Download Orthopaedic injuries: Rotator cuff and ACL tears

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Friday, December 26, 2014
The Princeton Packet
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
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
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
* 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
* 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
For young athletes, surgery to reconstruct the ACL is
commonly recommended.
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
calendar or call (888)
To find a physician with
Princeton HealthCare System,
call (888) 742-7496 or visit
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.
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
Ally (, 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-; 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.
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 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
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
Limited openings for the 2014-2015 school year.