Persistent Joint Pain in Children

Children that suffer from sore or achy joints may be experiencing natural growing pains or soreness resulting from a recent injury. However, if the pain persists, a medical evaluation is necessary to determine whether the pain is a result of a more serious condition like juvenile arthritis. An autoimmune disease, juvenile idiopathic arthritis should be diagnosed as early as possible so that proper treatment can be administered. Without treatment, this condition may result in irreversible joint damage, developmental problems, disability, or deformity.

Symptoms of Juvenile Arthritis Include:

• Tenderness, pain, or swelling of the joints
• Limited range of motion of the affected joint
• Joint stiffness upon waking that improves throughout the day
• Light rash
• Fatigue
• Weight loss
• Irritability
• High Fever
• Blurred vision or redness in the eyes

Patients may not exhibit all or any of these symptoms. Some patients will be diagnosed with juvenile arthritis while being treated for another injury. History is usually the best indicator of whether your child suffers from this or any other joint related condition. A physical examination is often necessary to identify these conditions.

Seeing a Physician for Joint Pain in Children

Joint pain in children is rarely a symptom of a more serious disease, but it is important to have a medical evaluation performed by a skilled orthopedic physician if you suspect that your child may be suffering from a recurring condition. Your physician will consider your child’s age, sex, the onset of symptoms, previous injuries or related episodes of joint pain, history of illness or injury, vaccinations, and the location/duration of pain to determine whether your child has juvenile arthritis.

If you think your child may have juvenile arthritis or another orthopedic problem, contact Shasta Orthopaedics for a proper evaluation.
Click here to request an appointment or call 530.246.2467.

Introduction To Knee Pain Causes

Are you suffering from knee pain? There are several common knee problems that could be the source of your knee pain, and you may need to see an Orthopaedic Specialist to address it.

You can review our introductory list of some common knee problems and symptoms to consider if anything you are experiencing could possibly need further attention. You can also visit our main website for more extensive information on knee pain and knee problems.

5 Common Knee Problems and Injuries

» Strain or Sprain of the Knee Muscles or Ligaments

• Aching in the knee
• Knee stiffness
• Pain that extends through the leg, hip, or foot

» Meniscus Tear

• Knee Pain
• Knee swelling

» Ligament Tears

• Knee popping
• Knee pain
• Feeling of instability
• Knee swelling

» Bursitis

• Pain in the affected knee, especially with motion or pressure
• Knee swelling
• Redness and warmth

» Tendon Injury

• Pain in the knee
• Tenderness
• Decreased strength
• Decreased movement

Please visit Shasta Ortho if you are interested in more information on Orthopedic Services.

Verilast Total Knee Replacement

For anyone suffering from knee pain, a total knee replacement can offer a new life of mobility and freedom from years of pain. One of the biggest concerns of anyone facing a total knee replacement is “how long will it last?”

Multiple factors affect how long a total knee replacement will last, with primary factors being:

• How well the knee is aligned in surgery.
• The durability of the components of the replacement knee

Verilast is a new knee replacement technology that is documented to dramatically increase the life of a knee replacement.

Historically total knee replacements have been anticipated to last 10 to 15 years. The Verilast knee has been tested to simulate 30 years of wear performance. Smith & Nephew, the make of the Verilast technology, has received approval from the FDA (the U.S. Food and Drug Administration) to support its claims of the 30-year claim.

“Physically active patients want to end their knee pain for good,” said Joseph M. DeVivo, president of Smith & Nephew Orthopaedics. “We’re working to make knee implants that last a lifetime — that’s our goal, and we’ve validated Verilast technology out to 30 years for a market that views 10 to 15 years as the gold standard.”

For more information, and/or to find out if a Verilast total knee replacement could be a solution for your knee pain, click here to request an appointment with a Shasta Orthopaedics knee replacement specialist or call 530/246-2467.

Watch Verilast Video from Smith & Nephew

You can also learn more about Verilast at Smith & Nephew’s Website.

Stopping Smoking can reduce your knee pain.

The Bad News: knee pain and complications for treating knee pain are more items you can add to your list of reasons smoking is bad for you.

The Good News: less knee pain and better outcomes for knee pain treatment are among the many benefits you could experience by quitting smoking.

