Nursemaid’s elbow typically occurs in children under the age of five.

It happens when a pulling force is applied to the hand while the arm is extended away from the body. This causes the radius bone to partially slip out of its normal position at the elbow joint, often resulting in entrapment of a nearby ligament.

Due to the pain, the child avoids using the affected elbow. It is treated with a simple maneuver to reposition the bone.

It may recur occasionally in children under five, but rarely recurs in those older than five.

Also known as adhesive capsulitis, this condition causes pain and progressive loss of motion in the shoulder. Symptoms develop gradually. It is more common in women and typically affects individuals between the ages of 40 and 60. The exact cause is not fully understood.

However, several risk factors have been identified:

Conditions that reduce shoulder movement: Rotator cuff injury, arm fracture, stroke, breast or upper limb surgeries.

Systemic conditions considered as risk factors: Diabetes, thyroid disorders, cardiovascular disease, tuberculosis, and Parkinson’s disease.

The disease progresses in three stages:

• Freezing stage: All shoulder movements are painful. Over time, movement becomes increasingly restricted. This stage typically lasts 6 weeks to 9 months.
• Frozen stage: Pain may start to diminish, but range of motion becomes severely limited, affecting daily activities. This stage may last 4 to 6 months.
• Thawing stage: Shoulder mobility gradually improves. Recovery may take 6 months to 3 years.

Treatment in the early stages includes anti-inflammatory medications and steroid injections. The goal is to reduce pain and maintain as much movement as possible. Physical therapy plays a key role. If conservative treatment is unsuccessful, arthroscopic release surgery may be considered. Recovery typically takes 6 weeks to 3 months.

In individuals with underlying diabetes or thyroid disorders, symptoms may persist even after surgery. Frozen shoulder may rarely recur, especially in those with diabetes.

In knees affected by osteoarthritis, meniscus tears may occasionally occur.

Meniscus tear with osteoarthritis: In knees with osteoarthritis, meniscus tears can develop from daily activities such as climbing stairs or getting on and off public transport — not necessarily from major trauma like in athletes.

If the injury does not cause locking or catching of the knee, the pain can often be managed with simple conservative measures.

However, if locking present, arthroscopy is usually required.

Cubital tunnel syndrome presents with pain, numbness, and in advanced stages, muscle weakness along the area served by the ulnar nerve in the arm.

The ulnar nerve controls many of the intrinsic muscles of the hand. It passes through a tunnel on the inner side of the elbow. Pressure on the nerve in this tunnel for various reasons leads to cubital tunnel syndrome.

Possible causes include:

• Use of vibrating tools
• Playing musical instruments
• Bone deformities around the elbow
• Scarring or adhesions from burns or other trauma
• Masses near the nerve
• Arthritis in the elbow joint

Symptoms include pain, numbness, tingling, and in later stages, loss of strength in the distribution of the ulnar nerve. These symptoms are aggravated by elbow flexion or shoulder abduction.

Treatment should target the underlying cause. If medication and night splinting are not effective, surgical options should be considered.

Important points in the treatment of meniscus tears:

• Not all meniscal tears seen on MRI cause symptoms.
• Some symptomatic tears can be managed non-surgically.
• If surgery is required, meniscus repair should be the first option when possible.
• If the tear is not repairable, the goal should be to remove the smallest possible portion of the meniscus to preserve cartilage health.

It has been scientifically proven that an expectant mother with strong spinal muscles experiences fewer and milder issues with the lower back, upper back, and neck during pregnancy compared to someone with weaker muscles.

Who’s going to carry all that weight, how will it be carried, and WHAT’S GOING TO HAPPEN TO ME?!

During pregnancy, a woman’s body undergoes a series of physically demanding changes. These include expansion of the uterus, loosening of ligaments, forward shift in the body’s center of gravity, and fluid retention.

As a result, the musculoskeletal system becomes more prone to injury. Although it may seem like only part of the spine is affected, in reality, these changes impact the entire spine. Consequently, the neck, shoulders, and arms may also be affected if the spine is not well-prepared for pregnancy. The good news is that most of these injuries can be prevented or treated without the need for surgery.

Even under normal conditions, the spine is subjected to considerable loads. For example, the pressure on the intervertebral discs can be twice the body weight when slightly leaning forward. When lifting an object from the ground while bending, this load can triple. In pregnancy — where the center of gravity shifts forward — these loads increase even more.

What should we do? The most effective approach is to be prepared. Studies show that expectant mothers with stronger spinal muscles experience less pain and fewer spinal issues compared to those with weak muscles.

If you've become pregnant without strong muscles, practices like prenatal yoga can help you get through both pregnancy and the postpartum period more comfortably. If you're experiencing painful muscle spasms around the spine, massage and physical therapy may be beneficial. Afterward, it's essential to do exercises that keep your muscles strong enough to handle these demands.

Shoulder muscle tears are classified based on their size and depth (full-thickness or partial-thickness). Partial-thickness tears are described by their location and depth.

When deciding between surgical and non-surgical treatment options, several factors are considered such as type and timing of the tear, size of the tear, patient’s age and expectations, condition of the affected muscle (e.g., presence of fatty degeneration), presence of shoulder osteoarthritis, any associated nerve damage or history of chronic infection.

When should hip or knee replacement surgeries be considered?

You may benefit from joint replacement surgery if you're experiencing any of the following due to hip or knee pain:

– Increasing reliance on pain medication over time

– Pain during movement or at rest, even severe enough to interrupt sleep

– Progressive decrease in walking distance

– Inability to walk without pain

– Difficulty performing daily activities (e.g., putting on shoes or socks, climbing stairs, sitting and standing up)

Stress fractures are tiny cracks in the bone caused by excessive repetitive load. They are most commonly seen in young, physically active individuals.

Stress fractures may occur in healthy bones (fatigue fractures) or structurally weak bones (insufficiency fractures).

Patients typically report pain at the fracture site that worsens with movement or weight-bearing.

Diagnosis is made using CT scan, MRI, or bone scintigraphy. Treatment involves rest and preventing weight-bearing on the affected bone. In some cases, surgical intervention may be necessary.

Torus fractures, also known as greenstick fractures, occur in children.

In this type of fracture, the bone partially breaks. On X-ray, one side of the bone appears broken while the other side is bent — similar to a green twig bending and cracking. Treatment involves repositioning the bone if necessary, followed by casting to ensure proper healing.

In addition to the physical examination, gait analysis is also performed under laboratory conditions.

Gait evaluation is an essential part of an orthopedic assessment. Observing the movements of the spine, arms, and legs, as well as joint motions during walking, provides valuable information about the patient’s condition.

If necessary, the patient should also be observed during fast walking, as certain issues may become more apparent under these conditions.

Joint movements during walking must always be compared with passive joint motion at rest.

In laboratory settings, walking is analyzed using pressure-sensitive surfaces. While standing and walking, a pressure map of the sole of the foot is generated.

Additionally, high-speed cameras are used to evaluate posture during walking and while standing still.

The data collected from these assessments is processed using computer software, significantly contributing to the planning of the appropriate treatment.