Further Reading on Injections for Knee Pain

As a San Diego orthopedic surgeon specializing in disorders of the knee, I am constantly scouring the medical literature for new approaches that might help my patients achieve lasting relief.

This recent study was picked up by national media outlets because of its unexpected conclusion: BOTOX, that mainstay of cosmetic care, has now been shown to help many patients who suffer with the chronic pain of runner’s knee, a condition known as lateral patellofemoral overload syndrome, or LPOS:

According to the investigators, two-thirds (69 percent) of the patients required no further treatment and were free of pain when assessed five years after the injection into the hip muscle.

I have written before about the connection between hip and knee pain, and especially how treating one can often relieve pain in the other. This study reinforces that link, and offers some hope for better pain relief for many active patients whose knee pain has resisted other therapies.

If you want to find lasting expert care for knee pain in San Diego, contact Dr. WIlliam Holland at AOSM, the center for American Orthopaedics and Sports Medicine.

When Steroids and Orthopedic Knee Surgery Don’t Mix

When it comes to knee pain, steroid injections can be a godsend. These powerful hormones trigger the body’s own healing mechanisms and dramatically reduce pain, giving many patients the sensation of a new lease on life.

But all that relief isn’t free: steroids can also suppress immune response, which can create problems if surgery is on the horizon. That’s the conclusion of a couple of new studies, which found that the incidence of infection among knee and hip replacement surgery patients is markedly higher if they have taken a course of steroids in the month before the procedure:

The infection rate one year after surgery for patients who did not have an injection was 2.06 percent, but for patients who had an injection it jumped to 2.8 percent — a 40 percent increase. The strongest period for increased risk was the 12 weeks before surgery, with injections given more than three months before surgery having a significantly lower infection rate of 0.87 percent.

It is one more data point in our ongoing effort to mediate pain without usurping the body’s natural healing response. If nothing else, these studies should stand as a reminder that pain management requires a sophisticated understanding of the risks and benefits involved, and that orthopedic surgery can levy its own demands on the treatment of chronic pain.

When to See a San Diego Orthopedic Surgeon

Anyone who has ever dealt with chronic pain knows it can hard to assess when the treatment should escalate. After all, we’ve gotten pretty good at managing chronic pain with therapy, steroids and painkillers. But each of these approaches has serious limitations: in the case of drugs, for instance, there are very real dangers to maintaining a high dose of powerful narcotics.

Orthopedic surgery is the next logical step for most patients. Unlike ongoing medication designed to manage the pain, surgery gets at the root of the problem, relieving the primary issue. If damage to your muscle, cartilage or tendons has become so advanced that the body can no longer heal itself, then it’s time for orthopedic surgery.

As a San Diego orthopedic surgeon, I see many patients complaining of shoulder pain, elbow pain, hand and wrist pain, or knee pain. Each of these may be caused in turn by any of several dozen causes, from arthritis to cancer. The only way to know for sure where the is to conduct a full diagnostic assessment here in the office.

If your chronic pain has graduated to something you can no longer simply manage, it’s time to visit an orthopedic surgeon. Call Dr. William Holland to get a full evaluation today.

The Best Pediatric Orthopedic Care in San Diego

Orthopedic surgery for children is a delicate and demanding discipline. Unlike adult orthopedic surgery, which favors permanent fixes predicated on a permanent physique, orthopedic pediatric surgery must incorporate the latest knowledge about how the body develops and changes.

As one of the best pediatric orthopedic surgeons in San Diego, I take very seriously the mandate that a child’s development must be left to its own nature. When surgery is required, my team plans and executes minimally invasive procedures designed to relieve pain and instability without interrupting your child’s natural growth. In other words, we treat the whole child, and not just the injury.

Pediatric orthopedic care frequently involves young athletes, from gymnasts to baseball pitchers, whose bodies have been pushed to the limit by rigorous training. As an orthopedic expert, my job is to address the training regime alongside the injury, offering keen advice for parents and kids alike to help avoid subsequent pain in the future.

If your child has suffered a serious injury, it’s time to visit a pediatric orthopedic specialist. Please contact my offices here to learn more.

More Effective Shoulder Surgery in San Diego

When shoulder injury or pain becomes too much to bear, it’s time to consider shoulder surgery. Here in San Diego, the offices of Dr. William Holland have proudly earned a spot at the forefront of specialized care such as this, offering an extraordinary focus on athletic injuries of every type.

If you have been trying to manage the searing pain of bursitis or the frustration of frozen shoulder, you won’t find a more detailed approach in Southern California. Dr. Holland takes pride in his philosophy of patience and communication, and has rightly earned a reputation as one of the best orthopedic surgeons for shoulder pain in California.

Orthopedic shoulder surgery in San Diego has come a long way since the days when such procedures were painfully slow to rehab. Today, advances in arthroscopic surgery, digital imaging and improved aftercare help many patients return to their regular lives within a few months. Dr. Holland offers followup care every step of the way, ensuring you achieve a better outcome than you’re likely to find from another shoulder surgeon.

