Bone, Joint, and Muscle Infections in Children

Bone, Joint, and Muscle Infections in Children

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Article Featured on AAOS

Children can develop infections in their bones, joints, or muscles. Often referred to as “deep” infections, the technical names for these conditions are:

  • Osteomyelitis (bone infection)
  • Septic arthritis (joint infection)
  • Pyomyositis (muscle infection)

This article covers the most common types of deep infections in children and includes the ways doctors identify and treat them.

Cause

Infections are usually caused by bacteria that are present in our normal living environment. The most common bacteria causing bone, joint, or muscle infections in children is Staphylococcus aureus (often referred to as “Staph” infections).

Bacteria can get into the body in a variety of ways. They circulate through the bloodstream until they reach a bone, joint, or muscle. Bacteria then leave the bloodstream and multiply in the bone, joint, or muscle tissues.

Description

Deep infections most often occur in the joints and at the ends of long bones where they meet to form joints. These include the hip, knee, and ankle joints of the leg, and the shoulder, elbow, and wrist joints of the arm.

The large muscle groups of the thigh, groin, and pelvis are the most common locations for deep muscle infections.

The reason infections occur in these areas is due to the way blood flows to these locations. There is a strong blood flow to the ends of bone near growth centers (called growth plates), the lining of the joints, and the large muscle groups. This allows bacteria to easily find their way to these areas.

The blood supply to the spine, pelvis, and heel is similar to that of the long bones, and infections often develop in these areas, as well.

Infections pose special risks to young children for a number of reasons:

  • Children under the age of three are easily infected. Their immune systems are not fully developed and they tend to fall down a lot, opening the skin to infection.
  • Infections spread quickly through a young child’s circulation system and bone structure.
  • Damage to bones and joints caused by infection can harm a child’s growth and lead to physical dysfunction. Infection of child’s hip joint is a surgical emergency.

Symptoms and Signs

Children who have infections of their bones, joints, or muscles often have the following:

  • Fever
  • Pain
  • Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Doctor Examination

Medical History and Physical Examination

Make sure to tell your child’s doctor the circumstances surrounding the symptoms, such as when the symptoms began, and whether there was a prior infection or injury.

After discussing your child’s symptoms and medical history, your doctor will examine the painful area. He or she may ask your child to move the affected area to see whether movement increases the pain.

Tests

Other tests that may help your doctor confirm a diagnosis and plan your child’s treatment include:

  • Blood tests and tissue cultures. Tests on your child’s blood, as well as fluid and/or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
  • Imaging tests. Tests, such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child’s doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision whether to treat the infection with antibiotics alone or to perform surgery to help resolve it.

Treatment

Antibiotic Treatment

Prescribing antibiotics is the mainstay of treatment for infections.

  • Intravenous. At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 1 to 2 weeks.
  • Oral. For many children, the antibiotic is eventually changed to a form that can be taken by mouth (oral) and given at home.
  • PICC line. Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced “pick”) line. This is a peripherally introduced central catheter (PICC).

The amount of time on antibiotics that is needed to resolve an infection varies from child to child but, in general, is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

It is very important to have your child take all of the antibiotics he or she is given, in exactly the way they are prescribed.

Surgical Treatment

In mild infections, antibiotics alone may resolve the condition. Many children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation and improve blood flow, which will make it easier for the antibiotics to reach the infected area. For most children, one surgical procedure is enough, but more severe infections may require two or more surgeries to help resolve the infection.

Infected biceps muscle

An infection in the biceps muscle has caused pus to accumulate in this child’s upper arm. During surgery, the pus will be drained so that antibiotics can effectively reach and resolve the infection.
Courtesy of Children’s Medical Center of Dallas

Outcome

Most children will completely recover from deep infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.

Methicillin Resistant Staphylococcus Aureus (MRSA)

In many communities, deep infections are more frequently being caused by a particular type of bacteria known as MRSA. This bacteria is more able to resist antibiotics that previously worked well to treat these infections.

Currently, there are several antibiotics that work very well against MRSA and are tolerated very well by the children who are treated.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

How to Tell if Your Toe is Broken

How to Tell if Your Toe is Broken

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Is it a sprain or a break?

If you’ve ever stubbed your toe hard, the immediate, severe pain can leave you wondering if your toe is broken. In many cases, the injury winds up being a sprain. This is painful, but it means the bone itself is still intact.

If the toe bone breaks into one or more pieces, then you have a broken toe.

Learning to recognize the symptoms and treatment of a broken toe is important. If a broken toe is left untreated, it can lead to problems that may affect your ability to walk and run. A poorly treated broken toe may also leave you in a lot of pain.

Symptoms of a Broken Toe

Throbbing pain in the toe is the first sign that it may be broken. You may also hear the bone break at the time of injury. A broken bone, also called a fracture, may also cause swelling at the break.

If you’ve broken your toe, the skin near the injury may looked bruised or temporarily change color. You’ll also have difficulty putting any weight on your toe. Walking, or even just standing, can be painful. A bad break can also dislocate the toe, which can cause it to rest at an unnatural angle.

A sprained toe shouldn’t look dislocated. It will still swell, but will likely have less bruising. A sprained toe may be painful for several days, but should then begin to improve.

