Elbow Pain: Orthopedic Treatment In Carrollton, TX

by Administrator 14. April 2015 08:26

Elbow pain may result due to a number of reasons such as a blow to the elbow, an injury or inflammation of the joint. Elbow joint is made of a number of muscles, tendons and ligaments, which can be injured and cause ebow pain. Elbow pain is quite common among athletes and sports persons, especially those involved in contact sports.


Some of the common causes of elbow pain include

  • Repetitive use of elbow
  • Wear and tear
  • Sports injury
  • Broken bone
  • Arthritis
  • Bursitis
  • Tendonitis
  • Skin growths such as cysts or tumors
  • Infection of the elbow
  • Dislocation
  • Nerve entrapment and compression


Depending upon the disorder, disease or condition, the symptoms of elbow pain vary. However some of the common symptoms include:

  • Redness
  • Bruising
  • Swelling
  • Warm sensation
  • Shoulder, arm, hand or finger pain
  • Muscle weakness
  • Reduced mobility
  • Tenderness
  • Deformity of the elbow
  • Itching feeling
  • Numbness


To diagnose the cause of pain the orthopedic doctor may examine the elbow and ask some questions about the medical history of the patient. The surgeon may also take details like the duration of pain, nature of injury and any other symptoms that you have. The orthopedic surgeon can also prescribe certain imaging tests such as X-ray, MRI, and CT scan to rule out any fracture or bone damage and to diagnose the condition.


The orthopedic doctor devises a treatment plan depending upon the symptoms and the cause of the pain. Ignoring the serious pain symptoms may lead to paralysis or serious damage, immobility and nerve damage.

If the pain is mild, then the doctor may advice resting for some time, using ice packs, compression and over-the-counter pain medications. However for treating serious elbow pain the doctor may prescribe physical therapy, prescription drugs and even surgery. Certain serious conditions such as elbow fracture, bicep tear and tennis elbow are treated surgically. The orthopedic surgeons use an arthroscope, a small instrument with a camera. They insert this instrument into the elbow by making a small incision and repair any damage that causes pain. Patients with ulnar nerve entrapment at the elbow also require surgery to repair the nerves. To recover effectively after the surgery, you may require physical therapy to return the range of motion and strength to the elbow.

For complete treatment of elbow pain, visit Dr. Fagelman in Carrollton, TX. To schedule an appointment, call (972) 492 - 1334 or visit  4780 North Josey Lane, Carrollton, Texas 75010.

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Common Causes Of Shoulder Pain

by Administrator 20. March 2015 09:01

Shoulder pain is a common condition, especially with the athletes and sportspersons. However for proper treatment it is essential for the doctor to determine the exact cause of the pain. Here are some of the common causes of shoulder pain.


Any activity that involves the repeated use of tendons often leads to Tendinitis. Rotator cuff tendons, which offer stability and motion to the shoulder, are the most commonly affected tendons in the shoulder. Acute tendinitis results due to excessive overhead activities or sports that involve ball throwing. Chronic tendinitis occurs because of arthritis or repeated wear and tear of tendons with age.


Bursae are fluid filled sacs in the joints, which act as cushions between the bone and the overlying soft tissues. They help in reducing friction between the bone and the gliding muscles. Due to excessive use of the shoulder, the patient experiences inflammation and swelling of the bursa between the shoulder blade and the rotator cuff. The condition is called as subacromial bursitis. The condition causes pain in the shoulder and it becomes difficult to carry out simple routine tasks.

Tendon Tears

Sometimes an injury or degenerative changes in the tendons lead to tearing and splitting of tendons. The tear may range from partial tear to complete damage. The tendon is often pulled away from the attachment to the bone.

Shoulder Instability

Often due to sudden injury or overuse, the head of the upper arm bone is forced out of the shoulder socket and this leads to shoulder instability or dislocation. The condition causes pain and unsteadiness while the dislocation can be partial or complete. If the ball of the upper arm comes partially out of the socket, the condition is called subluxation. If one experiences shoulder instability, he or she becomes susceptible to frequent dislocations, which increases the risk of arthritis in the joint.

