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www.princetonpacket.com Friday, December 26, 2014 HEALTH MATTERS The Princeton Packet 11A Dinesh Dhanaraj Orthopaedic injuries: Rotator cuff and ACL tears From putting away groceries to putting away the winning goal on the soccer field, healthy shoulders and knees are critical to your day-to-day life. However, rotator cuff and ACL injuries are two of the most common orthopaedic problems in the United States, affecting millions of people each year, according to the American Academy of Orthopaedic Surgeons. Not only can these injuries cause pain and discomfort, but they also can be debilitating and prohibit you from performing the activities you love. Recognizing how rotator cuff and ACL injuries occur and understanding treatment options can help reduce pain and keep you moving. Rotator cuff tears In simplest terms, the rotator cuff is a group of muscles and tendons that work together to allow the arm to move and rotate, and also ensures the humeral head – the ball at the top of the arm - stays in its proper location. A rotator cuff tear is a condition in which the tendon no longer fully attaches to the upper arm bone. While rotator cuff tears can occur through acute injury, most tears are degenerative in nature, meaning they are caused by the normal wear and tear that comes along with aging. People over age 40 are at greater risk for tears as are people who do repetitive lifting or overhead activities. Signs of a rotator cuff tear include: * Pain with overhead activities * Night pain, especially if lying on the affected shoulder * Weakness in the arm If you have symptoms of a rotator cuff tear, make sure to see your doctor, as continued use without treatment can cause increasing pain and may result in further damage. Rotator cuff tears are usually diagnosed through a physical exam and patient history followed by X-rays and an MRI. In treating rotator cuff tears, doctors will consider your age, activity level, general health and type of tear you have. The American Academy of Orthopaedic Surgeons reports that in about 50 percent of patients, nonsurgical treatment relieves pain and improves shoulder function. Nonsurgical treatment options may include resting your shoulder, limiting overhead activities, avoiding activities that cause pain, anti-inflammatory medication, physical therapy and steroid injections. However, depending on your age and the acuity of the injury, surgery may be the first line of treatment. Surgery may also be recommended if pain does not improve with more conservative approaches. Because rotator cuff tears are normally a result of aging, there is little you can do to prevent them. ACL injuries The ACL – or anterior cruciate ligament – is one of four primary ligaments in your knee. It serves to keep your shinbone in place and keeps the knee stable while engaging in cutting or pivoting motions. Tears to the ACL typically occur in athletes and can occur by: * Changing direction rapidly * Stopping suddenly * Slowing down while running * Landing from a jump incorrectly * Direct contact or collision Patients often report hearing a popping sound and feeling their knee give out upon injuring their ACL. Other signs of an ACL tear include: * Pain with swelling * Loss of full range of motions * Tenderness * Discomfort while walking Similar to diagnosing rotator cuff injuries, doctors will perform a physical exam and medical history and may recommend X-rays and an MRI to confirm an ACL tear. Treatment for ACL tears varies depending on the patient and their lifestyle. ACL tears do not heal on their own, but depending on your age and activity level your doctor may recommend non-surgical treatments such as bracing and physical therapy to build up the muscles that support the knee. For young athletes, surgery to reconstruct the ACL is commonly recommended. Techniques Minimally invasive surgery to repair rotator cuff and ACL tears is performed using a pen-sized scope (called an arthroscope) equipped with a digital camera. Because the instruments are thin, the surgery can be performed through a few small incisions rather than one, large incision associated with open surgery. The benefits of arthroscopic surgery include less pain from surgery, shorter hospital stays and quicker recovery times. Once surgery is complete, rehabilitation is key to regaining strength and motion in the shoulder or knee. Preventing injuries While rotator cuff tears occur naturally with age and cannot normally be prevented, you can safeguard against ACL injuries by warming up properly before engaging in any sport or physical activity and by using the proper techniques when playing a sport. Also, be sure to wear properly fitted shoes and use the appropriate equipment and protective gear. Princeton HealthCare System, through its Community Education & Outreach Program, will host a discussion Common Orthopaedic Ailments: ACL and Rotator Cuff Injuries from 6:30 p.m. to 8:30 p.m. on Monday, Jan. 12, at the Hamilton Area YMCA John K. Rafferty Branch, Suite 100, Conference Rooms A & B. To register for the free session or for more informat i o n v i s i t www.princetonhcs.org/ calendar or call (888) 897-8979. To find a physician with Princeton HealthCare System, call (888) 742-7496 or visit www.princetonhcs.org ——— Dinesh Dhanaraj, M.D., M.S.P.H. specializes in orthopaedic sports medicine and orthopaedic surgery. He is a member of the medical staff of Princeton HealthCare System. HEALTH BRIEFS Lyme disease group A Lyme disease support group meets on the second Thursday of most months at the Unitarian Universalist Church, Washington Crossing, 268 Washington Crossing-Pennington Road (Route 546), Titusville. Contact Dorothy Aicher at (609) 730-0939 for details. Amputee support group An Amputee Support Group has formed at St. Lawrence Rehabilitation Center for new and experienced amputees and their caregivers. A SLRC physical therapist will facilitate and there will be occasional guest speakers. Regular meeting day is the first Tuesday of each month. The meetings are from 6:30 to 8:30 p.m. at the cafeteria on the main floor, 2381 Law- fected by mental illness through education, connect with several other dyslexia groups and centers in NJ to join forces and become one mutual support, and advocacy. renceville Road, Lawrenceville. large voice throughout the state. For more information, contact Debbie DDNJ meets, thanks to the support of Miktus at 609-896-9500, ext. 2303 or dmik- Dyslexia group Learning Ally (www.learningally.org), at 20 [email protected] Decoding Dyslexia-NJ (DDNJ) is a grass- Roszel Road, Princeton. roots movement of New Jersey parents of dysFor more information, visit www.DecoNAMI support group lexic children who want to empower other par- dingDyslexiaNJ.org; find them on FaceBook ents, educate the public and persuade policy (type in “Decoding Dyslexia-NJ” in the search NAMI Connection Recovery Support makers to change the state’s educational sys- box); or email [email protected] Group is for people living with mental illness. tem to provide for early identification of chilNo registration required. Held at the NAMI dren with learning disabilities. Hepatitis support group Mercer Center, 2nd and 4th Tuesday evening After early identification, all public of every month, from 7 to 8:30 p.m. The monthly meeting of a hepatitis support schools must then provide appropriate, evidenThe NAMI Mercer Center is located at ced-based services for each child to reach his group is held the last Thursday of the month at Witherspoon Hall, 400 Witherspoon St., in the 3371 Brunswick Pike, Suite 124, Law- or her full potential in school and in life. Community Room at 7:30 p.m. renceville. DDNJ first held formal meetings in NoThe group is led by JoAnn Hill, RN, an inFor more information, visit www.nami- vember 2011 in Mercer County. Members are fection preventionist/hepatitis educator/trainer mercer.org or call (609)799-8994. Direct email getting positive response and support from and member of the Princeton Board of Health. inquiries to [email protected] policy makers. For information, contact the board at The group started with eight parents, now 609-497-7610 or email [email protected] Mercer is a nonprofit organization dedicated to improving the lives of people af- has16 and is growing. Plans are under way to ro.org Saturday, January 10th 1:00 - 3:00 pm A Quaker day school offering progressive education to children in pre-K through 8th grade. 470 Quaker Rd., Princeton, NJ 609.683.1194 www.princetonfriendsschool.org Limited openings for the 2014-2015 school year.