One other key difference between a break and a sprain is the location of the pain. Usually a break will hurt right where the bone has fractured. With a sprain, the pain may be felt in a more general area around the toe.

The only way to tell for sure if the injury is a break or a sprain is to see your doctor. They can examine your toe and determine the type of injury.

Causes

The two most common causes of a broken toe are stubbing it into something hard or having something heavy land on it. Going barefoot is a major risk factor, especially if you’re walking in the dark or in an unfamiliar environment.

If you carry heavy objects without proper foot protection, such as thick boots, you’re also at a higher risk for a broken toe.

What to expect when you see your doctor

A broken toe can usually be diagnosed with the use of an X-ray. If the pain and discoloration don’t ease up after a few days, you should definitely see your doctor.

A broken toe that doesn’t heal properly could lead to osteoarthritis, a painful condition that causes chronic pain in one or more joints.

Your doctor will examine your toe and ask for your medical history. Tell your doctor as many details as you can about the injury and your symptoms. Be sure to tell your doctor if you notice a loss of feeling or tingling in your toe. This could be a sign of nerve damage.

If there’s a chance the toe is broken, your doctor will likely want to get one or more X-rays of the injured toe. Getting images from different angles is important to understand the extent of the break.

Information from the X-ray will also help your doctor decide whether surgery is necessary.

Treatment of a Broken Toe

With most cases of a broken toe, there’s little your doctor can do. It’s mostly up to you to rest your toe and keep it stable.

Even before you know whether your toe is broken, you should ice the injured toe and keep it elevated. You may also take over-the-counter painkillers, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).

If you have surgery to repair the toe, your doctor may prescribe stronger pain medicines.

Splinting your toe

Typical treatment for a broken toe is called “buddy taping.” This involves taking the broken toe and carefully securing it to the toe next to it with medical tape. Usually, a gauze pad is placed between the toes to prevent skin irritation.

The non-broken toe is basically used as a splint to help keep the broken toe from moving too much. By taping the broken toe to its neighbor, you give the injured toe the support it needs to begin healing.

Surgery and additional treatment options

More serious breaks may require additional treatment. If you have bone fragments in the toe that need to heal, taping may not be enough.

You may be advised to wear a walking cast. This helps keep the injured toe stable while also giving your foot enough support to reduce some of the pain you may have while walking.

In very serious cases, surgery may be necessary to reset the broken bone or bones. A surgeon can sometimes put a pin or a screw into the bone to help it heal properly. These pieces of hardware will remain in the toe permanently.

Your toe is likely to be tender and swollen, even after a few weeks. You’ll likely need to avoid running, playing sports, or walking long distances for one to two months after your injury.

Recovery time can be longer if the break is in one of the metatarsals. The metatarsals are the longer bones in the foot that connect to the phalanges, which are the smaller bones in the toes.

Your doctor can give you a good estimate of recovery time based on the severity and location of your injury. A mild fracture, for example, should heal faster than a more severe break.

With a walking cast, you should be able to walk and resume most non-strenuous activities within a week or two after injuring your toe. The pain should diminish gradually if the bone is healing properly.

If you feel any pain in your broken toe, stop the activity that’s causing the pain and tell your doctor.

Outlook

The key to a good outcome is following through on your doctor’s advice. Learn how to tape your toe properly so you can change the tape regularly.

Carefully try to put more pressure on your broken toe each day to see how it’s recovering. Take any slight improvements in pain and discomfort as signs that your injury is healing.

Tips for recovery

Here are some things you can do to improve your recovery.

Footwear

You may temporarily need a bigger or wider shoe to accommodate your swollen foot. Consider getting a shoe with a hard sole and a lightweight top that will put less pressure on the injured toe, but still provide plenty of support.

Velcro fasteners that you can easily adjust can provide additional comfort.

Ice and elevation

Continue to ice and elevate your foot if your doctor recommends it. Wrap the ice in a cloth so that it doesn’t come into direct contact with your skin.

Take it slow

Ease back into your activities, but listen to your body. If you sense that you’re putting too much weight or stress on the toe, back off. It’s better to have a longer recovery and avoid any painful setbacks than to rush back into your activities too quickly.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery: When is it a good idea?

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By Mayo Clinic Staff

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery can help relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own within three months.

Low back pain is one of the most common ailments seen by family doctors. Back problems typically respond to nonsurgical treatments — such as anti-inflammatory medications, heat and physical therapy.

Back surgery might be an option if conservative treatments haven’t worked and your pain is persistent and disabling. Back surgery often more predictably relieves associated pain or numbness that goes down one or both arms or legs.

These symptoms often are caused by compressed nerves in your spine. Nerves may become compressed for a variety of reasons, including:

  • Disk problems. Bulging or ruptured (herniated) disks — the rubbery cushions separating the bones of your spine — can sometimes press too tightly against a spinal nerve and affect its function.
  • Overgrowth of bone. Osteoarthritis can result in bone spurs on your spine. This excess bone most commonly affects the hinge joints on the back part of the spinal column and can narrow the amount of space available for nerves to pass through openings in your spine.

