Orthopedic Treatment For Shoulder Instability

by Administrator 24. April 2017 10:56

Shoulder is a ball and socket joint made up by articulation of the three bones, clavicle (collarbone), the scapula (shoulder blade), and the humerus.  This joint is responsible for the gliding movement of the arm. Shoulder Instability refers to a condition in when these bones are unable to maintain the normal structure of the joint i.e. ball of the humerus begins to slip within the shoulder.


  • Sudden blow to the joint or overuse
  • Previous injury that may have torn the ligaments or cartilages of the joint
  • People born with congenital ligament laxity
  • Athletes involved in sports that require overstretching of the shoulder capsule like swimmers, baseball pitchers, volleyball players, etc.


  • Pain
  • Repetitive dislocations
  • Feeling like shoulder is giving out
  • Inflammation
  • Tendonitis or bursitis may develop
  • Shoulder looks deformed
  • Numbness and tingling in the arm


The doctor may begin by conducting a physical examination to check for the excessive laxity of the shoulder joint. This check will also uncover the secondary conditions that may be leading to instability in the shoulder joint.  To have a clear view of the deformity in humerus or arm bone that may occur due to unstable shoulder, the doctor may recommend an X-ray. A MRI scan may also be suggested to have a clear view of the outstretched joint capsule.

Treatment –

Non- Surgical Treatment

  • Medication – The doctor may recommend anti-inflammatory medicine to reduce inflammation in the joint.
  • Immobilization -   To keep the arm from moving the doctor may ask the patient to wear sling for few days. This will help the arm to stay stable and heal quickly.
  • Exercises - After the joint becomes a bit stable, the doctor may ask the patient to do some stretching and strengthening exercise. This will help to restore the lost strength of muscles and ligaments.

Surgical Treatment – 

  • Depending upon the severity of the conditions the orthopedic surgeon may choose to perform one of several surgical options available.
  • The surgeon may conduct an open surgery to restore the attachment of the labrum and the ligaments of the ball and socket joint.
  • If the anterior lip of the joint’s socket has a damaged bone, grafting can be used to restore its configuration.
  • In case the socket has become too flat the orthopedic surgeon may reshape the bones. This procedure is known as Posterior glenoid osteplasty.

If you are looking for an orthopedic surgeon to treat Shoulder Instability, contact Dr. Mitchell F. Fagelman. He is well-known for treating conditions like fractures, shoulder pain, elbow pain, etc. He also has expertise in treating various sports related injuries. To request an appointment, call at (972) 492 – 1334 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Shoulder Separation: Causes, Symptoms And Treatment

by Administrator 24. March 2017 02:56

Shoulder Separation refers to partial or complete parting of acromioclavicular joint that attaches collarbone to the scapula (shoulder blade). The condition occurs due to tearing of the ligaments (coracoclavicular (CC) and acromioclavicular (AC)) that stabilize the shoulder joint. Based on the severity of ligament damage, Shoulder Separation can be divided into three stages –

  • Type I injury - Partial tearing of AC ligament, but CC ligament is unaffected
  • Type II injury - Complete tearing of AC ligament
  • Type III injury – Ripping up off both AC and CC ligaments


  • A direct blow to the shoulder while playing contact sports or an accident
  • Trying to balance the body with hands, during a fall
  • Activities like football, hockey, rock climbing, rugby, skiing, volleyball etc.


  • Severe pain and tenderness
  • Restricted movement of the shoulder
  • Bruising and swelling
  • Bump on the top of the shoulder due to displaced collarbone


The doctor may look for a bony bump on the affected shoulder and check range of motion of the joint. He may also analyze patient’s pulse rate to assess the rate of blood flow. If it appears to be a major damage, imaging tests may be recommended.


For type I and type II injuries, the doctor may recommend conservative treatment.

