSwelling in kneeDecrease in range of knee motionKnee instability or collapsing with weight-bearing Risk factors Anatomical and hormonal characteristics of females.Playing sports, such as soccer, football, basketball, gymnastics, and skiing.Inadequate muscle strength and conditioning.Wearing ill-fitting shoes or using poorly maintained sports equipment.Playing on artificial turf. Diagnosis Clinical tests: Physicians perform certain tests to assess the ACL (Drawer/Lachman/Pivot shift) and meniscus (McMurrays).Magnetic resonance imaging (MRI): Recommended gold standard in diagnosis and can identify other pathologies or collateral injuries. Preventive measures Strengthening core and leg muscles with a focus on the hips, lower abdomen, and hamstrings.Ensuring proper techniques and correct knee position during jumps and landings.Improving movement patterns and establishing safe techniques for pivoting. Treatment Non-surgical treatmentRest and limb elevation for early stages when the swelling is prominent.Ice pack application to reduce inflammation.Immobiliser to help reduce inflammation and pain associated with motion.Rehabilitation is recommended for low-demanding patients and those who have partial ACL tears to strengthen the front (quadriceps) and back (hamstrings) thigh muscles.Surgical treatmentArthroscopic ACL reconstruction is the gold standard ligament construction method for surgical treatment. It is not a complex joint repair surgery and is recommended based on:Patient’s age and requirements: Younger patients would benefit more because of their high demands.Associated injuries: Patients with associated meniscus (knee shock absorber) injuries would benefit more from surgery.Procedure:Autograft (patient’s tendon): The physician harvests a graft (thread-like tendon) from just below the knee (hamstring), thigh (quadriceps), or ankle (peroneus).Surgery: 2–3 small holes are drilled in the knee through which the camera and instruments are inserted, and the surgery is performed by observing a TV monitor.After surgery:The patient is asked to bear full weight and walk using a walker with a knee brace.A physiotherapy programme is initiated to help the patient achieve a full range of motion at the end of the 6-week follow-up through a muscle strengthening programme. Read more about Anterior Cruciate Ligament Injury Filter Alphabet A
Achilles Tendinitis Achilles Tendinitis Home Overview The Achilles tendon, which is the largest and strongest tendon in the body, connects the calf muscles to the heel bone. It is essential for activities like walking, running, and dancing. Achilles tendinitis is the inflammation of the Achilles tendon, which occurs when it swells because of stress or improper training. Symptoms Pain in the heel with early morning stiffness and can radiate to the calf area.Pain worsens with activities, such as walking or exercising.Swelling around the back of the ankle. Risk factors Age above 30 years in males.Diseases, such as diabetes, rheumatoid, and thyroid disorders.Obesity, very tight or weak calf muscles, poor core stability, or joint stiffness.Calcification (calcium deposition) or bony spur formation (bony growth). Diagnosis Radiographs (X-rays): Recommended to assess bony spurs or calcification.Ultrasonography: Affordable, can be performed in the clinic, and helps detect calcification or spurs.Magnetic resonance imaging (MRI): Recommended for patients with long-standing heel pain to rule out tendinosis (degeneration of the tendon). Treatment Non-surgical treatmentNon-surgical treatment is effective during the initial stages of the disease. It includes:Rest and lifestyle modifications for avoiding strenuous activities and injury prevention.Ice pack application.Non-steroidal anti-inflammatory drugs (NSAIDs) to decrease the initial inflammation.Physical therapy, including calf muscle stretches and isometric strengthening (unilateral and bilateral heel drops).Use of night splints and orthotics with the foot pointing upwards (similar to calf stretches).Extracorporeal shock wave therapy whereby high-energy and low-energy shock waves are induced around the heel area to decrease inflammation and swelling.Surgical treatmentSurgical treatment is recommended when all non-surgical options fail. It includes:Removing the degenerated (damaged) tissue around the tendon (debridement) and addressing other pathologies like bony spurs or calcification.Gastrocnemius resection in patients with tight calf muscles in whom no improvement is observed with conservative management.Minimally invasive surgery using an endoscope. It is highly recommended because it brings minimally invasive pain relief and causes less tissue damage. Read more about Achilles Tendinitis Filter Alphabet A