It can be very difficult to pinpoint the exact cause of your back pain, even if your X-rays show that you have disk problems or bone spurs. X-rays taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Different types of back surgery include:

  • Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. Diskectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
  • Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
  • Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
  • Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. But these relatively new devices aren’t an option for most people.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons may hold different opinions about when to operate, what type of surgery to perform and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Common Orthopedic Injuries & Conditions Frequently Asked Questions

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Article Featured on OCPBC

What is the difference between a sprain and a strain?

A strain occurs when a muscle or tendon is stretched or torn. A sprain occurs when a ligament is stretched or torn.

Strains are often the result of overuse or improper use of a muscle, while sprains typically occur when a joint is subjected to excessive force or unnatural movements (e.g., sudden twists, turns, or stops). Sprains can be categorized by degree of severity:

  • A first-degree sprain stretches the ligament but does not tear it. Symptoms include mild pain with normal movement.
  • A second-degree sprain is characterized by a partially torn ligament, significant pain and swelling, restricted movement, and mild to moderate joint instability.
  • In a third-degree sprain, the ligament is completely torn with mild to severe pain, swelling, and significant joint instability.

What is sciatica?

In the low back, nerves join to form the sciatic nerve, which runs down into the leg and controls the leg muscles. Sciatica is a condition that may cause radiating pain, numbness, tingling, and/or muscle weakness in the leg but originates from nerve root impingement in the lower back. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

What is spinal stenosis?

Stenosis refers to a narrowing of the spinal canal, usually in the lower back (lumbar) region. This narrowing is often a result of the normal degenerative aging process. It occurs as the disks of cartilage that separate the spine’s vertebrae lose water and the space between the vertebrae become smaller, causing friction between the bones. The loss of water in the disks makes them less flexible and unable to act as shock absorbers in the spine. Daily wear and tear on the spine becomes more significant without these shock absorbers.

As the disks degenerate, vertebrae may shift, causing the spinal canal to narrow. In some cases, the nerves that travel through the spinal column to the legs become squeezed. This can cause back and leg pain, and even leg weakness. Arthritis and falls also contribute to the narrowing of the spinal canal, compressing the nerves and nerve roots and causing pain and discomfort.

What is degenerative disk disease?

Degenerative disk disease is a general term applied to back pain that has lasted for more than three months. It is caused by degenerative changes in the intervertebral disks in the spine and can occur anywhere in the spine: low back (lumbar), mid-back (thoracic), or neck (cervical).

Under the age of 30, these disks are normally soft, and they act as cushions for the vertebrae. With age, the material in these lumbar disks becomes less flexible and the disks begin to erode, losing some of their height. As their thickness decreases, their ability to act as a cushion lessens. The less dense cushion now alters the position of the vertebrae and the ligaments that connect them. In some cases, the loss of density can even cause the vertebra to shift their positions. As the vertebrae shift and affect the other bones, the nerves can get caught or pinched and muscle spasms can occur.

Degenerative disk disease is primarily a result of the normal aging process, but it may also occur as a result of trauma, infection, or direct injury to the disk. Heredity and physical fitness may also play a part in the process.

What is a torn rotator cuff?

The rotator cuff is a group of tendons and their related muscles that help keep the shoulder and upper arm bone securely placed in to the socket of the shoulder blade. The rotator cuff stabilizes the shoulder joint and helps you to move your arm in space.

What is shoulder impingement?

Impingement syndrome is a common disorder of the shoulder that refers to an improper alignment of the bones and tissues in the upper arm. Inflammatory conditions such as tendinitis, bursitis, and arthritis are all closely related to impingement syndrome, as are tears to the rotator cuff tendons.

If the rotator cuff becomes inflamed from overuse or there is a bone deformity or spur on the end of the shoulder blade, then the space between the upper arm bone and tip of the shoulder blade is narrowed, causing the rotator cuff and its fluid-filled bursa to be squeezed or pinched. This impingement causes irritation and pain to the rotator cuff when the shoulder is raised.

What is frozen shoulder?

Frozen shoulder (adhesive capsulitis) is a condition in which the tissues around the shoulder joint stiffen, scar tissue forms, andSeparated Shouldershoulder movements become difficult and painful. It can develop when you stop using the joint normally because of pain, other injury, or a chronic health condition, such as diabetes. Any shoulder problem can lead to frozen shoulder if you do not work to maintain its full range of motion.

What is a separated shoulder?

A shoulder separation (acromioclavicular joint injury) occurs when the outer end of the collarbone separates from the end of the shoulder blade because of torn ligaments. This injury occurs most often from a blow to the shoulder or a fall on a shoulder or outstretched hand or arm.

What is a dislocated shoulder?

A shoulder dislocation (shoulder instability) occurs when the upper end of the arm bone ball pops out of the shoulder joint socket. This injury may be caused by a direct blow to the shoulder, a fall on an outstretched hand or arm, or an exaggerated overhead throwing motion.

What are shin splints?

Shin splints are an inflammation of the periosteum, a fibrous sheath that surrounds bone. In this case, the affected bone is the shin bone, or tibia. Shin splints are usually accompanied by pain and swelling in the front of the lower leg. Most frequent in runners, this overuse injury is caused by the repetitive stress of running on hard surfaces.

What is a torn ACL? MCL?

There are four ligaments in the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The ACL and PCL stabilize front-to-back knee movements, while the MCL and LCL stabilize side-to-side movements.

