Achilles Tendon Rupture and Repair

The Achilles tendon is the largest and strongest tendon in the body. It links the calf muscles to the heel bone. This muscle/tendon unit produces the majority of force that pushes the foot down during walking or running. Regaining Achilles tendon function after an injury is critical for walking.

Those best suited for surgical repair of an acute or chronic Achilles tendon rupture include healthy, active people who want to return to activities such as jogging, running, biking, etc. Even those who are less active may be candidates for surgical repair. Non-operative treatment may also be an option. The decision to operate should be discussed with your achilles tendon imageorthopedic surgeon.

The surgical repair of an acute or chronic rupture of the Achilles tendon typically occurs in an outpatient setting. Patients are then put to sleep and placed in a position that allows the surgeon access to the ruptured tendon. Repair of an acute rupture often takes somewhere between 30 minutes and one hour. Repair of a chronic rupture can take longer depending on the steps needed to fix the tendon.

After surgery, the patient is placed in a splint or cast from the toes to just below the knee. Typically the patient will not be allowed to walk or put weight on the involved leg. Patients are encouraged to keep the operated leg elevated above heart level to decrease swelling and pain.

From two weeks to six weeks, patients may be allowed to begin weight bearing in a walking boot. Ankle motion is often allowed and encouraged. A cast is sometimes used instead of a boot.

At six weeks patients are usually allowed full weight bearing out of the cast or boot. Patients are usually able to return to full activity by six months. It may be over a year before a patient achieves full recovery.

If you are considering repair of a ruptured Achilles tendon, contact Dr. Wesley Johnson. He can advise you of your options and help you choose the best treatment for your unique case.

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Spine Information? We’ve Got your Back!

When discussing spinal disc conditions, there are essentially two types of problems that can occur. The first is when an injury occurs to the wall of the disc and it begins to bulge. The second is when the disc begins to dehydrate and starts to flatten and deteriorate.

Your spine is made up of 24 bones (called vertebrae) that are stacked on top of each other. Between each set of bones is a disc. The discs of your spine are very important because they essentially act as shock absorbers in order to protect the bones.

You will notice that the disc is made up of a strong outer covering called the Annulus Fibrosus and a softer, jelly–like center called the Nucleus Pulposus. The outer covering gives the disc strength, while the softer center is what allows it to act as a cushion, absorbing shock whenever forces are applied to your spine.

Spinal disc conditions tend to be really difficult to heal because the discs do not receive a very good blood supply. The body generally depends on good blood flow to transport nutrients and oxygen to damaged areas for faster healing.

Bulging Disc (which is also known as a Protruding Disc or a Slipped Disc), a Herniated Disc (which is also known as a Disc Prolapse), a Ruptured Disc and Degenerative Disc Disease are all spinal conditions that can be extremely painful, and in some casJune 18es, debilitating. Regardless of what the disc problem is called, it is most important for the patient to understand if the pain is being caused within the disc itself, or if it is pain along the nerve root. An accurate diagnosis of the cause of the patient’s pain is needed to determine the appropriate treatment options.

If you are experiencing back, leg, or even arm pain, it could be related to a disc problem. Make an appointment today with Dr. Wesley Johnson. He can diagnose your problem and work with you to devise the best treatment plan for your unique case.

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Recovering from Arthroscopic Knee Surgery

Your recovery after knee arthroscopy will depend on what type of problem was treated, but generally recovery from simple arthroscopic surgery is usually much faster than recovery from traditional open knee surgery or total knee replacement. Still, it is important to follow your orthopedic surgeon’s instructions carefully after you return home.

  • Keep your leg elevated as much as possible for the first few days after surgery.
  • Apply ice as recommended by your doctor to relieve swelling and pain.
  • Keep your incisions clean and dry. Your surgeon will tell you when you can shower or bathe, and when you should change the dressing.
  • Your surgeon will tell you when it is safe to put weight on your foot and leg.
  • Your doctor will discuss with you when you may drive. This decision is based on a number of factors, including:
    • The knee involved
    • Whether you drive an automatic or stick shift
    • The nature of the procedure
    • Your level of pain
    • Whether you are using narcotic pain medications
    • How well you can control your knee.

Your doctor will prescribe pain medication to help relieve discomfort following your surgery. He or she may also recommend medication such as aspirin to arthroscopy imagelessen the risk of blood clots.

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee.

