Your shoulder has a relatively wide range of movement and is sometimes subject to considerable strain. The ball-and-socket joint where your upper arm bone fits into your shoulder blade can pop out of place, and the complex web of muscles, ligaments, and tendons (called the rotator cuff) that supports the joint can suffer tears and strains.

You can also damage the structures in your shoulder when you overuse them by making repetitive motions over long periods.

Some of the commonly occurring shoulder conditions Dr. Stein treats include:

Shoulder impingement

A condition where the top of your shoulder blade rubs against the tendons in your rotator cuff when you raise your arm.

Rotator cuff injuries

Strains or tears in the tissues of the tendons and muscles that make up the rotator cuff.

Labral tear

The labrum is a piece of cartilage on the edge of your shoulder socket that helps the ball at the end of your upper arm bone stay in place. Labral tears result from acute injury or because of the aging process.

Frozen shoulder

As the name indicates, a frozen shoulder is one that’s stuck or has a significantly reduced range of movement. This is typically due to inflammation of the shoulder capsule surrounding the joint.

Shoulder dislocation

Dislocation means the ball of the shoulder joint is partially or wholly out of the socket. The rotator cuff often tears at the same time, making future dislocations more likely.

Osteoarthritis

Osteoarthritis can affect any joint, developing as a result of the deterioration and eventual wearing away of the cartilage protecting the ends of the bones.

AC joint pain

The acromioclavicular (AC) joint is at the top of the shoulder blade where it meets the collarbone. AC joint pain is caused by a separated shoulder, which develops when the collarbone ligaments tear.

Biceps pain

The tendon that connects your bicep to your shoulder joint can suffer from an injury, such as a tear, and inflammation, such as biceps tendonitis.

Dr. Stein starts your treatment using a conservative approach unless there is an immediate need for more invasive treatments. Physical therapy plays a vital role in treating shoulder pain, helping tissues to heal and strengthening surrounding structures.

In some cases, injections of corticosteroids to reduce inflammation and viscosupplementation to lubricate joints can be beneficial. Regenerative medicine therapies, such as platelet-rich plasma and bone marrow aspirate stem cell injections, can be used to promote healing and tissue growth.

If you require surgery for shoulder pain, Dr. Stein is highly skilled in carrying out arthroscopic procedures to repair, release, stabilize, or replace the affected tissues or bones.

For effective relief from shoulder pain, call Drew Stein, MD, PLLC, today to schedule a consultation or book an appointment online

A meniscus tear occurs when a section of rubbery cartilage in your knee, called the meniscus, stretches and tears. Sometimes small pieces of the meniscus separate and get stuck inside the knee joint, causing your knee to lock up.

The meniscus is a tough, thick shield that protects the bones in your knee, absorbing the shock created when you walk or run, and helping to stabilize the knee joint.

Meniscus tears are a common sports injury, but also develop as a degenerative problem in older people.

The meniscus typically tears while you’re engaging in some form of physical activity, so you’re likely to feel a popping at the moment of injury. You may also experience:

• Pain at the injury site
• Swelling in your knee
• Problems flexing your knee joint
• Knee joint locking in place

Meniscus tears aren’t always overly uncomfortable when they first occur but become more painful as the inflammation increases.

One of the issues with treating a meniscus tear is that the best approach depends on what part of the meniscus tears. The outer “red zone” of the meniscus has a good blood supply, so small tears may heal spontaneously. However, the larger “white zone” of the meniscus doesn’t have enough blood in it to heal without intervention.

Physical therapy plays a vital role in healing and strengthening red zone tears and surrounding tissues. Injections of regenerative platelet-rich plasma (PRP) or bone marrow aspirate stem cells can help, but severe tears or damage in the white zone require surgery.

Dr. Stein uses minimally invasive arthroscopic techniques to repair the meniscus where possible. The arthroscope passes through small incisions that he makes in your knee, allowing him to see the tear clearly without needing to cut the knee open. He then repairs the meniscus tear using small, dart-like devices that your body absorbs once the meniscus heals.

He can also remove the damaged section or remove the meniscus altogether, depending on the extent of the injury.

If you have knee pain, get an accurate diagnosis and expert treatment by calling Drew Stein, MD, PLLC, or booking an appointment online.