The ACL can be sprained or torn if the knee is straightened beyond its normal limits (hyperextended), twisted, or bent side-to-side. A sprained or torn ACL is common in sports and usually results from a hard stop or aggressive twisting of the knee. The PCL is the least common ligament to be injured.

The MCL is injured when a force is exerted on the outside of the knee, pushing it inward, while the LCL is injured by a force exerted on the inside of the knee that pushes it outward. This type of hit is frequent in contact sports like football or hockey.

A torn knee ligament is usually accompanied by feeling or hearing a pop in the knee at the time of injury, severe pain and swelling, and joint instability.

What are muscle spasms?

When muscles become inflamed, they can also spasm, or contract tightly, as a response to injury. While they are the body’s way of protecting itself from further injury, they often produce excruciating and often debilitating pain. Muscle spasms are common in the low back (lumbar) muscles.

What is a torn meniscus?

The medial and lateral menisci (plural of meniscus) of the knee are two crescent moon-shaped disks of tough tissue that lie between the ends of the upper leg bone and lower leg bone that form the knee joint. Meniscus tears commonly occur during sports when the knee is twisted while the foot is planted firmly on the ground. In people over the age of 40 whose menisci are worn down, a tear might occur with normal movement, minimal activity, or minor injury.

What is tendinitis?

Teninitis is inflammation of a tendon, a band of tissue that connects muscle to bone. It is most commonly the result of overuse during physical activities. Repetitive motions can stretch and irritate the tendon, causing pain and swelling. Tendinitis occurs around joints such as the elbow, shoulder, wrist, ankle, or knee.

What is bursitis?

Bursitis is inflammation of a bursa or bursae (more than one bursa), small fluid-filled sacs that cushion areas of friction around joints. Bursae contain synovial fluid that lubricates the joints. Bursitis typically occurs as a result of overuse during physical activities or infection of the synovial fluid. If a bursa becomes infected or irritated from repetitive stress, it will cause pain and limited movementJoint Pain. Bursitis is most common in the shoulder, knee, hip, elbow, or heel.

What is arthritis?

The most common form of arthritis, osteoarthritis, can affect any joint in the body, but most often afflicts the knees, hips, and fingers. Most people will develop osteoarthritis from the normal wear and tear on the joints through the years. Joints contain cartilage, a rubbery material that cushions the ends of bones and facilitates movement. Over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As bones rub together, bone spurs may form and the joint becomes stiff after long periods of activity or inactivity.

What is a stress fracture?

A stress fracture is a microscopic crack in a bone that occurs from overuse. Muscles normally absorb the shock of physical activities, but when they become too fatigued to do so, they transfer the stress to the bones which results in a hairline-sized fracture.

Stress fractures usually develop in the weightbearing bones of the feet and lower legs, often after a rapid increase in the duration or intensity of exercise or from wearing improper or worn out athletic shoes.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is the term used to describe a specific group of symptoms (tingling, numbness, weakness, or pain) in the fingers or hand and occasionally in the lower arm and elbow. These symptoms occur when there is pressure on a nerve (median nerve) within the wrist (carpal tunnel). Carpal tunnel syndrome develops over time because of repetitive hand motions that damage muscle and bone in the wrist area.

What is tennis elbow?

Lateral epicondylitis, commonly known as tennis elbow, is inflammation of the tendon that connects the muscles of the forearm, wrist, and hand to the upper arm at the elbow. The tendon on the bony outside (lateral) part of the elbow (the epicondyle) is most often irritated by overuse during physical activity.

What is plantar fasciitis (heel spur)?

Plantar fasciitis is the most common cause of heel pain. It is commonly referred to as a heel spur, although a heel spur, or bony growth on the heel bone, develops as a result of plantar fasciitis. The condition occurs when the long, flat ligament on the bottom of the foot (plantar fascia) stretches irregularly and develops small tears that cause the ligament to become inflamed. This inflammation is most often caused by walking with an abnormal inward twisting of the foot, called pronation. Over time, this slightly abnormal step may increase tension on the plantar fascia and cause it to become inflamed.

What is a ruptured Achilles tendon?

The Achilles tendon is the largest tendon in the body. It connects the muscles in the lower leg (calf) to the heel bone. With every movement of the foot, the Achilles tendon stretches and tightens. Because it is under so much stress, it can partially or completely tear (rupture) from excess force or overuse. Ruptures usually occur about two inches above where the tendon attaches to the heel bone.

An Achilles tendon rupture is most common in middle-aged “weekend warriors” who are not conditioned for athletics and who neglect to properly warm up and stretch prior to exercise. Ruptures frequently occur from sudden movements that stress the calf muscles, such as jumping or quick stops; from overstretching; from vigorous exercise after a long period of inactivity; or from untreated Achilles tendinitis/tendinosis (overuse).

What is a bulging/ruptured/herniated disk?

The spinal vertebrae are separated by flexible disks of shock absorbing cartilage. These disks are made of a supple outer layer with a soft jelly-like core (nucleus). If a disk is compressed, so that part of it intrudes into the spinal canal but the outer layer has not been ruptured, it may be referred to as a “bulging” disk. This condition may or may not be painful and is extremely common.

Herniated disks are often referred to as “slipped” or “ruptured” disks. When a disk herniates, the tissue located in the center (nucleus) of the disk is forced outward. Although the disk does not actually “slip,” strong pressure on the disk may force a fragment of the nucleus to rupture the outer layer of the disk.

