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Things you may not know about an injury to the AC joint

Things you may not know about an injury to the AC joint

Apr 20, 2024

Photo by Riley McCullough on Unsplash

The acromioclavicular joint, or AC joint as it is more prevalently known as refers to the shoulder joint and the point at which the collarbone and scapula meet. Injuries to the AC joint account for between 40% and 50% of all shoulder injuries in contact sports and are most common in males under the age of 35.

The role of the AC joint is to underpin normal physiological conditions and allow gliding movement of the arms. It permits an additional range of motion to the scapula and assists in any movement to the arm, including shoulder abduction and flexion. At this joint, something known as three-dimensional motion occurs; internal rotation, upward rotation, and posterior tilting, which allows for movement as we know it. An injury to this joint, therefore, can have a profound effect on conducting daily activities. We discussed the severity of AC joint injuries in a previous post. Here, we will focus on things you may not know about an injury to the AC joint.

1. Symptoms of an AC joint injury

Shoulder injuries are common, and it can often be challenging to determine whether your injury is simply a strain to the limb or if it is an injury to the AC joint. When you have an AC joint injury, the pain and discomfort experience often extends to everyday activities, significantly hindering movement throughout the day. Below is a list of common symptoms that you may experience:
  • Shoulder or arm pain,
  • A visible bump, bruise, or swelling of the shoulder,
  • Limited shoulder mobility,
  • Weakness in the shoulder, extending to the arm,
  • Pain when lying on the shoulder,
  • A popping sound when you move your shoulder
If you are experiencing any of the above symptoms, it is likely that you have an AC joint injury and should get in touch with our team to assess your condition and treatment options.

2. Should you leave an AC joint injury untreated?

It is often very easy to ignore mild pain and discomfort of our joints and dismiss it as simple overuse; however, leaving an AC joint injury untreated can, in some cases, cause your condition to worsen. Although serious consequences are rare, it is better to play it safe when it comes to these sorts of injuries and seek medical assistance to ensure you recover fully. In most cases, getting the correct treatment can also result in a shorter healing time.

3. The role of regenerative medicine in treating AC joint injuries

For the majority of people with an AC joint injury, a full assessment followed by reduced activity and rest often does the job. However, if you are experiencing repeated pain in this joint, then a more long-term option may benefit you, specifically platelet rich plasma (PRP) injections or mesenchymal stem cell therapy. The goal of these treatments is to assist in the healing process by activating your cells to regenerate new, healthy tissue. Several case studies have shown immense success in patients with AC joint injuries using these techniques, and we discuss these in more detail on our research page.

At Opus, we ensure that your injury is fully assessed so that you receive the best possible treatment that is tailored to your needs. Get in touch to discuss your recovery with one of our world renowned specialists.

Skier’s Thumb: A common injury amongst winter athletes

Skier’s Thumb: A common injury amongst winter athletes

Apr 16, 2024

Photo by Vidar Nordli-Mathisen on Unsplash

What is Skier’s thumb?

Thumb ligament injuries are common occurrences and occur when the ligaments that support the thumb are stretched beyond their limit and tear, as with a sprain. The injury itself is to the ligaments at the joint located at the base of the thumb, known as the MP joint. When the thumb is forcefully bent sideways, it can result in a tear to the ulnar collateral ligament. Skier’s thumb, in particular, is a condition common amongst winter athletes.

Depending on the severity of the sprain, categorised as three different grades, pain may or may not occur at the time of the injury. However, bruising, tenderness, and swelling around the base of the thumb are to be expected. Moreover, the characteristic symptom of Skier’s thumb is difficulty grasping items between the thumb and index finger.

    • Grade 1 sprain (mild). The ligaments are stretched but do not appear torn.
    • Grade 2 sprain (moderate). The ligaments are partially torn and may result in some loss of function.
    • Grade 3 sprain (severe). The ligaments are completely torn and is described as a significant injury. This type of sprain requires medical or surgical interventions and can result in lasting loss of function. 