Shoulder Impingement

The impingement occurs when the acromion, the top of the shoulder blade, pressurizes the underlying soft tissues, bursa and rotator cuff tendons. Shoulder impingement leads to tendinitis and bursitis, which cause pain and limit movement.


Arthritis is one of the major causes of shoulder pain. With age, people often develop osteoarthritis, which occurs due to chronic wear and tear of the joint, sports and work related injuries, inflammation and infection. The soft tissue parts of the joint become tight and stiff resulting in restricted shoulder movement.


Due to trauma or high impact injury, the shoulder bones, clavicle, scapula and humerus may break and this results in fracture, which is quite painful.

Besides these causes, various other infections or nerve disorders can also lead to shoulder pain.

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

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Rotator Cuff Injury: Prevention Tips

by Administrator 23. February 2015 11:42

Rotator Cuff is made of tendons and muscles, which help in the movement of the shoulders. An injury to it can lead to pain and inflammation in the shoulder, which may disrupt its normal functioning. Here are some prevention tips that help you avoid the injury.

Reduce Repetitive Overuse

The major cause of rotator cuff injury is the overuse of the muscles. Certain jobs and activities require you to perform repetitive shoulder action, which puts strain on the rotator cuff muscles. To avoid this situation you should try to use both arms or switch the arms to do the task. This will offer rest to the rotator cuff muscles in the arm and is especially important for people who regularly lift and carry heavy objects at work.

Avoid Sleeping On One Side

If you sleep on your side for long it will put pressure on your shoulder and cause damage to the rotator cuff. As your entire weight lies on the shoulder it not only harms the rotator cuff but also puts a large amount of stress on the shoulder joint. Chronic side sleepers often develop rounded shoulders and their rotator cuff muscles weaken. The situation ultimately leads to chronic shoulder pain and dysfunction.

Improve Your Posture

Another problem that often leads to rotator cuff injury is wrong posture. You should have a strong and stable posture to avoid the injury. You should try and keep your arm close to your body when lifting heavy weights and avoid putting undue strain on your shoulder. By carrying weight close to your body, you can prevent rotator cuff injury. You must keep your elbows at your side as it keeps your shoulder musculature in a stable position.

Warm Up Before Exercise

It is crucial that you perform warm up exercises before playing or doing any strenuous activities that involve the shoulder. As warm muscles are stronger, flexible and faster, they can bear stress and tension easily without taxing the rotator cuff muscles. If you do weight lifting or play sports such as basketball, cricket, baseball, tennis, etc., that involve repeated shoulder movement, you must start with a warm up session.

By strengthening your cuff muscles and exercising them regularly you can make sure that they are strong enough to bear any wear and tear. You should exercise properly and make sure you work under expert supervision to avoid over straining your shoulder.

For more prevention tips, contact Dr. Fagelman at OrthoTexas, Carrollton. To schedule an appointment with the shoulder specialist, call at (972) 492-1334.

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Distal Bicep Tendon Rupture: Treatment In Carrollton, TX

by Administrator 19. January 2015 13:51

Bicep is the main muscle that flexes the forearm and is used in lifting weights. Distal bicep tendon rupture occurs when the ligament that attaches the bicep muscle to the elbow is torn from the forearm bone. It can either be partial or complete depending upon on severity of the tear. The condition is more commonly seen in middle-aged and old people.


  • Lack of physical exercise
  • Sport activities that exert pressure on the forearm or biceps
  • Injury due to fall from a height, with an outstretched arm
  • Carrying very heavy items puts pressure on the forearm that causes the tendon to tear
  • Performing persistent activities that put strain on the bicep tendon
  • Bending the elbow forcefully


  • Severe pain in the elbow, biceps, arm or shoulder
  • Swelling and bruising on the elbow or shoulders
  • Weakness or numbness in the arm or elbow
  • Inability to lift objects
  • Difficulty in rotating, bending or moving your arm and elbow
  • A visible bulge in the upper arm
  • A popping sound in the elbow at the site of injury


The orthopedic doctor examines the patient and asks questions about the medical history in order to determine the exact condition and severity of the injury. Distal bicep tendon rupture is usually diagnosed with the help of MRI (Magnetic Resonance Imaging), X-rays and clinical examination.