If the disk fragment does not interfere with the spinal nerves, the injury is usually not painful. If the disk fragment moves into the spinal canal and presses against one or more of the spinal nerves, it can cause nerve impingement and pain.

If the injured disk is in the low back, it may produce pain, numbness, or weakness in the lower back, leg, or foot. If the injured disk is in the neck, it may produce pain, numbness, or weakness in the shoulder, arm, or hand.

What is radiculopathy/nerve impingement?

Radiculopathy refers to a condition in which the spinal nerve roots are irritated or compressed. Many people refer to it as having a “pinched nerve.” Lumbar nerve impingement indicates that the nerve roots in the lower spine are involved, while cervical radiculopathy is associated with nerve roots in the neck. Nerve impingement is most often caused by a herniated disk or spinal stenosis.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Winter-Safety-Tips-from-New-Mexico-Orthopaedics

Avoid Common Winter Injuries with These Helpful Tips

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Thanks for these tips from OIP!

If you’ve experienced an injury or pain while performing a wintertime activity, you are not alone. Personal injury during winter is likely to occur from performing simple activities, especially if you aren’t prepared to prevent an incident. From your back, shoulder and neck to joints and knees, pain and injury in these areas are commonplace during the winter.

The good news? Preventing winter injuries is possible, and you can enjoy the season without unnecessary pain and stiffness. Read on to discover information about winter back injuries, winter shoulder injuries, and — most importantly — health and safety tips to avoid any orthopedic winter injuries.

What Are the Most Common Winter Injuries?

Winter weather conditions bring with them a variety of potential risks for personal injury, as well as injury to others. Some of the most common winter incidents that lead to personal injury include:

  • Falling on ice and snow
  • Experiencing muscle strain from shoveling snow or scraping ice off the car
  • Driving and motor vehicle collisions
  • Accidents while playing winter sports and activities

Not all incidents will cause severe injury, but some winter accidents can be quite serious, especially for certain age groups and for people suffering from previous injuries.

 

SLIPPING AND FALLING ON ICE AND SNOW

Slipping and falling on ice can be a scary experience. Ice can be difficult to see both at night and during the day. What looks like water pooled on the pavement can actually be a sheet of ice. You could step off the curb and right onto a slippery ice patch. When this happens, severe injury can occur if you fall to the ground. You may be able to recover and only skid briefly, but even if you don’t end up falling, you can wrench your back or experience another kind of injury in your attempt to recover.

Anyone is in danger of injuring themselves by falling or slipping on ice or snow, but seniors are especially at risk. In fact, according to the CDC, falls are the leading cause of injury among older Americans, and winter weather conditions only exacerbate that concern.

There are a variety of potential injuries that can occur from falls on ice, but the most common include the following:

  • Bruises
  • Head or brain injuries, including concussions
  • Ankle strains and twists, and other kinds of muscle sprains and ligament strains
  • Broken bones, most commonly hip and wrist fractures
  • Back injuries, including spinal compression fractures
  • Injuries to the spinal cord

Prevention is always the best method to avoid a slip or fall on icy days, and there are a few things you can try to keep you and your family safer:

  • Wear proper footwear made for icy and snowy conditions.
  • Keep your stride shorter and avoid long steps.
  • Slow things down — try not to rush or run outdoors.
  • Keep de-icer or sand on hand for when things get slippery around your house.
  • In case of injury, always have your cell phone handy.
  • If you need to do outdoor chores, take your time and don’t hurry.

Unfortunately, even with the best preventative measures, accidents happen. Skeletal and muscular issues arise every winter when people fall on ice or snow. If the fall is serious, you may need to call 9-1-1 or go to the ER immediately.

 

SHOVELING SNOW

One of the most loathsome winter jobs is shoveling the driveway and sidewalk. It can take a long time and require a lot of physical exertion. The low temperatures make the task of shoveling snow even more unpleasant. The repetitive actions of twisting and lifting while shoveling can cause severe strain on the body. All it takes is one muscle to be pulled the wrong way for your back, neck or shoulders to seize up.

Snow shoveling can be a potentially risky duty that can cause severe injury. A national study found that over the course of eleven years, there was an average of 11,500 emergency room visits due to snow shoveling injuries. The most common injuries reported were soft tissue injuries mostly to the lower back region. Among the remaining injury reports, lacerations and fractures were also reported, including injuries to the hands, arms and head.

 

DRIVING AND COLLISIONS

Most of us must continue to work and carry on with our normal, everyday activities even in snowy winter weather conditions. But if you aren’t prepared for winter driving conditions and don’t take the proper safety precautions, you can put yourself and others at risk. A study found that over a period of ten years, there were over 445,000 people injured as a result of weather-related vehicle collisions. The winter weather brings with it all kinds of potentially hazardous road conditions, such as:

  • Wet pavement
  • Sleet and slush
  • Full coverings of snow and ice

FALLING OR COLLIDING DURING WINTER ACTIVITIES

One of the most enjoyable parts of winter is the fun you and your family can have with all kinds of winter activities and sports. From ice hockey and skating to skiing and snowboarding, there are plenty of ways to stay active and have fun in the winter. For kids especially, sledding and tobogganing are some of the best childhood memories of their winter seasons.