    Treatment

    The treatment of a sprained thumb entirely depends on the severity of the injury, the timing, and whether or not there is arthritis present in the joint. At Opus, we also consider your activity levels, your job requirements, and individual preferences. There are two primary routes of treatment; nonoperative and operative.
    1. Non-surgical treatment. This represents the most common route of treatment for patients with Skier’s thumb and often involves splinting and casting. Typically, a sprained thumb takes between four and six weeks for the ligament to heal sufficiently for light use. However, it is important to consider that for more intense activities, such as sports, it may take substantially longer.
    2. Operative interventions. In some instances, where either the ligament does not heal adequately with non-surgical treatments or the severity of the injury is too great, surgery may be considered. In these cases, the treatment will involve repairing the torn ligament back down to the bone using sutures.

    More recently, a third option for treatment has been proposed: regenerative medicine. We have discussed the roles of platelet rich plasma and mesenchymal stem cell therapy in regenerative medicine in previous updates, which you can find here. Introducing stem cells to the site of the thumb injury can speed up the healing process exponentially and has been used to accelerate the recovery of several sporting figures across the globe.

    Sprained thumbs, although not usually a significant injury, still require medical intervention. When diagnosed and treated accordingly, the vast majority of patients will heal without any additional complications. However, if ignored, the thumb may heal incorrectly and cause long-term problems, including chronic instability, weakness, and arthritis. Get in touch with our team at Opus to ensure that the ligament is correctly healed and your recovery journey is as seamless as possible.
    Shin splints versus stress fractures. What’s the difference?

    Shin splints versus stress fractures. What’s the difference?

    Apr 12, 2024

    Photo by Jakob Owens on Unsplash
    Sports medicine emphasises the importance of physical activity in Shin
    splints are characterised by inflammation of the muscles, tendons and bone tissues surrounding the tibia, also known as the shin bone. Stress fractures, on the other hand, are tiny cracks in the bone. However, both conditions are caused by the same problem, overloading.
    Shin splints refer to pain along the shin bone and are common in athletes, especially runners, dancers, and gymnasts. This condition is also known as medial tibial stress syndrome, as it often occurs in athletes who have recently intensified their training routines, putting added stress on their shin bone. In the vast majority of shin splint cases, treatment involves rest, ice, and other self-care measures, as with most inflammatory and strain injuries. To prevent future recurrence of shin splints, it is advised that you wear appropriate footwear and modify your exercise routine accordingly.
    Whilst shin splints are characterised by pain caused by stress to the bone; stress fractures cause actual damage to the bone. They are common amongst athletes, especially long distance runners, due to repeat force and overuse of the limbs. This injury is most common in the weight-bearing bones of the lower leg and foot. Treatment for stress fractures, as with shin splints, is lots of rest. However, you may be asked to wear a walking boot or use crutches to further reduce the weight-bearing load on the limbs.
    It is worth remembering that, although predominately occurring in athletes, stress fractures and shin splints can also develop from the normal use of a bone that is weakened. This arises with conditions such as osteoporosis.

    How to tell these two conditions apart?

    The main determinant between shin splints and stress fractures is pain. With a stress fracture, the pain will get progressively worse as you run and will continue to persist at a localised point once you have finished exercising. With shin splints, on the other hand, the pain tends to present over a broad area and will cause swelling and significant discomfort, but does not stop physical activity. Once you have warmed up, shin splints also tend to dissipate. Moreover, shin splints exclusively occur in the lower leg; whereas stress fractures, although common in the weight-bearing bones of the lower leg and foot, can occur in any bone.

    Treatment with regenerative medicine

    As mentioned, treatment of these injuries tends to focus on rest and exercise modifications; however, you may experience persistent shin splints or stress fractures, which has a significant impact on your daily activities. This is where regenerative medicine, specifically platelet rich plasma (PRP), comes in. You can read more about how this treatment works here.

    Preclinical studies have emphasised the potential value of PRP injections in stress fractures. This technique is capable of shortening the fracture healing time so you can be back on your feet in as short a time as possible. PRP injections have also shown great promise in the treatment and prevention of shin splints.