Smoking has been shown to cause increased pain in those suffering from osteoarthritis. We also know smoking causes complications in treatment of osteoarthritis, including knee replacement surgery.

So for your knee problems – and the rest of your health – make it a priority to stop smoking. (By the way, smoking is also related to similar problems with back, hip and other joints).

By following the tips in this article, children and adults can help prevent winter sports injuries

People spend hours of recreation time on activities ranging from sledding, snow skiing and tobogganing to ice hockey, ice skating and snow boarding. According to the American Academy of Orthopaedic Surgeons (AAOS), however, if the proper precautions are not taken to ensure warmth and safety, severe injuries can occur.

Winter sports injuries get a lot of attention at hospital emergency rooms, doctors’ offices and clinics. Injuries include sprains and strains, dislocations and fractures. In 2007, the U.S. Consumer Product Safety Commission reported:

• 139,332 injuries from snow skiing
• 164,002 injuries from snow boarding
• 133,551 injuries from ice skating
• 53,273 injuries from ice hockey
• 160,020 injuries from sledding, snow tubing, and tobogganing
• 34,562 injuries from snowmobiling

Many winter sports injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day’s end. A majority of these injuries can easily be prevented if participants prepare for their sport by keeping in good physical condition, staying alert and stopping when they are tired or in pain.

The AAOS urges children and adults to follow these tips for preventing winter sports injuries:

• Never participate alone in a winter sport.
• Keep in shape and condition muscles before participating in winter activities.
• Warm up thoroughly before playing. Cold muscles, tendons and ligaments are vulnerable to injury.
• Wear appropriate protective gear, including goggles, helmets, gloves and padding.
• Check that equipment is in good working order and used properly.
• Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.
• Know and abide by all rules of the sport in which you are participating.
• Take a lesson (or several) from a qualified instructor, especially in sports like skiing and snow boarding. Learning how to fall correctly and safely can reduce the risk of injury.
• Pay attention to warnings about upcoming storms and severe drops in temperature to ensure safety.
• Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.
• Drink plenty of water before, during, and after activities. Dehydration is still a risk, even in cold weather. Alcohol increases the risk of dehydration, decreases your ability to perform sport specific tasks (even though you might THINK you are skiing better), and actually makes you more prone to hypothermia as it shunts blood away from your core and out to the skin, where you suffer heat loss even faster, although you FEEL warm due to the flushing effects of the alcohol. Overall, alcohol and cold weather add up to serious risk of injury.

Many winter sports injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day's end.

Skiing and Snowboarding
Children and adolescents are the highest risk groups for injury when skiing and snowboarding. This may be related to the risk-taking behavior common in these age groups, especially the desire for “air” and taking jumps. The most common injuries are wrist fractures (snowboarding), knee injuries (skiing), and head injuries (both). Head injuries are often the result falls or collisions (skier-tree, and skier-skier) and collisions are the leading cause of death. In one study, of those children who suffered head, neck, and face injuries, 70% were not wearing a helmet. The use of ski helmets results in up to a 60% decrease in risk of head injury.
Wrist guards can decrease the risk of hand, wrist and forearm injuries by 85% in those who snowboard, yet only 5% of snowboarders wear these devices. 
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What is the take-home message? Require your child to wear protective equipment (especially a helmet) when skiing or snowboarding!

Sledding
Sledding can be problematic because it usually does not occur in a controlled environment. Whereas skiing and snowboarding are primarily enjoyed at ski resorts, sledding can occur anywhere there is a hill. Thus, unlike the groomed slopes of a ski hill, obstacles in the path of the sled may not have been removed. Injuries from sledding again usually occur from collisions with fixed objects, and most occur with sleds that do not have steering capabilities. Sledding is the most common activity associated with admission to a hospital in children under 16 years of age.
How can you minimize the risk? Supervise your child. Be sure to inspect the hill where your children will be sledding. Try to use a sled with some steering capability. Remove any object that could pose a risk (keep in mind that some may be hidden under the snow), and require your child to wear protective equipment. While there are no studies specifically looking at helmets in those who are sledding, and there are no helmets specifically designed for the sport, using a helmet makes sense. Be sure the hill is not too steep so they do not reach high speeds, and a hill that leads onto a street where there is vehicular traffic can have disastrous results. Finally, never sled head first.
Innertubing should also be considered here. Innertubes may have valves that stick out and can impale the rider. In addition, a hard landing on the snow or ice can result in spine and neck injuries. Inspect the tube to be sure there is no valve that could pose a risk, choose a hill that is not too high (to keep the speed down) and doesn’t have any bumps or “jumps” to prevent hard landings. Most importantly, supervise your children.