These winter activities can be quite risky if you aren’t practicing safety. Falls and collisions in many winter activities can cause several forms of injury. Broken bones and stiff muscles and joints are some of the most frequently reported injuries when it comes to outdoor sports and activities. Running outdoors along the sidewalk or on trails can also pose safety risks if the pavement isn’t salted and the trails aren’t properly cleared.

 

TYPES OF WINTER INJURIES

These incidents produce various types of injuries, which can range from mild and easily treatable to severe and long-term. Some of the resultant injuries from these winter accidents most commonly include:

  • Head injuries
  • Shoulder injuries
  • Back injuries
  • Neck pain and tension
  • Knee joint pain and soreness
  • Wrist sprains
  • Elbow fractures and dislocation
  • Ankle sprains and strains
  • Hip fracture and soreness

HEAD INJURIES

Head injuries occur during the winter as a result of any number of incidents. Most commonly, falling on ice and hitting your head on the pavement can lead to a potentially serious brain injury. If this occurs, it will need immediate treatment by a physician. A brain injury can be difficult to treat, and often the symptoms won’t be noticed until long after the injury has occurred.

Head injuries can occur during winter activities like tobogganing, snowboarding and skiing, or one can also occur as a result of a motor vehicle collision, which has the potential to lead to serious long-term health consequences.

SHOULDER INJURIES

Shoulder injuries commonly occur when you fall on icy pavement. When your shoulder meets contact with the hard ice-covered pavement, dislocation can occur. This damage to the shoulder joint can be quite severe and leave you suffering from soreness and bruising for a long time afterward.

A torn rotator cuff can happen as the result of repetitive overhead motions from winter sports or shoveling snow. This muscle tear can leave you feeling sore and stiff and may result in a chronic injury as well.

BACK INJURIES

There are plenty of winter incidents and activities that can cause a back injury. The most common injury associated with shoveling snow is to the back, specifically the lower back. Back injuries can also be the result of a serious fall on the icy pavement or on the stairs. Falls during winter sports and activities can also result in a back injury.

Another common way to injure your back during the winter time is by scraping your car’s windshield to remove ice and snow. The bending and leaning motion your body performs while reaching across to scrape the ice can result in pulled and strained back muscles.

Depending on the level of severity, treating a back injury with heat may help to relax sore muscles. An injury that is caused by a fall on ice may damage your spine, so treatment by a physician will be required.

NECK INJURIES

Like back and shoulder injuries, neck injuries can occur due to a number of different winter incidents. The repetitive motion of shoveling snow can certainly lead to stiffness and soreness in the neck muscles. Neck injuries can also happen when scraping snow and ice from your car’s windshield when your muscles become strained from leaning and reaching.

These injuries can usually be treated with a heating pad to relax tense neck muscles. If a neck injury is caused by a fall or a motor vehicle collision, it should be treated at the emergency room.

KNEE PAIN AND STRAIN

High-impact winter sports can be very damaging to your knees over a period of time. This type of injury usually occurs while performing activities and sports such as skiing and snowboarding, where your knees are absorbing the shock of hard landings. Running outdoors on pavement can also cause a similar injury to your knees. The best thing to do with a knee injury is to take it easy until it heals, avoiding any high-impact activities.

WRIST FRACTURES AND STRAINS

A fall on the icy pavement can cause wrist injuries such as fractures and strains. When you take a fall, your natural instinct is to extend your arms and brace your fall with your hands. The impact of the fall on your hands can cause a severe wrist strain or even fracture.

The result can be a serious injury if not treated properly. Your wrist may heal improperly, which could lead to chronic pain later in life.

ELBOW INJURIES

Like wrist injuries, elbow injuries can also arise from a fall on icy pavement. When you extend your arms to brace your fall, not only do your wrists take the impact but your elbows do as well. Your elbow could become dislocated if the impact is so significant that it pops your bone out of position. Otherwise, a more potentially severe injury could be an elbow fracture. This can lead to long-term pain if not treated properly.

ANKLE STRAIN

Falls on slippery, icy pavement can also cause ankle injuries. When you struggle to recover your balance after slipping on ice, you can easily roll and twist your ankle. This may end up being a muscle injury whereby the tendon has been strained. Otherwise, a certain type of fracture in the ankle bone can result if more impact has been felt. This type of fracture can be caused not only by a fall on iced-over sidewalks, but also due to winter sports injuries.

HIP FRACTURE

Slips and falls on icy roads and sidewalks can result in many different types of broken bones, fractures and injuries. But one of the more severe injuries occurs when a fall is so hard and sudden that it fractures the hip bone. This can be a very difficult injury to repair, and it can also cause chronic, long-term pain. This injury especially affects seniors who are predisposed to osteoporosis or previous hip injuries. This injury should certainly be treated as an emergency by a physician.

Age Groups and Demographics Most Affected

Certain incidents and their resulting injuries may affect certain age groups more than others. It’s important to apply appropriate safety measures, so everyone can stay safe during the winter.

CHILDREN

 

Children are susceptible to falls. They can easily fall and injure themselves if they can’t reach handrails or don’t have proper balance. If your child experiences a fall, it’s important to first assess their head for any injuries and then check for elsewhere, like wrists and elbows.