For the very highest standard of orthopedic shoulder surgery in San Diego, please contact Dr. William Holland today.

Connect With the Best Orthopedic Surgeon in San Diego

It is a fact of orthopedic medicine that not every specialist in this area covers a wide range of ailments. Although there is something to be said for the benefits of specialization, patients often express frustration upon discovering that their orthopedic surgeon only treats, say, a certain subset of back injuries and nothing else.

Here at American Orthopedics and Sports Medicine, or AOSM, we proudly offer a more versatile approach to orthopedic care. Dr. William Holland has earned the highest marks from patients through Southern California for his competency and high success rate, as well as an abiding commitment to a full range of orthopedic specialties, including:

If you’re looking for the best orthopedic surgeon in San Diego for chronic pain or injury, don’t hesitate: contact the offices Dr. William Holland for an expert consultation.

The Latest Bogeyman of Hand Pain: Smartphone Pinky

As an orthopedic surgeon, I spend a good deal of time assisting patients with pain in the hand and wrist. Some of these cases arise from sports injuries, but many more occur as a result of daily overuse, leading to repetitive stress. All well-known conditions with reliable paths to recovery.

But now a brand-new condition is making the rounds on social media this month: “smartphone pinky.” Predicated on the notion that balancing a phone on your pinky is harmful over the long term, this supposed disfigurement inspired a storm of media attention.

Alas, it’s probably all an urban legend. As one surgeon put it:

“It would be pretty hard to deform any of your fingers just by holding a cell phone,” she says adding that it would probably take many years of gripping a phone really hard to make any noticeable change. “As a hand surgeon, I think it’s more likely there’s something going on here to begin with, another condition, that they didn’t realize [they had] and thought it might be related to the phone.”

Needless to say, we have plenty of actual work-related injuries to worry about before we start spilling ink on an invented pinkie ailment.

If you have lasting hand or wrist pain and want an expert opinion, contact Dr Bill Holland for the best orthopedic care in San Diego.


An Innovative Approach to Knee Pain

Here in San Diego, I see everyone from soldiers to civilians, and from athletes to couch potatoes. One constant among all my patients is an aversion to physical therapy, especially where chronic knee pain is concerned.

I get it: therapy is designed to push the limits of your comfort zone in an effort to increase mobility. But when that therapy proves too frustrating, a discouraging number of people simply give up altogether.

Now a group of researchers have discovered something that joggers with iPods have known for a while: keeping a steady beat can improve your performance in physical therapy:

[U]sing a device such as a metronome seemed to “fire up different parts of the brain”, allowing patients to workout without pain.

The audio “pacing” was accompanied by a single, heavy bout of stationary exercise, like weighted leg extension, targeted at the knee. The method resulted in 19 percent increased muscle strength over the 4 week trial.

Just one more good idea in our ongoing battle against the monotony of exercise, and the tyranny of pain. If your knee pain has lasted more than a few weeks, it’s time to see an orthopedic expert in San Diego. Please contact the offices of Dr. William Holland for an appointment today.

Managing Shoulder Pain Medication Safely

Pain medication is one of the great conveniences of modern life, but it can also be a double-edged sword. People who don’t know how to use this medication properly, or who accidentally mix it with contraindicated compounds, can find themselves running into problems that dwarf the original injury.

Shoulder pain is one of the most common complaints that send people to the store for these pain medications. Now recent research suggests that a surprising number of people fail to heed the printed warnings about mixing analgesics with other prescriptions:

The survey questioned 1,015 U.S. adults and 251 gastroenterologists about OTC medicine practices. Results show that people who take OTC medicines for chronic pain often mix the medicines with other drugs, view label instructions as general suggestions, ignore signs of an overdose, and fail to mention their OTC medicine use in conversations with doctors.

Caution is the watchword here. If you’re already on a daily or weekly medication, be sure to check all the warnings, even if it’s something as “harmless” as aspirin or acetaminophen. And if your pain persists longer than a few weeks, visit an  for a consultation.

Better Treatment for Shoulder Injuries

Shoulder injuries can be notoriously complicated to rehab, especially when the injury involves multiple musculoskeletal systems. It is no wonder that an entire industry has cropped up to handle therapy and rehabilitation for injuries such as these, as shoulder recovery can be an exacting science.

Now some medical researchers believe they may have found a better way: robot rehab. A new line of exoskeleton systems designed to learn and repeat specific motions has proven a boon to some patients i physical therapy for shoulder pain:

According to the main researcher, Cecilia García Cena, simulating the skeletal system is not enough to develop this exoskeleton, it is needed to incorporate both the kinematics and dynamics of a complete model that takes into account the skeletal system, muscles, tendons and ligaments. All these elements are included in the new intelligent robotic system.

Time will tell if this system is versatile enough for different injuries, or whether it proves safe in larger trials. Still, this announcement is a harbinger of the time when physical therapy can be done in the home, safely and alone.

If your shoulder pain won’t go away and your robot steward has the day off, please contact the San Diego orthopedic offices of Dr. William Holland.