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 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.


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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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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Shoulder Pain: Causes, Symptoms & Treatment

by Administrator 17. December 2013 13:52

Shoulder pain can be caused by an injury to the shoulder, or arise from a disease affecting the shoulder joint. Pain in the shoulder arises when the tendons, ligaments, cartilages, menisci, or bursae comprising the shoulder joint are affected. Shoulder pain is highly common, because of the high mobility of the shoulder joint, which makes it prone to injuries. In certain cases, pain in the shoulder could be indicative of a disease affecting the joint itself, or the soft tissues and bones surrounding it. Shoulder pain could also be caused by an abnormality in the nerves supplying sensation to the shoulder.

If you are experiencing chronic shoulder pain, you can seek treatment from an experienced orthopedic doctor in Carrollton, TX. There are various remedies that can be adopted to provide relief from shoulder pain and restore a normal range of motion. Below is a look at the common causes of shoulder pain, the symptoms of the condition, and its treatment options:


  • Inflammation of the bursae, which are tiny fluid-filled sacs that cushion and lubricate the joint, reducing friction between the bones. This is known as shoulder bursitis, and can result from injury, infection, or rheumatic disease.
  • Inflammation of the tendons, which connect the muscles to the bones. This is referred to as tendinitis.
  • Muscle strain
  • A frozen shoulder, which is usually caused by a shoulder injury, and associated with a limited range of motion.
  • Impingement syndrome- a condition in which the rotator cuff tendons get inflamed due to their rubbing against the shoulder blade.


  • Pain which can range from dull to sharp and severe
  • Muscle spasm
  • Inflammation
  • Restricted movement
  • Numbness or tingling sensation
  • Visible deformity
  • Arm weakness


  • The treatment of shoulder pain usually involves the use of anti-inflammatory medications or over-the-counter pain relievers.
  • Acute shoulder pain, such as that caused by a sports injury can be relieved by the local application of moist heat or ice.
  • If shoulder pain persists, you might need to get a local corticosteroid injection. It is especially useful for pain caused by arthritis of the shoulder.
  • Shoulder exercises can expedite recovery by helping to restore the normal range of motion.
  • Surgery might be required if the pain is caused by an underlying nerve condition.

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Burners and Stingers: Causes, Symptoms, Treatment& Prevention

by Administrator 20. November 2013 13:05

Burner and stringers are the painful injuries to the nerves which are responsible for the movement, sensation and coordination of upper arm. These nerves run from the back of the neck into the arm forming the network of nerve fibers in the upper shoulder called brachial plexus. Injuries to the brachial plexus, causing stinging or burning sensation from shoulder to hand are called burner and stringers.


  • Contact sports: According to orthopedic sports surgeons in Carrollton, a sudden fall onto the head can lead to burner and stringers. Normally, the athletes associated with contact sports like wrestling, soccer, football, etc. are more likely to cause these injuries.
  • Spinal stenosis: There is a growing evidence of an association between spinal stenosis and burner and stringer. Spinal stenosis is basically a condition caused due to narrowing of the open spaces in spine cord.
  • Quick movement of neck and shoulder: A jerk to the neck or shoulder can cause the neck to bend towards the opposite shoulder which further leads to burners and stringers.

It is important to seek immediate medical help if any of the following symptoms are noticed:

  • A burning or electric shock sensation from shoulder to hand
  • Numbness and weakness in the area
  • A warm feeling in the arm
  • Intense pain in the arm
  • Tingling sensation

Treatment of burners and stringers depend on the severity of the condition. The sports injury doctor may perform imaging tests like X-rays or MRI or electrodiagnostic tests such as an electromyogram in order to determine the extent of the injury. The treatment recommended most often include:

  • Taking break from the involved activity until the pain stops.
  • Applying ice to the affected area.
  • Anti-inflammatory medications may be prescribed by the doctor to reduce inflammation and pain.
  • The doctor may also recommend wearing neck roll for a few weeks.
  • A range of strengthening, stretching and motion exercises may also be recommended by the doctor. These exercises help rehabilitate your injury and improve the flexibility of injured tissue. Some of such exercises include axial extensors, cervical side bend, cervical rotators, neck circles, cervical flexors, etc.


  • Using protective gear while performing any physical activity
  • Keeping the neck and head in comfortable position
  • Performing neck and shoulder stretching and strengthening exercises prior to any physical activity
  • Wearing the proper running shoes for better traction on uneven and slippery surfaces.

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