Depending upon your age and severity of the condition, the doctor may either suggest non-surgical or surgical treatment to cure distal bicep tendon rupture.

  • Non-surgical treatment: It is usually chosen for aged patients and for those who are not fit for surgery. The reason older people are most likely to suffer from a tendon tear after an injury is due to their advancing age and lack of physical activity. Non-surgical treatment may most likely work for injuries that are less than 3 weeks old. The orthopedic doctor may also prescribe anti-inflammatory medications to relieve pain and get the arm back to its normal functions. After initial treatment, the doctor may focus on strengthening the muscles in order to decrease the chances of tendon ruptures in the future. Physiotherapy can also be recommended for patients under professional supervision.
  • Surgical treatment: It is usually recommended for injuries that are more than 3 weeks old or very severe in nature. The surgical method reattaches the torn tendon to the forearm bone with the help of different techniques by the orthopedic surgeon.

For treatment options for distal bicep tendon rupture, contact Dr. Fagelman in Carrollton, TX. To schedule an appointment, call at (972) 492 - 1334.


Orthopedic Treatment For Shoulder Labral Tear

by Administrator 20. November 2014 09:47

An injury to the Labrum of the shoulder is known as Shoulder Labral tear. Labrum is a cartilaginous ring that surrounds the socket (glenoid) of the shoulder joint. It stabilizes the joint and is an attachment site for many ligaments. Often athletes suffer from a Shoulder Labral Tear due to repetitive shoulder motion.


  • Injury to the Labrum from trauma
  • Repeated motion of shoulder
  • A direct blow to shoulder
  • A sudden pull
  • Trying to stop a fall
  • Shoulder dislocation
  • Athletes participating in throwing activities or sports
  • Falling on an outstretched arm
  • Repetitive overhead sports players such as volleyball, baseball and basketball players get shoulder injury due to repeated motion of shoulder


  • Pain
  • Inflammation
  • Sensation of locking, popping, catching or grinding
  • Instability in the shoulder
  • Difficulty in lifting objects
  • Pain during daily activities
  • Loss of strength
  • Reduced range of motion


When the patient visits an orthopedic physician with above stated symptoms, the physician physically examines him and enquires about his medical history. The physician can also perform some physical tests to check pain, stability and range of motion of the shoulder. The doctor may suggest X-ray, MRI, CT scan and other imaging tests to confirm the extent of the injury and access the situation.


To relieve pain and inflammation, the orthopedic physician can prescribe anti-inflammatory medicines and rest. The patient greatly benefits from rehabilitation exercises which help in strengthening the rotator cuff muscles. The patient is treated non-surgically; however, if the non-invasive methods do not work, then surgery is kept as the last option. To treat the Shoulder Labral Tear, Arthroscopic surgery is performed in which the surgeon operates according to the condition of the Labral.

Rehabilitation after the surgery can take a month or more. Once the pain and swelling subsides, the physician recommends physiotherapy, which helps a patient recover quickly. The doctor designs a therapy program for the patient while considering his needs. During the rehabilitation period, the patient needs to keep the shoulder in a sling. Once the sling is removed, the patient is suggested do some flexibility exercises to regain the muscle strength and flexibility. The athletes should make sure their shoulder is completely healed before resuming sports activity.

For complete treatment of Shoulder Labral Tear, visit Dr. Fagelman. To schdeule an appointment with the orthopedic surgon in Carrollton, call at (972) 492-1334.

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Orthopedic Treatment For Shoulder Dislocation

by Administrator 22. September 2014 11:05

Shoulder Dislocation is a condition caused due to an injury leading to darting out of the bone of the upper arm from the cup shaped opening in the shoulder blade. The shoulder, being the most flexible of all joints, is most susceptible to getting dislocated.