Children especially enjoy their time sledding and tobogganing, which can put them at risk for injury. Be sure to always supervise kids during winter activities and provide them with helmets to protect their heads.

SENIORS

Like children, seniors are also at a higher risk of slipping and falling on icy pavement. Seniors can easily lose their footing and take a fall that can put them in severe danger. Seniors who have suffered in the past from hip injuries could further damage their hips or back. Seniors should be accompanied and helped down driveways and across parking lots to ensure they are stable and have the support to walk safely. Seniors with mobility issues may want to consider motorized scooters during the winter months for extra safety precautions.

ADULTS WITH PREVIOUS MEDICAL CONDITIONS

Adults with previous back, neck and shoulder injuries are also at risk to be severely injured in any of these winter incidents. A slip or a fall can trigger a past injury and can cause further damage. Additionally, adults with a predisposition to osteoporosis are also at higher risk for broken and fractured bones if involved in a collision or a fall.

ACTIVE ADULTS

Adults who remain active throughout the winter months are also at greater risk for injuries if proper safety precautions aren’t followed. Adults who ski and snowboard should be advised that, without the proper equipment, they can be at risk for head injuries as well as neck, shoulder, knee and ankle injuries.

People who run in the winter should be advised to use properly cleared and salted trails and sidewalks, so they don’t risk slipping and falling.

WINTER INJURY PREVENTION TIPS

Though many of these winter accidents can be quite common, they are easy enough to prevent by following specific steps.

  • Thoroughly and regularly salt driveways, sidewalks and stairs
  • Walk carefully across parking lots and provide children and seniors with additional support
  • Stretch before performing any physical exercise
  • Stay hydrated while exercising and shoveling snow
  • Ensure proper footing when shoveling snow or scraping ice off the car
  • Wear a helmet and protective equipment during winter sports
  • Always supervise children playing outdoors in the snow
  • Before shoveling or scraping, make sure to properly stretch

Most businesses and shopping centers take precautions to salt their parking lots and sidewalks once winter hits. Even still, patches may be missed or ice may have formed since the last salting. When rushing into stores and shopping centers, slow down and take your time to carefully walk across the parking lot. Look for areas that have been clearly salted or do not appear wet. Hold onto children and seniors to help stabilize them as you walk across the parking lot or driveway and indoors.

For back injury prevention, it is advised to stretch lightly at first, then move into a deeper stretch. If you are going to be shoveling snow, then it’s important to stay well-hydrated and take frequent breaks so as not to exhaust your body and muscles.

When performing winter sports and activities, be sure to always have the proper protective equipment, like helmets, to prevent head and other serious injuries. If you have access to a gym or can use a treadmill at home, it will prevent any risk of slipping and falling while running outdoors during the winter.

If you choose to run outdoors, go with a buddy and be sure one of you carries a cell phone to call for help in the event of an injury. Familiarize yourself with your running route ahead of time to ensure it’s an area that has been salted and cleared of ice and snow.

WINTER DRIVING SAFETY TIPS

Winter weather can make driving more difficult, which means it can put yourself and others at risk of injury. In order to prevent motor vehicle collisions, follow these winter driving safety tips:

  • Have proper winter-grade tires installed on your car
  • Store an ice scraper in your car
  • Keep windshield washer fluid full
  • Have your vehicle inspected, especially breaks
  • Have a winter safety kit in your trunk, including a high-visibility safety vest, gloves and jumper cables
  • Keep a first aid kit in your car
  • Never drive without a cellphone
  • Limit the time spent driving in the dark

WHAT TO DO IF YOU SUFFER A WINTER INJURY

If you or a family member suffers a winter injury, it’s important to first assess the severity level. Sometimes muscle injuries can be treated with ibuprofen and by applying ice or a heating pad (whichever is more comfortable) or taking a warm bath. However, more severe injuries will need to be treated immediately by a professional. If you suspect broken or fractured bones or a head injury, report it to a physician right away, visit the emergency room or visit your orthopedic injury clinic.

Educate yourself and your family about the potential incidents and accidents that can occur during the winter, and you’ll be much more prepared to prevent them. If a serious injury occurs, be sure to contact us to schedule an appointment with a doctor who can treat you for your specific injuries. Follow these winter injury prevention tips, and you can enjoy a happy and safe winter season.

 

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

11 Things Your Orthopedic Specialist Wants You to Know

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Original Article By healthgrades.com

Insights from the Bone and Joint Experts

Whether you have ongoing backaches or sustain Read more

FALL PREVENTION FOR OLDER ADULTS

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Original Article By healthcare.utah.edu

Falls are a serious problem for the elderly. According to the Centers for Disease Control more than one out of every four people over the age of 65 suffers a fall each year. University of Utah Health’s Trauma Program treats hundreds of falls involving elderly patients each year — with nearly half of those patients between the ages of 65-84.

Those falls can result in numerous orthopedic injuries, as well as the potential for skin damage and even a more serious head injury. They also increase the likelihood that the person will fall again. Yet, despite the serious implications of falling, most patients do not tell their doctors when it happens.