Physical therapy is an important component of your recovery from knee arthroscopy. It helps to regain control of the leg muscles, wean you from crutches, regain full knee motion, and will hasten your return to normal activity. Once your knee is strong enough to bear some weight, the intensity of your physical therapy will increase. At this point, your physical therapy goals will be to regain full knee motion and to continue to strengthen the knee.

If you are considering knee surgery, contact Dr. Wesley Johnson. He can explain all of your surgical options and what is right for your unique case.

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How to Fix your Posture at Work

Do you slouch in your office chair at work? It’s something we all do. Do you stand up at 5 P.M. and feel like your back resembles a question mark?

If you answered yes to these questions, you are part of a growing group of people who experience postural problems from working in an office. Studies have shown that bad posture can increase feelings of depression, zap your energy, and cut off your circulation. Couple that with sitting for long periods of time, and you’ve got a health hazard on your hands. posture image (2)

Slouching all day in an office chair forces your chest muscles to tighten, which pulls your spine forward and rotates your shoulders inward, while at the same time weakening the muscles of your upper back that aid in posture. Not only do you start looking like a hunchback, but you also may experience pain in your neck, lower back, and even arms and legs.

Thankfully, there are plenty of little tricks you can use to improve your posture gradually.

  • MONITOR POSITION: You should be able to sit straight in front of your computer and not have to turn from side to side to access it. The top half of the monitor should be in line with your eye height.
  • DISTANCE FROM MONITOR: Keep your arms and elbows close to your body and parallel to the floor. You should not have to reach forward to use your keyboard. Try sitting about 18 inches from your computer screen.
  • NECK: If you find yourself cradling your phone between your shoulder and chin so you can type and talk at the same time, switch to a headset, or use a speaker phone. Also, be careful to not protrude your neck forward while looking at the computer screen. Try keeping your ear in line with your shoulder.
  • SHOULDERS: Keep your shoulders down and relaxed.
  • BACK: Sit with your back pushed to the back of the chair with some form of lower back support between you and the chair back.
  • ELBOWS and WRISTS: While typing, elbows should be at a 90-degree angle from your body, and your wrists and hands should be in a straight line. Make sure not to place stress on your wrists – keep them in a neutral position, not arched or bent. Have the keyboard and mouse near each other and at the same height as your elbows.
  • LEGS: When you’re sitting, your hips/thighs should be parallel to the ground or a little higher than your knees. Also, you don’t want the end of chair hitting the back of your knees—make sure to leave a little gap.
  • FEET: Feet should touch the ground and lay flat on the floor. Sitting cross-legged or on one leg can lead to slouching. If your feet cannot touch the floor, try using a footrest or box.

Remember to give yourself breaks after you have been sitting for an extended period of time. Get up and move around regularly throughout the day. For every hour you work at your desk, give yourself several 1-2 minute breaks. Take a quick walk around the office, grab some water, chat with a coworker, or at least stand up and stretch.

If you are experiencing back pain or other muscle or bone problems, contact Dr. Wesley Johnson for a consultation.

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Osteoarthritis: Symptoms and Solutions

According to the Centers for Disease Control and Prevention, osteoarthritis (OA) affects more than 25 million men and women over the age of 25 in the United States. That is nearly 14 percent of all adults. OA is even more common in the elderly. More than one-third of adults over the age of 65 suffer from OA. OA is known by many names – degenerative joint disease, degenerative arthritis, wear-and-tear arthritis; whatever you call it’s a common painful condition that can develop slowly and worsen over time.

OA is the most common chronic condition of the joints. It occurs when the cartilage or cushion between joints breaks down leading to pain, stiffness, and swelling. It can occur in any joint, but usually it affects the hands, knees, hips, or spine.

Osteoarthritis breaks down the cartilage in the joints. Cartilage is the slippery tissue that covers the ends of bones in a joint. Healthy cartilage absorbs the shock of movement, but when you lose cartilage, your bones rub together. Over time, this rubbing can permanently damage the joint.

Signs and symptoms of OA include:

  • Pain
  • Tenderness
  • Stiffness
  • Loss of flexibility
  • Grating sensation
  • Bone spurs

Risk factors for osteoarthritis include:

  • Being overweight
  • Getting older
  • Injury

To diagnose OA doctors consider medical history and perform a physical examination. These may be followed by laboratory tests, X-rays, and a magnetic resonance imaging (MRI) scan. No single test can diagnose osteoarthritis.