Shoulder can be either partially or completely dislocated. In a partial dislocation, the top of the humerus (upper arm bone) gets moderately out of the glenoid (opening in the shoulder). In a complete dislocation, it gets completely detached from the socket and both the conditions can cause unsteadiness and pain in the shoulder joint.


  • Trauma: Shoulder dislocation may occur when the joint is in an exposed position and gets popped out suddenly. A hard knockback to the shoulder in a road accident is one of the common causes of dislocation.
  • Excessive strain on shoulder ligament: Sports such as swimming, volleyball, baseball, tennis etc. that need recurrent overhead movements can overstrain the ligaments in the shoulder.
  • Falls: Shoulder may also get dislocated as a result of falling from a height or tripping on something.


  • Extreme pain
  • Visible disfigurement in the shoulder
  • Recurrent instances of dissemination of shoulder
  • Feeling of weakness, numbness, pins and needles in the arm
  • Shoulder might feel loose, hanging and sliding in our out of the joint
  • Uneasiness while making certain movements of the shoulder
  • Swelling and bruising


The treatment options for shoulder dislocation may include:

  • Closed reduction: The orthopedic doctor may use manual exercises to get the shoulder bones back into place. You might be administered a muscle relaxant or sedative if the pain is intense.
  • Immobilization: The patient might need to use a sling or splint for some time to restrict the movement of shoulder. The time for which the splint should be worn varies from patient to patient.
  • Surgery: If a person has frail shoulder ligaments or joints, surgery might be needed to treat the dislocated shoulder.
  • Rehabilitation: After the splint is removed, a gradual rehabilitation therapy is required to restore, stability, strength and range of motion of the shoulder.

If your shoulder has suffered a minor dislocation and there has not been much damage to the tissues or nerves, the joint is likely to recover within a few weeks. However, you must not resume activity soon after the treatment as it may make you susceptible to injuring your shoulder and getting it dislocated again.

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Orthopedic Treatment For Shoulder Impingement

by Administrator 21. August 2014 10:35

Also known as Rotator Cuff Tendinitis, Shoulder Impingement is caused when the tendons are recurrently stuck and flattened while moving the shoulder. While raising the arm over the shoulder, the acromion can rub against the tendons and bursa, resulting in irritation and pain. This syndrome is quite common in athletes and middle aged people. Repetitive overhead movements while performing activities like painting, construction, swimming, tennis, basketball, volleyball, badminton, weight lifting etc. is a risk factor for impinging of the shoulder. It can also cause other bone and joint abnormalities. Due to this, the tissues within and around shoulder joint get stressed and cause inflammation and swelling.


  • Repetitive overhead movements while playing volleyball, tennis, badminton, golf, baseball, softball etc. and similar activities like stocking shelves, paper hanging, and construction can cause this syndrome.
  • Shoulder instability in young athletes is a likely cause of Shoulder Impingement. 
  • It can also be a result of some kind of fall injury.
  • Arthritis can cause narrowing of the subacromial space, due to which the rotator cuff and bursa have less room to travel. During motion, these structures get pinched, causing Shoulder Impingement.
  • Structural or anatomic abnormalities can also result in a narrow subacromial space, resulting in this syndrome. 


  • Difficulty reaching behind the back.
  • Pain in shoulders with overuse of arm.
  • Weakness in shoulder muscles.
  • Swelling and tenderness in front of the shoulder.
  • Pain and stiffness while lifting up the arm.
  • Pain radiates to front of the shoulder to the side of arm.
  • Loss of strength and motion in the shoulder.
  • Limited and painful movement of the shoulder.


This syndrome can be diagnosed by an orthopedic doctor by performing physical examinations and evaluating medical history. These diagnostic tests help to detect if there are any changes in the bone or if there is some injury to the muscles.