    At Opus, we are able to thoroughly assess your condition and provide you with evidence-based techniques underpinned by the current research to ensure the greatest chance of success on your journey. Get in touch today to book a consultation with one of our world renowned doctors.

    Pain down there? Common causes and treatment of groin pain

    Pain down there? Common causes and treatment of groin pain

    Apr 2, 2024

    Photo by Victoire Joncheray on Unsplash

    In the vast majority of cases, groin pain results from a muscle strain or tear and usually resolves on its own. Athletes disproportionately experience groin pain due to their activity levels, with statistics suggesting prevalence rates between 0.5% and 28% amongst football players. But what actually causes groin pain in the first place?

    There are several unique causes of groin pain; however, the most common cause is a muscle strain, also known as a pull groin muscle. This occurs when the hip joint is involved in an acquired movement that causes a stretch or tears to the inner thigh muscles. The pain experienced is usually sharp and sudden, with the source of it often apparent. Inner thigh muscle spasms and leg weakness may also occur.

    Beyond muscle strain, the following are also common causes of groin pain:

    • Inguinal hernia. A condition where the fatty tissue of the intestine protrudes through the abdominal wall.
    • Kidney stone. A small clump of minerals will form inside the kidney, causing waves of pain as it passes down through the urinary tract.
    • Hip osteoarthritis arises when the smooth hip joint is worn down, causing leg movements to become painful and stiff.

    Treating groin pain depends on what started it in the first place. In most instances, you may not need medical intervention; however, if the pain persists and impacts your daily activities, then get in touch.

    When determining the best route of treatment, you will be asked when the pain started, what activities exacerbate the pain, and if you have experienced any accompanying symptoms. A full physical examination will then be performed, with imaging often being used as well.

    There are five treatment approaches that may be taken, depending on the severity of the pain and your lifestyle:

      1. Rest and recuperation. Although it seems repetitive with sports injuries, rest and ice are your best friends. Limiting your activities as much as possible for a short period of time can significantly speed up the healing process.
      2. This approach solely offers short-term pain relief and has no significant impact on the healing process.
      3. Physical therapy. Depending on the cause of the groin pain, you may be referred for physical therapy. For example, if your groin pain results from hip-related causes, such as hip osteoarthritis, then long-term physical therapy may be beneficial in managing flare ups. Moreover, certain exercises can help improve your range of motion and flexibility, further preventing further injuries.
      4. This intervention is not always necessary and is only applicable in some serious conditions, including hip joint infections.
      5. Regenerative medicine. Platelet rich plasma (PRP) is a novel treatment that has had great success in treating arthritic conditions, including hip osteoarthritis. We go into more detail on the process of PRP here. The benefits of PRP on hip function and pain have been shown to be superior to other options given the long-term duration of its effects.

      At Opus, we pride ourselves on offering a range of treatments to our patients to ensure that the most appropriate route of recovery is selected. If you are experiencing persistent groin pain, we can provide you with the traditional routes of treatment but also the regenerative options, including PRP. Get in touch today to discuss the best option to get you back on your feet.

      Debunking myths about PRP

      Debunking myths about PRP

      Mar 20, 2024

      Photo by Kindel Media on Pexels
      PRP is a minimally invasive outpatient procedure and can reduce pain, improve function and help you return to your normal activities or sporting pursuits. This novel approach, despite its success in clinical studies, is still surrounded by several myths. So, let’s debunk them.

      1. PRP therapy requires surgery.

      The plasma, the liquid where the platelets reside, is drawn from your body before being placed in a machine that separates the PRP from the rest of the blood. This PRP is then injected into the area of your body being treated. Once the platelets are in the target area, they will break down, releasing growth factors, important proteins that stimulate cell growth, differentiation, survival, inflammation, and tissue repair; collectively triggering your body’s healing process.
      As you can see, PRP therapy does not require surgery, solely injections. In most instances, real-time imaging will also be used to guide us and ensure that the PRP is injected directly at the site of your injured tissues.