Because they come under a lot of strain every day, knees are a frequent cause of pain for a lot of people. Typically, knee pain is either due to an acute injury sustained during physical activity or as a result of an accident, or it’s from the effects of wear and tear over months and years.

Degenerative changes that take place over time are often due to repetitive strain and are a common result of certain occupational activities or playing sports.

Degenerative changes occur with aging, too, resulting in diseases such as osteoarthritis, where the cartilage that protects the ends of the bones in the knee wears away. Degenerative joint changes cause inflammation and dull, throbbing pain, and make it more difficult to flex the knee or put weight on it.

Because they come under a lot of strain every day, knees are a frequent cause of pain for a lot of people. Typically, knee pain is either due to an acute injury sustained during physical activity or as a result of an accident, or it’s from the effects of wear and tear over months and years.

Degenerative changes that take place over time are often due to repetitive strain and are a common result of certain occupational activities or playing sports.

Degenerative changes occur with aging, too, resulting in diseases such as osteoarthritis, where the cartilage that protects the ends of the bones in the knee wears away. Degenerative joint changes cause inflammation and dull, throbbing pain, and make it more difficult to flex the knee or put weight on it.

Fractures, dislocations, sprained ligaments, and strained tendons are the most common knee injuries.

Cruciate and collateral ligament tears

The anterior cruciate ligament (ACL), medial cruciate ligament (MCL), posterior collateral ligament (PCL), and lateral collateral ligament (LCL) join the bones in the knee together and provide stability for the joint. They can stretch and tear during physical activity, so these types of injuries are especially common in athletes.

Meniscus tear

The meniscus is a tough piece of cartilage in your knee that protects the bones and provides stabilization to the joint. Meniscal tears are also common in athletes.

Patellar pain and tendon rupture

The patella (kneecap) is a small section of bone that sits in front of the two main bones in the knee: the femur and tibia. The patella may dislocate, or the tendon connecting the patella to the shinbone may rupture.

Quadriceps tendon rupture

Your quadriceps tendon joins the quad muscles in your thigh to your knee, and like any tendon, it can rupture if put under too much strain.

After diagnosing the cause of your knee pain, Dr. Stein uses conservative approaches to repair the damage when possible, particularly physical therapy, which is a vitally important part of any treatment program. With certain injuries, you may also need to wear a knee brace to support the knee while it heals.

Injections of corticosteroids can help reduce inflammation, and viscosupplementation injections that lubricate the knee joint can also be beneficial. Regenerative medicine techniques such as platelet-rich plasma therapy and stem cell injections help promote healing and tissue growth.

If you need surgery for your knee pain, Dr. Stein has extensive experience in carrying out minimally invasive procedures including:

• Arthroscopic knee surgery
• Meniscal repair
• ACL, PCL, MCL, and LCL reconstruction
• Loose body removal
• Patella realignment surgery
• Patella and quadriceps tendon repair

For a prompt and accurate diagnosis of the cause of your knee pain and effective treatment solutions, call Drew Stein, MD, PLLC, today or book an appointment online.

An ACL tear is an injury to the anterior cruciate ligament, which is one of four ligaments that join the bones in your knee together and help stabilize the joint.

There are two collateral ligaments, one on either side of the knee, and the cruciate ligaments that cross over inside the joint. Cruciate ligaments enable you to move your knee backward and forward.

An ACL tear is a Grade 3 injury, which means the ligament has torn in half, but you can also suffer less severe sprains where the ACL stretches but doesn’t tear.

ACL tears are typically the result of a sports injury or occur during exercise because of:

• Changing direction rapidly
• Making sudden stops
• Slowing down after a run
• Using a poor landing technique after a jump
• Sustaining impact injuries, such as being tackled

At the moment when the ACL tears, you might hear a pop and feel the stability go from your knee, possibly causing you to collapse. After the injury, your knee swells and gets more painful, and you may have trouble walking for a day or two.

One problem that can happen with an ACL tear is that these acute symptoms start to resolve after a few days, making you believe everything is ok. Unfortunately, ACL tears can’t heal themselves, and if you return to exercising and playing, the damage could get worse.

For older people who have a quiet, non-sporting lifestyle, using a brace and undergoing a program of physical therapy can be sufficient to restore enough function for their needs.