Go out and enjoy the winter sports activities, but paying attention to the above information can significantly improve your chances of having a fun, safe, and enjoyable sinter sports experience. Remember also, that in case of injury, we at Shasta Orthopaedics and Sports Medicine are here to help.

Article by Paul Schwartz, MD

Our complete team approach makes a difference in your care.

When choosing an orthopedic specialist to help you with your knee or hip problem, arthritis, back pain, sports injury or other orthopaedic-related problems, consider the complete approach of Shasta Orthopaedics.

Shasta Orthopaedics has worked hard developing – and continuing to develop – a complete team that includes a range of specialists to address your specific needs. That means that you will see a sports medicine specialist for your sports injury. In addition, that sports medicine specialist is able to consult with – and possibly refer you to – our hand specialist if the problem is related to your hand or to our spine specialist if your problem is related to your neck or back.

The range of our team also means we will be able to offer you a range of surgical or non-surgical options, depending on what is determined to be the optimal course of treatment.

A complete range of specialists working closely together make a difference in your care at Shasta Orthopaedics.

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The Shasta Orthopaedics Sports Medicine Team loves being a part of the athlete’s world. It brings us great pleasure to help athletes get back to their sport after an injury, help them reduce their risk of getting hurt, and give them tools to perform better. The Athlete’s Edge is another part of that effort.

The Athletes Edge is a quarterly eNewsletter full of tips and insights from the front lines of Sports Medicine. To receive updates, just click here to sign up. We also welcome your suggestions and story ideas.

Prevention

• Neuromuscular training with bent-knee landing and pivoting can be helpful in injury reduction

• Strength training of thighs, hips and lower leg may help prevent injury
• Proper warm up and stretching may also decrease knee injuries
• Use ice treatment after knee exercise training

Guidelines for Return To Play
• Full weight bearing ability
• Pain resolved or minimized
• Motion up to 90% compared to uninjured knee
• Swelling mostly resolved

Additional Considerations
With any complaint of knee pain, clinicians must also rule out hip or back injury causing referred pain to the knee
• Knee injury may result from bone, ligament, or meniscal trauma
• Combination injuries often occur
• Terrible Triad: Injury to ACL, MCL and medial meniscus

Common Injury Types, Signs and Treatment

Patellar Fracture
Results from direct blow to patella (kneecap)

Signs
• Generalized pain or lateral dislocation of patella

Evaluation
• Physical exam and x-rays

Treatment
• Minimally displaced may be non-operative but displaced/comminuted fractures need surgery. Usually immobilized for 2-4 weeks

Patellar Dislocation
Results from direct blow or twisting injury

Signs
• Laterally displaced patella more common than medial

Evaluation
• Physical exam and x-rays will demonstrate lateral dislocation

Treatment
• Normally non-operative
• Knee sleeve with patellar stabilization
• Crutches and avoidance of twisting motions
• Physical therapy

Meniscus Injury
Results from rotation stress on a weight-bearing knee

Signs
• Medial or lateral joint line tenderness
• Locking, clicking, popping sensations in knee

Evaluation
• Clinical knee exam
• MRI may be done

Treatment
• Surgical repair or debridement

Ligamentous Injury
• Results from direct or indirect trauma to knee
• Often occurs when body rotates around a fixed/planted foot

Types:
• ACL-can be from non-contact deceleration injury such as landing from jumps
• PCL-often results from hyperextension of knee; common dashboard injury in car accidents
• MCL-results from direct blow to outside of knee (valgus force)
• LCL-results from blow to inside of knee (varus). Less common than MCL injury

Signs
• Instability, giving way
• Tenderness over inside or outside of knee

Evaluation
• Clinical knee exam
• MRI may be done for confirmation

Treatment
• Surgical reconstruction for ACL via patient’s own tissue (autograft) or cadaver tissue (allograft)
• No surgery usually needed for PCL, MCL, LCL injuries
• Physical therapy for operative and non-operative injuries