  • Supporting the shoulder with a sling may help to immobilize the shoulder and ease discomfort.
  • Performing muscle strengthening exercises may increases shoulder’s range of motion.
  • Icing the affected area as recommended by the physician may help to reduce inflammation
  • Anti-inflammatory medications may also be prescribed

Surgical treatment may be recommended to the patients suffering from type III shoulder injury. In this procedure, the orthopedic surgeon may trim the ends of a collarbone, so that it does not rub against the acromion (a bony projection over the scapula).

The surgeon may also perform a reconstruction surgery by excising the distal ends of the clavicle. In order to stabilize the joint, he may use a screw or suture.

Prevention Tips

  • Wear protective gear while playing contact sports
  • Warm up before a strenuous exercise
  • Exercise daily

If you are looking for an effective treatment of Shoulder Separation, visit Dr. Fagelman in Carrollton, TX. He has an extensive experience in treating a wide range of sports related injuries. To schedule an appointment with the orthopedic surgeon, you can call at (972) 492 – 1334.

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Shoulder Fractures: Sports Injury Carrollton

by Administrator 26. October 2016 08:10

Shoulder joint comprises of three bones scapula (shoulder blade), clavicle (collar bone) and humerus (arm bone), connected through muscles, tendons and ligaments.  When there is a break or crack in any of these bones, it results in shoulder fractures.   People involved in strenuous activities such as rock climbing, sky diving, car racing etc. are at higher risk of having this condition. Athletes are more susceptible to have shoulder fractures.

Based on the location of the damage, shoulder fractures can be classified into:

  • Clavicle Fractures: Breaking of the clavicle bone
  • Scapula Fractures: When there is a break in scapula bone 
  • Proximal Humerus Fractures: When there is a crack in the upper part of the arm, it results in proximal humerus fractures. 


  • Fall from a height 
  • Motor vehicle accidents
  • Sudden impact or trauma to the shoulder
  • Sports injuries


  • Shoulder Pain
  • Swelling around the shoulder
  • Tenderness
  • Deformity in the shoulder
  • Inability to move the arm
  • Bruising


During the physical examination, the orthopedic doctor may check the position of the shoulder to determine the extent of damage and deformity. He may ask the patient about his previous medical history.  The doctor may recommend imaging tests such as X-rays, MRI or CT scan to identify the underlying cause of the condition.


Non-surgical treatment

  • Rest: The doctor may advise providing sufficient rest to the affected area. Activities that strain the joint must be avoided.
  • Medications: Non-steroidal anti-inflammatory medications may be prescribed by the doctor to relieve pain and discomfort.
  • Sling: Wearing a sling or strap may help to immobilize the shoulder joint and promote recovery. It may be worn for three to eight weeks depending on the extent of damage.  
  • Physical therapy: The doctor may recommend stretching and strengthening exercises to boost recovery. These exercises may also help to reduce stiffness and improve range of motion.

Surgical treatment:

  • Fusion Surgery: This surgery may be recommended if the broken fragments are displaced in the shoulder. The surgeons may use wires, pins, plates, or screws to join the pieces together.
  • Shoulder replacement: If the ball is completely broken or damaged, shoulder replacement surgery may be performed by the doctors. In this procedure, damaged or broken parts of the shoulder joint are replaced by artificial implants. 

For comprehensive diagnosis and treatment of Shoulder Fracture, visit Dr. Fagelman in Carrollton, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 492 - 1334 or visit 4780 North Josey Lane, Carrollton, Texas 75010.


Common Causes Of Elbow Pain

by Administrator 25. April 2016 12:35

The elbow is one of the most frequently used joints in the body which allows extension and rotation of the arm. Since the joint is prone to wear and tear, it can get hurt due to many causes, leading to pain and affecting the patient’s ability to carry out routine tasks.