Treatments include:

  • Exercise
  • Medicines
  • Surgery

MAY21If you have joint pain or stiffness that lasts for more than a few weeks, make an appointment with Dr. Wesley Johnson. His experience and expertise can help make the right diagnosis and choose the correct treatment for your individual case.

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All about Articular Cartilage

Articular cartilage is found in all moving joints in the body, and its role is to protect the bones by keeping the surfaces of the bones apart from each other, to absorb shock, and to help make movement smooth. Articular cartilage does this by providing a protective, wear-resistant surface to the end of the moving bones. Articular cartilage is composed of cells made of collagen and proteins. In healthy joints, this unique and durable material allows bones to move against one another with minimal friction.

Articular cartilage is a particular type of cartilage called hyaline cartilage. Hyaline cartilage is a hard, white, shiny material with a unique structure that articular cartilage imagecreates a surface that allows the bones to glide easily past each other. The special nature of this material also makes it particularly vulnerable once it becomes damaged.

When areas of cartilage are worn away or torn away, exposing underlying bone, treatment is designed to fill in the missing area or defect with healthy articular cartilage and provide new protection for the joint surface. Areas of cartilage loss interfere with normal joint mechanics and result in pain and poor joint function in affected individuals.

In addition to patient history and physical evaluation, orthopedic surgeons rely on Magnetic Resonance Imaging (MRI) to assess the nature of a cartilage injury and formulate a treatment strategy. Advanced MRI technology has been tremendously useful to orthopedic surgeons in detecting articular cartilage lesions before surgery and objectively assessing articular cartilage repair methods in treated patients over time.

If surgery is the treatment you choose, your doctor may prescribe physical therapy afterward. This will help restore mobility to the affected joint. As healing progresses, your therapy will focus on strengthening the joint and the muscles that support it. It may be several months before you can safely return to sports activity, but hopefully, when you do, it will be to a life of less pain and more mobility.

If you have joint pain or other joint problems, schedule an appointment with Dr. Wesley Johnson. He has the experience and expertise to find the right solution for your joint issues.

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Physical Examinations: What is the Doctor Looking for?

A physical examination together with a medical history is used by your doctor to assist in the diagnosis process. Physical examinations are great for the fact that they can be interpreted immediately.

Orthopedic surgeons use a variety of diagnostic tests to help identify the specific nature of a musculoskeletal injury or condition, and while every orthopedic evaluation is different, there are many commonly used tests that an orthopedic surgeon may consider in evaluating a patient’s condition.

In general, the orthopedic evaluation usually consists of:

  • A thorough medical history
  • A physical examination
  • X-rays
  • Additional tests, as needed

A medical history is taken to assist the orthopedic surgeon to evaluate a patient’s overall health and possible causes of their joint pain. In addition, it will help the doctor determine to what degree your joint pain is interfering with your ability to perform everyday activities.

What the physician sees during the physical examination – which includes examination of posture during standing, sitting, and lying down, and gait analysis (watching how you walk) – helps to confirm (or to rule out) a possible diagnosis. The physical exam will also enable the orthopedic specialist to evaluate other important aspects of your joints, including:

• Rjoint exam picange of motion
• Swelling
• Reflexes
• Skin condition

After the physical examination, X-ray evaluation is usually the next step in making a diagnosis. X-rays help show how much joint damage or deformity exists. An abnormal X-ray may reveal:

  • Narrowing of the joint space
  • Cysts in the bone
  • Spurs on the edge of the bone
  • Areas of bony thickening called sclerosis
  • Deformity or incorrect alignment

If you are experiencing pain or other symptoms related to the musculoskeletal system, contact Dr. Wesley Johnson for a consultation. He will work with you to find the best solution for your unique case.

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Spinal Stenosis: Symptoms and Remedies

Spinal stenosis is a condition due to narrowing of the spinal cord causing nerve pinching which can lead to persistent pain in the buttocks, limping, lack of feeling in the lower extremities, and decreased physical activity.

There are two types of spinal stenosis: lumbar stenosis and cervical stenosis. 75% of cases of spinal stenosis occur in the lumbar spine (low back), which is called lumbar spinal stenosis, and most will affect the sciatic nerve which runs along the back of the leg. When this happens, it is commonly called sciatica. While lumbar spinal stenosis is more common, cervical spinal stenosis is often more dangerous because it involves compression of the spinal cord.