However, if you wish to play sports or be physically active and need the full function in your knee, then surgery is your best option. ACL surgery involves reconstructing the ligament using a graft because it’s not possible to sew the ends of the ligament together.

Following the surgery, you need to take regular pain medication as prescribed by Dr. Stein and use ice packs to reduce swelling. The dressing stays on for five days, and you must keep it dry during that time. Dr. Stein gives you a knee brace and crutches to enable you to move around without putting weight on your knee.

You need to keep the brace on for two weeks and follow the exercise program Dr. Stein gives you to build strength in your knee and keep it flexible. It takes about six months for the ACL to heal after surgery, but if you maintain your rehabilitation program, you should regain full use of your knee.

For more information, call Drew Stein, MD, PLLC, today or book an appointment online.

The rotator cuff is a network of muscles and tendons that help the ball at the end of your upper arm bone (humerus) to stay securely in place in the shoulder socket.

The tendons in the rotator cuff attach the shoulder muscles to the bones in your shoulder, giving you the ability to move your arm in different directions. However, the tendons and muscles can stretch and tear, resulting in rotator cuff injuries.

Most often, rotator cuff injuries develop from degeneration of the tendon, either due to aging or as a result of years of making repetitive shoulder movements – for example, rowing, playing tennis, or working as a carpenter or decorator.

It’s also possible to cause rotator cuff injuries by falling on your outstretched arm, or by using an unsafe lifting technique.

The initial treatment for rotator cuff injuries includes conservative approaches, including:

• Rest
• Supporting the shoulder with a sling
• Physical therapies
• Strengthening exercises

Steroid injections can help reduce inflammation, and regenerative medicine techniques like platelet-rich plasma (PRP) therapy and stem cell therapy can aid in tissue healing. However, in some cases, surgery is the best option for repairing rotator cuff injuries.

If you need rotator cuff surgery, Dr. Stein is skilled in arthroscopic tendon repair. During this procedure, he inserts a tiny camera on a flexible tube called an arthroscope into your shoulder and uses the images sent back by the camera to guide him as he reattaches the torn tendon to the bone.

Arthroscopy is the most likely type of surgery you’d need to undergo for rotator cuff repair. The procedure is minimally invasive, so there’s less tissue damage than with traditional open surgery. Dr. Stein gives you prescription painkillers to use and a sling to support your shoulder.

The dressing stays on for three days, after which time you see Dr. Stein to have it taken off. You also need to follow the prescribed exercise program to help your shoulder heal and regain full range of motion.

If shoulder pain is disrupting your life, rotator cuff surgery may be the answer. To find out more, call Drew Stein, MD, PLLC, or book an appointment online.

A biceps tear can be damage to the biceps muscle itself or to the biceps tendon that attaches the bicep to the shoulder joint. Although it’s less common, it can also be a tear of the tendons that attach the bicep to the elbow joint.

Bicep tendon tears may be partial, where the tendon is still attached, or complete, where the tendon breaks in two. Biceps tears at the elbow are typically more painful and disabling than tears at the shoulder.

The biceps tendon attaches to your shoulder joint in two places, so it’s possible to sustain a complete tear of one attachment but still be able to use your arm because the other attachment remains functional. You may also damage other structures in your shoulder at the same time, such as the rotator cuff or the labrum.

Biceps tears have two chief causes: injury or wear and tear.

Injury

Acute biceps injuries can arise from lifting a heavy weight or suddenly taking the weight of an object and trying to hold on to it. You can also sustain a biceps tear by falling onto your arm when it’s outstretched. Tears of the biceps tendon at the elbow attachment are almost always due to acute injury.

Wear and Tear

Over time, the biceps tendon frays and wears down, which happens as a natural result of the aging process. Making repetitive shoulder movements over many years can make the wear and tear damage worse.

Tears to the biceps muscle are likely to respond well to rest and physical therapy. Biceps tendon tears that aren’t causing any serious problems, like those in older, less-active patients, may also benefit from physical therapy. Dr. Stein also offers regenerative medicine options, an exciting new approach to stimulating new tissue growth using platelet-rich plasma therapy and bone marrow aspirate stem cells.

If nonsurgical treatments aren’t working or the damage is more severe, as may be the case with a tear of the elbow attachment, surgery may be advisable. Dr. Stein uses minimally invasive arthroscopic techniques to repair the biceps tendons wherever possible. In the shoulder, the technique is to reattach the biceps tendon with a small incision. Providing you follow his recommendations on aftercare and physical therapy, you should recover full strength and range of motion.