Below is a list of certain reasons that can cause elbow pain:

  • Broken arm: Falling on an outstretched arm is generally the cause behind this injury. It can either involve one or all three bones in the arm- the ulna, radius and humerus. Wearing a cast may be recommended by the doctor to immobilize the elbow joint.
  • Sprains and strains: Overstretching or tearing of ligaments in the elbow can also be one of the reasons behind the pain. Conservative treatment options like RICE therapy and bracing are generally effective but surgical intervention may be required if the condition is severe.
  • Bursitis: The inflammation of small, fluid-filled sacs in the elbow joint bursae is termed as Bursitis. The condition may be caused by repetitive elbow movements and lead to discomfort as well as swelling. Providing proper rest to the elbow and avoiding strenuous activities may help to ease the symptoms. Surgical drainage of the fluid from the bursa may also be required.
  • Tennis Elbow: The condition is caused due to damage of forearm muscles. The pain can even extend to the forearm or wrist and generally felt in the region where the tendons of the forearm muscles attach to a bony bump outside the elbow. People involved in activities that require overuse of elbow muscles such as tennis, swimming, painting, plumbing etc. are prone to this condition. 
  • Rheumatoid Arthritis: This is basically an autoimmune disorder that can affect the lining of the elbow joint. Symptoms include painful inflammation that eventually leads to bone erosion and deformity of the joint. Rheumatoid Arthritis generally affects both elbows at the same time.
  • Golfer’s Elbow: Similar to Tennis Elbow, this condition can be seen in people who make repetitive wrist motions or clasp their fingers frequently. Adequate rest is very effective in treating the condition.
  • Elbow Dislocation: The elbow can get dislocated if a person lands on an outstretched hand during a fall. The condition can cause complications such as trapping of the blood vessels and nerves attached to the lower arm as well as hand. 

For comprehensive diagnosis and treatment of elbow pain, visit Dr. Fagelman in Carrollton, TX. To schedule an appointment with the surgeon, call at (972) 492 - 1334 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Cubital Tunnel Syndrome: Causes, Symptoms And Treatment

by Administrator 23. November 2015 11:02

Cubital Tunnel Syndrome is a painful condition that results due to compression of the ulnar nerve where it crosses the inner edge of elbow.  It is one of the most common nerve compressions in the arm.  The condition is more prevalent among people who indulge in activities that require repetitive movements and prolonged flexion of the elbow.


  • Prolonged stretching of nerve
  • Bending the arm for a long time
  • Traction force that reduces the blood flow to the nerve
  • Nerve irritation
  • Trauma or elbow fracture


  • Pain that extends down to the hand
  • Numbness
  • Tingling sensation on the inside of the forearm
  • Inability to grip and hold objects
  • Muscle wasting
  • Hand deformity
  • Loss of strength


To diagnose Cubital Tunnel Syndrome, the orthopedic doctor may thoroughly examine your arm as well as neck. Once it is determined that the ulnar nerve is compressed, he may recommend certain tests to check the mobility of the arm. He may conduct a sensory examination and the Tinel’s sign test that involves tapping the nerve at the elbow. The doctor may also check muscle strength and the gripping ability to confirm the condition.


  • Medication: The physician may prescribe non-steroidal anti-inflammatory medicines to control swelling and reduce pain.
  • Immobilize the elbow: To offer support to the affected elbow, you may be suggested to wear an elbow splint.
  • Elbow pads: The physician may advise you to use an elbow pad while working or performing any activity that may strain the affected joint.
  • Lifestyle alterations: You may also be asked to modify activities and routine to avoid putting undue pressure on the elbow.

In severe cases of Cubital Tunnel Syndrome, the orthopedic doctor may recommend surgery to remove the pressure on the ulnar nerve. The surgeon releases the nerve or moves it to the front of the elbow where it is less exposed to stress.

Physical therapy can help to speed up recovery from the condition. The therapist will guide you on modifying activities and doing some range-of-motion exercises to regain the strength of the elbow. He will design a comprehensive post-surgery rehabilitation program so that you can resume your daily routine as soon as possible.