Shoulder Impingement syndrome can be treated by avoiding overhead and repetitive movements so that the pain and irritation subsides. Anti-inflammatory medicines and ice can help to reduce the swelling. To restore normal range of motion in athletes, exercises can help to reduce the pain. These non-surgical methods can take up to several weeks and even months, but help in gradual improvement to return to function normally. Physical therapy also reduces pain and strengthens the shoulder. Steroid injections may be needed if these methods do not provide relief from the pain.


Surgery is required when the pain does not subside. The shoulder surgeon performs surgery on the shoulder to create more space for movement of rotator cuff. By way of this, the inflamed portion of the bursa is removed.  The doctor may either use open surgery and arthroscopic surgery to perform the procedure. Post-surgery, a rehabilitation program helps to regain the strength and movement of the shoulder, which might take 2 to 4 months or a year.

This syndrome can occur to anyone but it is, nevertheless, avoidable. Athletes can modify their playing techniques and avoid movements that risk hurting the shoulder. Avoiding repetitive movements can prevent this syndrome. Taking necessary treatment in time can prevent the condition from getting worse and protect the rotator cuff and bursa from getting pinched.

For expert treatment of Shoulder Impingement or any other shoulder condition, contact Dr. Fagelman at (972) 492-1334.  You can also visit him at 4780 North Josey Lane, Carrollton, Texas 75010.

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Common Sports Injuries Of The Shoulder

by Administrator 14. July 2014 06:44

Shoulder injuries are a common consequence of repetitive and overhead movements of the shoulder that result in acute shoulder pain. People who are involved in sports like tennis, badminton, bowling, baseball, swimming etc subject their shoulders to enormous stress and strain, and unfortunately end up injuring their shoulders. Activities like washing walls, carpentry and gardening have been found to strain the shoulders as well.

The shoulder is a ball and socket joint which is made up of- the upper arm bone (humerus), collar bone (clavicle) and shoulder blade (scapula). Muscles, tendons and ligaments hold these bones together for free movement of the shoulder. Due to injuries to shoulder there may be swelling, tingling sensation, weakness, numbness and changes in range of motion in shoulder. Though minor injuries can be healed easily, serious shoulder injuries caused due to collisions and falls require medical attention. They can cause dislocation of the joints of shoulders. A few common sports injuries to shoulder are discussed below:

  • Rotator Cuff Tendinitis – It occurs in people who use consistent overhead motions and overuse their shoulders. This occurs to athletes who play sports like tennis, baseball etc and to the elderly due to degeneration of the tendons. Exercises recommended by orthopedic surgeon may gradually heal the injury and anti inflammation medicines can help reduce the pain and swelling.
  • Impingement Syndrome – Excessive rubbing of the shoulder muscles against the shoulder blade cause impingement. It is a form of rotator cuff injury where the tendons feel pinched and inflamed.
  • Dislocated Shoulder – Trauma may cause the shoulder to dislocate or pop put of a joint. It causes severe damage to the tendons and ligaments that help hold the shoulder joint in place.  It requires immediate medical attention and needs to be put back in place by an experienced professional.  Shoulder dislocations may need surgical treatment to repair the damage.
  • Shoulder Instability – It can occur as an aftermath of dislocated shoulder.  If the shoulder remains unstable, subsequent dislocations may occur. Physical therapy and anti inflammatory medicines help relieve symptoms of pain or else surgery may be required to repair torn ligaments and tendons so that they keep the shoulder in place.
  • Thrower's Shoulders – It causes abnormal gliding of the shoulder due to overhead throwing movements. The shoulder joints get stretched and the back gets tighter and this injury requires special expertise to treat and diagnose.
  • Labral Tears – It may occur as a result of falls, throws or blows to the shoulder. The labrum that cushions the shoulder joints can tear and cause intense pain. If the tears are large, they may cause shoulder dislocations.

Apart from these injuries, a number of injuries because of sports occur and cause damage to the shoulder. These sports injuries can become chronic if they are not treated on time or if the straining activities are continued before the joint fully recovers. Special care and treatments are a must before continuing any activity that causes strain or stress to the shoulder.