If you have pain or dysfunction in your arm or shoulder, call Drew Stein, MD, PLLC, to schedule a consultation or book an appointment online.

A SLAP tear involves the labrum, a ring of cartilage that lines the socket of your shoulder joint. The labrum helps to keep your upper arm bone secure in the socket of the shoulder joint and acts as an attachment point for the biceps tendon and several shoulder ligaments.

SLAP stands for superior labrum anterior and posterior, which describes the tissues involved in this type of injury. Superior means top, so the injury is to the top of the labrum, where the biceps tendon attaches. Anterior means front, and posterior means back, so the injury is affecting both the front and back of the attachment point.

• Being in a car accident
• Falling onto your arm when it’s outstretched.
• Pulling forcefully on your arm, like when attempting to catch a heavy object
• Moving your arm rapidly or forcefully when it’s above the level of your shoulder
• Dislocating your shoulder

SLAP tears are found in athletes who frequently raise their arms above their heads, such as weightlifters and basketball players. SLAP tears are also a problem that develops because of gradual wear and tear over the years.

Treatments for SLAP tears may be possible using nonsurgical approaches. The primary nonsurgical treatment is physical therapy. Stretching the shoulder capsule and strengthening the muscles surrounding your shoulder can help reduce pain and prevent any worsening of the injury. You may need to undergo physical therapy for between three and six months for optimal results.

Dr. Stein also offers innovative regenerative medicine treatments, including platelet-rich plasma therapy and bone marrow aspirate stem cell injections to promote healing and new tissue growth.

Surgery for SLAP tears most often involves the use of arthroscopy, a minimally invasive technique in which Dr. Stein inserts a tube with a tiny camera on its end into a small incision he makes in your shoulder. Using the video images sent back by the camera, he can repair the SLAP tear using tiny instruments without needing to open up your shoulder with a large incision.

Once he can see the images of the affected tissues, Dr. Stein decides how to repair the damage. He may remove the torn section of the labrum or stitch the torn section back into place; he may also need to cut the biceps tendon where it attaches to the labrum.

SLAP tears can be painful and limit your strength and range of movement, so don’t delay in getting a diagnosis and the necessary treatment. Call Drew Stein, MD, PLLC, or book an appointment online.

The labrum is a special type of fibrous, rigid cartilage in the socket of your shoulder joint that helps to keep the head of your upper arm bone (humerus) in place within the socket. The labrum also serves as an attachment point for shoulder ligaments.

A labrum tear usually occurs at the same time as either a shoulder dislocation or subluxation (partial dislocation). Labrum tears can heal themselves, but are prone to healing in the wrong location, resulting in joint instability.

There are many types of labral tears depending on where they occur around the shoulder. They are superior (SLAP tears), anterior (Bankart tears), or posterior. All of these tears can cause pain, weakness, and/or instability.

The labrum is deep within the shoulder joint, which makes it harder to assess, but Dr. Stein has expertise in diagnosing these kinds of injuries. After doing a physical exam, he may order an MRI scan.

The problem with diagnosing labrum tears is that they may not always show up even when using sophisticated imaging techniques. In some cases, diagnosis is only possible using arthroscopy, a minimally invasive surgical procedure in which Dr. Stein inserts a miniature camera into your shoulder on the end of a flexible tube called an arthroscope. Using this technique, he can get a clear view of the labrum and make a positive diagnosis.

Treatment for labrum tears depends on the type of tear. If the tear is severe or causing shoulder instability, surgical repair is the best option. Labrum repair surgery is possible using arthroscopic techniques, or in certain cases, open surgery may be preferable.

SLAP lesions may only need trimming or may require reattachment, which is best achieved using arthroscopic surgery. Other types of labral tears, including Bankart tears and posterior labral tears, also may only need trimming or may require reattachment depending on findings during arthroscopy.

Following surgery, you embark on a carefully designed program of physical therapy designed to optimize healing and restore full function to your shoulder.

If you’re experiencing shoulder pain or instability in the joint, don’t wait for it to get better on its own, as it may well just get worse instead. Call Drew Stein, MD, PLLC, or book an appointment.