For comprehensive diagnosis and treatment of Cubital Tunnel Syndrome, consult Dr. Fagelman. To schedule an appointment with the orthopedic surgeon in Carrollton, TX, you can call at (972) 492 – 1334 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Golfer's Elbow: Orthopedic Treatment In Carrollton

by Administrator 26. October 2015 10:35

Golfer’s Elbow, also known as Medial Epicondylitis, is a painful condition characterized by swelling in the tendons connecting the forearm and the elbow. It is caused due to repetitive swing motion used by the golfers while playing. However, tennis players and people who repetitively use the wrists or clench fingers can also develop Golfer's Elbow. The condition can hamper the functionality of the forearm and wrist.


  • Overuse of muscles: Excessive use of the forearm or elbow can lead to Golfer’s Elbow.
  • Repetitive activities: Performing certain strenuous activities repeatedly can put strain on the elbow tendons. These activities may include shoveling, gardening, hammering nails, running a chain saw etc.
  • Swimming: Repeatedly pushing the arm to acquire speed while swimming can also strain the flexor tendon in the elbow.


  • Pain and inflammation: The patient may experience pain and tenderness at the inner side of the elbow or forearm.
  • Tingling and lack of sensation: Numbness can be felt in one or more fingers. The ring finger and little fingers are the most affected due to Golfer’s Elbow.
  • Stiffness: The patient may feel stiffness in the elbow, making it difficult to grip and lift objects.
  • Weakness: There may be weakness in the muscles of hands and wrists which can make it difficult to perform daily tasks.


The elbow doctor may conduct a physical examination and inquire about the medical history of the patient. He may put pressure on the affected area and move the arm, hand as well as fingers in different ways to assess pain. An X-ray may be recommended to rule out a fracture or other medical conditions.


Taking a prescribed course of anti-inflammatory medications can help to reduce pain and inflammation. Cortisone injections can also be administered if the patient is experiencing severe pain. Giving proper rest to the affected elbow, applying ice pack, wearing a brace can help to relieve the symptoms. The orthopedic doctor may refer you to a physical therapist to perform light stretching and strengthening exercises. This will help to facilitate restoration of normal joint movement and functionality.
Surgery is usually required in severe cases of Golfer’s Elbow or if conventional methods fail to provide relief. During the procedure, the orthopedic doctor may remove the scar tissue adjacent to the affected tendons.

For treatment of Golfer’s Elbow, visit Dr. Fagelman. To schedule an appointment with the orthopedic doctor in Carrollton, TX, you can call at (972) 492 – 1334.

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Risk Factors For Rotator Cuff Injuries

by Administrator 16. September 2015 14:07

Rotator Cuff is a group of tendons and muscles that help to keep the shoulder joint stable. They also enable the extensive movement of the joint. An injury to the Rotator Cuff can adversely affect even the basic daily activities such as lifting an object, pulling a door, brushing your hair etc. The condition may cause intense pain, stiffness, loss of motion, muscle weakness, tenderness and swelling in the shoulder joint.

Risk factors associated with Rotator Cuff injuries:

  • Falls or Accidents: In case of an accident or a fall which impacted the shoulder, there are chances of the tendons, ligaments or bursae to get bruised and cause pain.
  • Sports Activities: Sportsperson involved in racquet games or requiring repetitive movements of the shoulder, such as weightlifters, disc throwers, swimmers etc. are likely to suffer from a Rotator Cuff injury.
  • Construction Jobs: Occupations such as house painting or carpentry require repetitive overhead arm movements that may gradually cause damage to the Rotator Cuff.
  • Muscle Overuse: Anyone who is involved in jobs that require lifting heavy objects or keeping the shoulder joint over head for longer durations (e.g. painters) have an increased risk of sustaining the injury.
  • Arthritis: People who have Shoulder Arthritis are more prone to Rotator Cuff conditions. Arthritis weakens the bones as well as muscles, and cause related problems in the shoulder joint.
  • Age: As age progresses, people become more prone to Rotator Cuff injuries due to weakened muscles and stiff joints. The condition is more commonly seen in people aged over 40 years.
  • Heredity: Genetic factors are also linked to developing Rotator Cuff injuries.
  • Smoking: Smokers are more likely to be prone to Arthritis and weak muscles, hence at higher risk of sustaining Rotator Cuff injuries.