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Orthopedic Treatment For Tennis Elbow

by Administrator 14. May 2014 10:50

Tennis Elbow is a painful and debilitating condition of the elbow region most often affecting people who make heavy use of their arms. It is a problem associated with the condition of several small tendons which are attached to the rear part of the elbow joints. They serve to provide the elbow and wrist with a heightened range of motion. This painful condition usually surfaces as a result of prolonged damage to these tendons due to excessive and frequent use without the time interval needed for natural healing. As the name suggests, this condition is frequently seen in tennis players and people who practice similar forms of sport. It can also occur among people who have reason to profusely use their arms on a regular basis due to the nature of their work.

Tennis Elbow is believed to be caused when there are microscopic tears in the tendons attached to the elbow, occurring due to prolonged periods of heavy use. This is the reason why this condition is seen mostly in athletes and people who do physical labor. As a result, minuscule tears form along these tendons which have no time to heal. The excessive use happens on a daily basis and there is no time to repair for the tendons.

The condition of Tennis Elbow manifests itself with acute pain in the elbow region. This pain can be a constant sensation or can sometimes come to surface when you try to use your arm to lift objects. Any action which involves any cocking of the wrist or the attempt to grab something with your hand can make the elbow pain increase substantially. There can also be a marked loss of mobility and strength of the arm in question.

It is usually a complicated procedure to properly diagnose a case of Tennis Elbow, as tests such as x-rays and MRIs very often come out normal. In these cases, there is need for other tests like a nerve conduction test. For any kind of an elbow pain you should consult an orthopedic surgeon. He might look into your medical history and check if you have a precedence of elbow joint problems or arthritis.

Usual treatments include partial or complete immobilization of the affected arm and medication to alleviate the pain. Sometimes orthopedic doctor can also prescribe the use of an elbow brace. Targeted exercise of the area can also bring significant relief from the pain. In extreme cases, doctors might opt for surgical measures which usually involves repair of the damaged tendon by grafting.

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Rotator Cuff Syndrome: Causes, Symptoms & Treatment

by Administrator 21. April 2014 09:58

Rotator cuff syndrome is a debilitating and extremely painful condition of the shoulder. It can come about in a variety of ways and can have many causes or problem areas. The rotator cuff gives the shoulder its mobility and range of motion, and consists of muscles and tendons.  Any damage to these tendons causes rotator cuff syndrome. This condition happens due to a number of different causes and can be treated based on the nature and severity of the condition. It can be the cause of severe pain and loss of motion and needs to be treated immediately to avoid any further complication.


Rotator cuff syndrome can happen due to a variety of different external causes which can damage the tendons in the area. A few of these are -

  • Keeping the hand and shoulder in one particular position for long periods of time. This happens to people whose work involves daily and heavy use of computers.
  • Sports activity like tennis which involves heavy use of the rotator cuff.
  • Activity that needs long periods when the hand remain overhead.
  • Bad sleeping posture.
  • Lack of coordination of movement in shoulder blades.
  • These are a few of the things that can be responsible for rotator cuff syndrome.


Rotator cuff syndrome brings acute pain especially felt when there is any attempt to move the hand or shoulder. The pain might be mild at first but usually increases in intensity. There is also severe loss of mobility and range of motion accompanied by lack of strength and stability.


The first step of treatment is to undergo a physical exam by an orthopedic surgeon and conduct important diagnostic tests like an x-ray. Depending on the acuteness of the pain, doctors in Carrollton might also recommend procedures like ultrasound tests or MRIs to gauge the extent of the shoulder pain. Once the damage has been ascertained treatment for normal cases usually consists of rest, regular application to hot or cold compress and generally avoiding activity except for the kind that is absolutely necessary. Over the counter painkillers and anti-inflammatory medication can also be used. This is ideally supplemented with a range of exercises and physical therapy to give strength to the area and to restore range of motion. In severe cases orthopedic doctors can also use the application of steroids to stimulate the healing process. In case of a complete rotator cuff tear, the only helpful mode of treatment might be surgical repair.

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