This begs the question: What can be done to prevent someone from sustaining a fall while at their home?  The National Council on Aging (NCOA) has some tips that could help you from sustaining a fall in your residence:

  • Find a good balance and exercise program
  • Talk to your health care provider
  • Regularly review your medications with your doctor or pharmacist
  • Get your vision and hearing checked annually and update your eyeglasses
  • Keep your home safe
  • Talk to your family members

When you are looking for an exercise program, find one that will build balance, strength, and flexibility. In Utah, programs such as “Stepping On” and “Tai Chi for Arthritis” are available all across the state. Talking to your doctor about your current health and having them perform a fall assessment could also help prevent a fall.

While visiting with your doctor, ask them to review your medications for unwanted side effects that may cause you to fall. In addition to speaking with your primary care physician, talk to your eye doctor annually about your vision. Update your eye glasses prescription at a minimum of every year. Look for tripping hazards such as rugs or loose carpet, and have them removed. Have family members help update your lighting in poorly lit areas, and install grab bars near stairs. Finally, have your family help as much as possible. Falls can impact families, so ask them for support to make your life falls free.

For additional resources, please contact your primary care provider and tell them you are worried about falling. You can also contact the Faint and Falls Clinic at University of Utah Health, our Trauma Program (www.healthcare.utah.edu/trauma), or the National Council on Aging (www.ncoa.org). Local senior centers have great resources (and workout classes also!) that you could use to help keep yourself free from falls.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

After Years of Paralysis, A Man Walks the Length of a Football Field

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Original Article By Emily Willingham | Scientific Journal

An electrical stimulation device combined with intensive rehabilitation restores walking ability to a spinal cord injury patient

Read more

How Do Broken Bones Heal?

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Original Article By Hallie Levine

Bones are flexible enough to give a bit when physical force is applied, but if that force is too great, they’ll snap like a plastic ruler bent too far. Luckily, they also repair themselves naturally. Here’s how it works.

Adults are held up by a skeleton composed of 206 bones that protect the body’s vital organs. Though it’s a sturdy frame, it’s vulnerable to problems—think issues like like osteoporosis and stress fractures, says Chad Deal, MD, director of the Center for Osteoporosis and Metabolic Health at the Cleveland Clinic.

Bones are flexible enough to give a bit when physical force is applied, but if that force is too great, they’ll snap like a plastic ruler bent too far. Luckily, they also repair themselves naturally (even better with a cast). Here’s how bones heal.

1. Immediately after a fracture occurs, a blood clot and callus form around it.

2. New “threads” of bone cells start to grow on both sides of the fracture line toward one another.

3. Eventually, the fracture closes up and the callus is absorbed by the new cells. This process may

take from six weeks to a year.

 

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What Is Physical Therapy? How to Feel and Function Better

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Original Article by WebMD Medical Reference
Your doctor might suggest this type of treatment if you’ve had an injury or illness that makes it hard to do daily tasks. Physical therapy (PT) is care that aims to ease pain and help you function, move, and live better. You may need it to:
  • Relieve pain
  • Improve movement or ability
  • Prevent or recover from a sports injury
  • Prevent disability or surgery
  • Rehab after a stroke, accident, injury, or surgery
  • Work on balance to prevent a slip or fall
  • Manage a chronic illness like diabetes, heart disease, or arthritis
  • Recover after you give birth
  • Control your bowels or bladder
  • Adapt to an artificial limb
  • Learn to use assistive devices like a walker or cane
  • Get a splint or brace

People of all ages get physical therapy. It can treat a variety of health problems.

What Is a Physical Therapist?

These licensed health professionals get specific graduate training in physical therapy. You may hear them called PTs or physiotherapists.

Some PTs get a master’s degree. Others also have a doctorate in physical therapy. They must pass a national exam to get certified. They’re licensed by the states where they practice.Physical therapists look at your needs and guide your therapy. They may perform hands-on treatments for your symptoms. They also teach you special exercises to help you move and function better.In most states, you can go directly to a physical therapist without a referral from your doctor. Or your doctor might prescribe it. Check your insurance policy to see if you need a prescription to cover the cost.If you have a serious illness or injury, a PT won’t take the place of your doctor. But he will work with your doctors and other health care professionals to guide treatments. You’ll feel better and you’ll be more likely to get back full function in the area being treated.PTs often have assistants. They’re also trained to do many types of physical treatments.

What Does a PT Do?

At your first therapy session, your PT will examine and assess your needs. He’ll ask you questions about your pain or other symptoms, your ability to move or do everyday tasks, how well you sleep, and your medical history.

  • How well you can move around, reach, bend, or grasp
  • How well you walk or climb steps
  • Your heartbeat or rhythm while active
  • Your posture or balance

Then, they will work with you to create a treatment plan. It will include your personal goals like functioning and feeling better, plus exercises or other treatments to help you reach them.

You may take less or more time to reach those goals than other people in physical therapy. Everyone is different. You may also have more or fewer sessions than others. It just depends on your needs.

You treatments might include:

  • Exercises or stretches guided by your therapist
  • Massage, heat, or cold therapy, warm water therapy, or ultrasound to ease muscle pain or spasms
  • Rehab to help you learn to use an artificial limb
  • Practice with gadgets that help you move or stay balanced, like a cane or walker

Your therapist will watch your progress and adjust your treatments as necessary.

You can do the exercises your therapist teaches you at home between sessions. This will help you stay on track and improve your fitness.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.