It is important to consult an orthopedic doctor for proper diagnosis and treatment of the injury. Based on the symptoms and range of motion of the shoulder joint, the doctor may recommend rest, hot/cold compressions, wearing a sling or medications. There could be other conditions accompanying Rotator Cuff injury, such as nerve damage, tearing of ligaments, torn cartilage etc. which, if not treated timely, increases the risk of further damage.

Dr. Fagelman is a Carrollton, TX based shoulder surgeon providing surgical and non-surgical treatment for Rotator cuff injuries. To schedule an appointment, you can call at (972) 492 – 1334.

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Elbow Pain Prevention: Orthopedic Carrollton

by Administrator 23. July 2015 07:09

Elbow pain usually occurs due to sudden injury, severe fall or repeated use of the elbow joint. The condition requires proper medical treatment and if left untreated, the pain can worsen and lead to other severe complications. By following certain measures and precautions, you can prevent elbow pain.

  • Wear Protective Gear: In order to keep yourself safe during sports or recreational activities it is important to wear protective gear such as supportive splints, elbow pads etc. This will reduce the chances of sustaining an elbow injury and provide the necessary protection during a fall or accident. 
  • Avoid Carrying Heavy Objects: It is advisable to avoid lifting heavy weights as it can put undue pressure on the elbow. It is also important to maintain the proper posture when carrying weight to prevent elbow injury and pain.
  • Warm Up: It is advisable to do some stretching exercises before and after physical work out or sports. By doing stretching exercises, warm up and proper cool down, you can prevent stiffening of the elbow muscles and tendons.
  • Avoid Repetitive Motions: You should take regular breaks while performing overhead activities or repetitive motions of the elbow to avoid elbow pain.
  • Use Correct Techniques While Exercising: To avoid straining your elbow muscles, make sure you use the correct techniques while doing exercises. When playing any sport you must ensure that you get proper training from a skilled trainer and use the appropriate training equipment.
  • Preventing Falls: Elbow injuries often occur due to falling on a hard surface or landing on your elbow. You should always wear proper comfortable shoes, avoid heels and use handrails in the shower.
  • Changes To Your Workstation: If your job involves working on the computer for long hours or sitting at a desk, you must ensure that your table and chair is ergonomic. It is advisable to take regular breaks, stretch your fingers and hands to increase blood circulation and give break to your elbow from repetitive stress.

By following the above-mentioned tips and by being cautious, one can avoid elbow pain. However, it is essential to get proper medical treatment if suffering from elbow pain. For comprehensive diagnosis and treatment of elbow pain, you can consult Dr. Fagelman in Carrollton, TX. To schedule an appointment with the shoulder surgeon you can call at (972) 492 – 1334.

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Tips To Prevent Shoulder Pain

by Administrator 19. June 2015 05:09

The shoulder is the most mobile joint in the human body with the widest range of motion. It is made up of three bones, Clavicle, Scapula and Humerus, and various associated muscles, tendons and ligaments. Most of the movements carried out throughout the day involve the shoulder which makes it vulnerable to injuries, strains, sprains etc. Any problem with the shoulder can cause severe pain and inability in the movement of the joint. Here are some tips to prevent shoulder pain:

  • Exercises: Shoulder pain can be caused by overuse and fatigue in the shoulder and Rotator Cuff. Exercising the muscles and tendons regularly, can help in building strength which increases the ability of the muscles to work for longer durations. It is advised to do low intensity and low impact exercises to prevent strains.
  • Stretch: Pain which is caused by stiffness can be prevented by stretching. It helps in flexing the muscles and improving their range of motion. Conditions like Frozen Shoulder can also be prevented with the help of stretching.
  • Avoid injuries: Injuries to any part of the shoulder can cause severe pain in the joint. Prevention of injuries to the Rotator Cuff or the ligaments of the joint can help in avoiding pain. Also injuries like fractures which can be caused by falls on the shoulder, accidents or sudden landing on the joint must be avoided by walking carefully on uneven grounds, wearing proper shoes to avoid falling and wearing seat belts while driving.
  • Massage: Sometimes, due to overuse and strain, knots can be formed in the muscles. Massaging the muscles of the shoulder can be helpful in relieving the built up stress in them and avoiding the possibility of shoulder pain.
  • Proper posture: Improper posture for prolonged duration of time can also cause injuries or sprains to the joint. Sleeping while keeping the arm in an awkward position may cause pain in the muscles. Also, inappropriate posture while lifting heavy objects can cause severe injuries to the Rotator Cuff. Maintaining proper posture while sitting, standing, sleeping etc. is suggested in order to avoid shoulder pain and any injuries. Also, taking precautions while picking heavy objects can be helpful in preventing injuries.
  • Comfortable workstation: The work setup at your office should be comfortable and soothing. There should be proper support for arms in order to avoid overuse or strains in muscles of arms and shoulder.
  • Sports activities: People who get involved in rough sport activities like football, rugby, basketball etc. are more susceptible to shoulder pain and injuries. These can be avoided by wearing proper protective gears during such activities. Also, people who take part in sports which require repetitive overhead movements of the arm like swimming can suffer from shoulder pain. It is suggested to take precautions in order to prevent shoulder pain.

These tips can be helpful in the prevention of shoulder pain. 

Consult Dr. Fagelman in Carrollton, TX for diagnosis and treatment of shoulder pain. To schedule an appointment with the orthopedic surgeon, call at (972) 492 – 1334

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Orthopedic Treatment For Frozen Shoulder

by Administrator 21. May 2015 11:08

Frozen Shoulder is a painful condition in which the shoulder capsule becomes inflamed and stiff, restricting the movement of the joint. Also known as Adhesive Capsulitis, the condition is characterized by formation of scar tissue in the shoulder capsule, making it impenetrable and leaving less room for movement. It occurs when the sleeve surrounding the joint swells and thickens. The symptoms of Frozen Shoulder may appear and resolve gradually over a time period of 1 to 3 years.


  • Diabetes: People suffering from Diabetes are more likely to develop Frozen Shoulder.
  • Other Medical Conditions: Other medical conditions such as a heart problems or Parkinson’s disease can also make you susceptible to Frozen Shoulder.
  • Previous Injury: The medical condition may also develop if the arm is left immobilized for a long period of time after a fracture, surgery or injury.


Stiffness and pain are the two main symptoms of Frozen Shoulder. People who suffer from this condition tend to experience difficulty in moving the arm and severe pain while carrying out normal shoulder movements. Symptoms of Frozen Shoulder normally develop appear in stages.

  • Freezing: This is the stage when the symptoms start emerging. The pain grows from mild to severe and the patient begins to face difficulty in carrying out daily tasks that involve shoulder movements. This stage can last for 2 to 9 months.
  • Frozen: In this, the stiffness in the shoulder may severely increase. However, the pain generally decreases. This stage lasts for 4 to 12 months.
  • Thawing: The stiffness significantly decreases and the patient may regain some movement in the arm while the pain begins to fade. Although, the pain may occasionally come back as the stiffness decreases. This stage can last for 12 to 24 months.


  • Heat Or Ice Packs: Applying heat pads, ice packs or using both alternately can help to ease stiffness and pain.
  • Anti-Inflammatory Medicines: The shoulder surgeon may prescribe non-steroidal anti-inflammatory drugs to provide relief from pain.
  • Physical Therapy: Once the pain has subsides, physical therapy may be recommended to restore the normal range of motion of the shoulder joint.
  • Surgery: This is usually recommended if the symptoms do not subside with non-surgical treatment.

For comprehensive treatment of Frozen Shoulder, consult Dr. Fagelman in Carrollton, TX. To schedule an appointment with the shoulder specialist, you can call at (972) 492 – 1334

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