      2. PRP is only good for pain relief.

      Although PRP is generally used in patients with chronic pain conditions, there are so many additional benefits that this treatment will present beyond pain relief. This includes reduced inflammation, the recruitment of stem cells to the area triggering new tissue production, stimulation of blood vessel growth, and the degeneration prevention of healthy tissues. These benefits combine to speed up tissue regeneration and healing, relieving your pain. This is especially beneficial for athletes who are looking to get back on their feet as soon as possible.

      3. PRP is a highly risky procedure.

      Given that PRP therapy relies solely on injections, the procedure itself is deemed exceptionally safe. For starters, the plasma injected is autologous, meaning that it is made for your own blood, and you do not need to worry about potential negative reactions or side effects. What’s more, PRP therapy has been used for several years now, with no major complications being reported.

      One study, in particular, investigated the clinical application and safety of PRP therapy for patients with patellar tendinopathy, a condition that causes chronic back pain. One of the key points the researchers noted, besides the remarkable improvement in back pain, was the safety of PRP and that no complications or side effects were seen across all 15 clinical studies included.

      Considering PRP therapy but don’t know where to start? Or have more questions that you need answering? Get in touch with our team to discuss your options and how we can help relieve your pain.

      Common shoulder injuries amongst athletes and how we treat them

      Common shoulder injuries amongst athletes and how we treat them

      Mar 12, 2024

      Photo by Quino Al on Unsplash

      Acromioclavicular joint injury

      The acromioclavicular (AC) joint is the point at which two bones, the collarbone (clavicle) and part of the shoulder blade (scapula), meet. An injury to this joint is characterised by shoulder separation and can be defined as one of six types. The severity of the injury also impacts the treatment approach.
      1. Type I. The AC ligament is slightly torn; however, there is no significant damage to the coracoclavicular ligaments. Treatment often centres around rest and recovery, with the joint being iced and protected, often with an arm swing. Following this, range-of-motion exercises are recommended as soon as they can be tolerated. 2. Type II. The AC ligament is completely torn; however, there is little to no tear to the coracoclavicular ligaments. Initial treatment involves rest, ice, pain medication, and up to a week of shoulder immobilisation in a sling. Range-of-motion exercises are recommended alongside strengthening exercises.
      3. Type III. The AC and coracoclavicular ligaments are completely torn, resulting in the collarbone separating from the scapula. Although treatment for this injury can be conducted non-surgically, as with type I and II injuries, the duration of recovery is significantly longer, with a sling being required for up to a month. 4. Type IV, V, VI. Treatment of these injuries almost exclusively involves surgical interventions, with specialists required to reduce the risk of long-term complications. In these cases, regenerative medicine may also be considered.

      Rotator cuff tendonitis

      Rotator cuff tendonitis is characterised by pain and swelling of the cuff tendons and the surrounding bursa (a soft fluid filled sack that cushions the joint). This injury, unlike an injury to the AC joint, does not occur all at once. Usually, rotator cuff tendonitis transpires over a substantial period of time following repeated irritation to the area. Although it can affect anyone, this injury most commonly presents in people with loose joints, abnormal bone anatomy in the shoulder, and those who do repetitive heavy lifting, such as weightlifters and powerlifters.
      Treatment of rotator cuff tendonitis is predominantly non-surgical and involves plenty of ice, NSAIDS for pain management, including ibuprofen, and steroids. In the instance that surgery is required, the most common procedure is an acromioplasty. However, recent advances in regenerative medicine have permitted the accelerated and enhanced recovery of these injuries using mesenchymal stem cell therapy.

      Beyond these individual conditions described, there are also activity-specific injuries, including thrower’s shoulder, swimmer’s shoulder, and rugby shoulder. At Opus, we ensure that your injury is fully assessed so that you receive the best possible treatment that is tailored to your needs. Get in touch to discuss your recovery with one of our world renowned specialists.