  • In lumbar stenosis, the spinal nerve roots in the lower back are compressed; this can produce tingling, weakness, or numbness that radiates from the low back and into the buttocks and legs – especially with activity.
  • Spinal stenosis pain in the neck (cervical spinal stenosis) can be far more dangerous by compressing the spinal cord. It can lead to major body weakness or even paralysis.

Virtually the entire adult population faces degenerative stenosis because it is a result of the natural process of aging. It is a degenerative narrowing of the spinal canal that results in compression of spinal nerves and nerve roots, causing myriad symptoms including lower back pain and lower extremity pain.

Congenital lumbar stenosis is relatively rare and usually presents at an early age, often between 30 and 40. It is a puzzling condition that can’t be predicted or prevented.

Spinal stenosis diagnosis typically involves:spinal stenosis image

  • MRI scan or CT scans
  • X-Rays to detect the growth of bone spurs
  • Physical Exam

Treatment will usually involve exhausting all conservative treatment approaches first, using a combination of rest, support devices, physical therapy, and pain medications. If pain continues, a surgical procedure may be pursued.

If you suffer from back or neck pain, contact Dr. Wesley Johnson for a consultation. He can help you get to the root of the problem and work to find the best solution for you.

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Recovering from Knee Replacement: What to Expect

Research suggests that joint surgery may have benefits beyond pain relief. It could even extend your life. For example, according to a 2012 study by Exponent, a scientific consulting firm in Menlo Park, California, people with osteoarthritis pain who opted for knee replacements had a 50% lower risk of dying from any cause seven years later than those who didn’t have the surgery. However, even if the surgery makes life better in the long run, what can one expect for the short term? What is the recovery period like?doctor examinging knee

During the first few weeks after surgery, you’re more likely to experience a good recovery if you follow all of your surgeon’s instructions concerning wound care and diet and exercise. Your physical activity program should include:

  • A graduated walking program — first indoors, then outdoors — to gradually increase your mobility
  • Slowly resuming other normal activities, including walking up and down stairs
  • Knee-strengthening exercises performed several times a day

In the time it will take for your knee to initially heal from surgery, you will be dealing with pain, but medications can make the pain manageable.
While in the hospital, you’ll be prescribed activities to prevent blood clots, help your joint heal properly, minimize scar tissue, and strengthen your muscles to support the new joint. Within a few days, you should be able to move well enough to leave the hospital and return home.

Within the first six weeks, physical therapy continues to be important for improving the motion of the knee and allowing for a natural transition back to normal knee movement. Patients who comply with physical therapy exercises tend to recover much faster. The average time for this short-term recovery is 6 to 12 weeks.
Long term recovery involves the complete healing of the surgical wounds and the internal soft tissues involved in the operation. When you are ready to return to work and your normal activities, you are on the way to full term recovery. This phase can last between 3 and 6 months.

Senior couple dancing on veranda
If you are considering knee replacement, contact Dr. Wesley Johnson for a consultation. With more than 20 years performing orthopedic surgery, he can inform you of all your options and set you on the road to new, pain-free knees!

All About Joint Replacement

More than 1 million Americans have a hip or knee replaced each year. Research has shown that even if you are older, joint replacement can help you move around and feel better. A doctor may suggest a joint replacement to improve quality of life because replacing a joint can relieve pain and help you move and feel better.

While hips and knees are replaced most often, joints that can be replaced include the shoulders, fingers, ankles, and elbows. Joints can be damaged by arthritis and other diseases, injuries, or other causes. Arthritis or simply years of use may cause the joint to wear away. This can cause pain, stiffness, and swelling. Bones are alive, and they need blood to be healthy, grow, and repair themselves. Diseases and damage inside a joint can limit blood flow, causing problems.

A new joint, called prosthesis can be made of plastic, metal, or both. It may be cemented into place or not cemented so that your bone will grow into it. Both methods may be combined to keep the new joint in place. Sometimes, the surgeon will not remove the whole joint, but will only replace or fix the damaged parts. New joints generally last at least 10 to 15 years.

knee jointAny surgery has risks. Risks of joint surgery depend on your health before surgery, how severe your arthritis is, and the type of surgery done. Only a doctor can tell if you need a joint replaced. After examinations, the doctor may say that you should consider exercise, walking aids such as braces or canes, physical therapy, or medicines and vitamin supplements. Medicines for arthritis include drugs that reduce inflammation, or depending on the type of arthritis, the doctor may prescribe corticosteroids or other drugs.

If you are considering joint replacement, make an appointment for a consultation with Dr. Wes Johnson. He can help you decide what options might be best for you.